Low fruit and vegetable consumption (Indicator 16)
Updated
The indicator describes the following: Percentage of population aged 18+ years who eat less than five servings of fruit and/or vegetables on average per day.
The recommended daily intake of fruit and vegetables is five servings per day. The indicator describes the percentage of individuals whose intake is too low.
Results
The proportion who consumed less than the recommended amount of fruit and vegetables was 83 per cent among men and 70 per cent among women. These numbers are based on results from the 7th survey of the Tromsø Study conducted in 2015-2016.
Figure 1. Proportion (%) who eat less than five daily portions of fruit and vegetables by sex. The numbers are based on 11 425 men and women aged 40 years and older who completed a food frequency questionnaire in the 7th survey of the Tromsø Study, 2015-2016.
Figure 2. Proportion (%) eating less than five daily portions of fruit and vegetables by sex and 10-year age groups. The numbers are based on 11 425 men and women aged 40 years and older who completed a food frequency questionnaire in the 7th survey of the Tromsø Study, 2015-2016.
In the previous nationally representative dietary survey among adults, Norkost 3, carried out in 2010-2011, 78% of men and 75% of women consumed less than five daily portions of fruit and vegetables.
Figure 3. The proportion of adults eating less than five servings of fruit and/or vegetables per day in 2010-11. The numbers are based on 1,787 men and women aged 18-70 years responding to two repeated 24-hours dietary interviews in the third national dietary survey, Norkost 3, 2010-11. The University of Oslo, the Norwegian Food Safety Authority and the Norwegian Directorate of Health.
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Data sources
The data sources for this indicator are the Tromsø Study and the national dietary surveys in adults (Norkost).
Results from the HUNT Study will be published at a later date.
A description and definitions of the Tromsø Study and the Norkost study follow below.
Data source: The Tromsø Study
Description
The Tromsø Study was initiated in 1974 and consists of repeated health examinations of whole birth cohorts and random samples of the population in Tromsø municipality (Tromsø 1-7). The last two surveys are particularly relevant to the period that is subject to reporting from the member states to the World Health Organization; 2010-2025. Tromsø 6 (2007-2008) included almost 13 000 adults between the ages of 30 and 87 years, with an attendance rate of 66 per cent. Tromsø 7 (2015-2016) included more than 21 000 adults aged 40 years and older, with an attendance rate of 65 per cent.
Effect measure
The proportion of men and women aged 40 years and older in the Tromsø Study who consume less than five daily portions of fruit and vegetables, defined as at least 250 grams per day of vegetables and 250 grams per day of fruit and berries. Beverages (juice) and potatoes are not included. The proportions are age standardised according to the population of Norway 2016.
Interpretation and sources of error
The results from the Tromsø Study are estimated from a validated food frequency questionnaire with questions about consumption of 261 different foods, beverages, dishes and food supplements. Respondents were asked to indicate the frequency (how often do you eat …) and amount (how much…) of each food item, having one’s habitual diet (previous year) in mind. The food frequency questionnaire was handed out at attendance in Tromsø 7 and 72% of the 21,083 participants returned the questionnaire. Valid results from 11,425 respondents have been included. Possible sources of error in this type of data may be related both to the sample (selection of participants where the healthiest and highly educated attend to a larger degree) and to the variables (over- and underreporting of healthy and unhealthy foods, respectively).
Reference
Nilsen L, Hopstock LA, Grimsgaard S, Carlsen MH, Lundblad MW. Intake of Vegetables, Fruits and Berries and Compliance to "Five-a-Day" in a General Norwegian Population-The Tromsø Study 2015-2016. Nutrients. 2021 Jul 18;13(7):2456.
Data source: National Dietary Surveys (Norkost)
Description
The National Dietary Surveys of Adults (Norkost) provide data at the individual level about the intake of food and drink among a nationally representative sample of the population of Norway. National dietary surveys were conducted among adults in 1993, 1997 and 2010-2011 under the direction of the Department of Nutrition at the University of Oslo, in collaboration with the Norwegian Food Safety Authority and the Norwegian Directorate of Health.
Norkost 3 was conducted in 2010-2011 among a nationally representative sample of adults aged 18-70 and with a 37 per cent participation rate (a total of 1787 people participated). The method used was a combination of repeated 24-hour dietary recall interviews and a food propensity questionnaire. The fourth Norkost study is currently being piloted.
Effect measure
- Percentage of adults who eat less than five servings of fruit and/or vegetables per day.
The results are based on two 24-hour dietary recall interviews with 862 men and 925 women.
One serving is defined as 100 grams of vegetables, fruit or berries. The data is calculated to show the daily intake of vegetables, fruit and berries, which includes a maximum of 100 grams of juice per day. (Potatoes are excluded.)
The age distribution of the population of Norway has not been taken into account which means that the data are not age-standardised.
Interpretation and sources of error
Since the intake for each person is the average of two days of data collection, this does not provide sufficient basis on which to comment on the individual’s normal intake.
Global indicator definition
Indicator 16 Age-standardised prevalence of persons (aged 18+ years) consuming less than five total servings (400 grams) of fruit and vegetables per day.
National adaptation to global indicators
In the context of Norway, five servings are defined as 500 grams. In the figures from Tromsø 7, at least 250 grams of vegetables and 250 grams of fruit was required to fulfil the recommendation.
The figures shown from Tromsø 7 apply to the ages 40 years and older.
The figures shown from Norkost 3 include ages 18 years and older, but they represent the age distribution in the dietary survey and are not age-standardised.