Socio-economic differences in the change of fruit and vegetable intakes among Dutch adults between 2004 and 2011: the GLOBE study.

Public Health Nutr. 2018 Feb 20:1-13. doi: 10.1017/S1368980017004219. [Epub ahead of print] Dijkstra SC1, Neter JE1, Brouwer IA1, Huisman M2, Visser M1, van Lenthe FJ3, Kamphuis CB3. Author information 1 1Department of Health Sciences, Faculty of Science,Vrije Universiteit Amsterdam,Amsterdam Public Health Research Institute,De Boelelaan 1085,1081 HV Amsterdam,The Netherlands. 2 2Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute,VU University Medical Center,Amsterdam,The Netherlands. 3 4Department of Public Health,Erasmus University Medical Center,Rotterdam,The Netherlands. Abstract OBJECTIVE: To investigate socio-economic differences in changes in fruit and vegetable intake between 2004 and 2011 and explore the mediating role of financial barriers in this change. DESIGN: Respondents completed a self-reported questionnaire in 2004 and 2011, including questions on fruit and vegetable intake (frequency per week), indicators of socio-economic position (education, income) and perceived financial barriers (fruits/vegetables are expensive, financial distress). Associations were analysed using ordinal logistic regression. The mediating role of financial barriers in the association between socio-economic position and change in fruit and vegetable intake was studied with the Baron and Kenny approach. SETTING: Longitudinal GLOBE study. SUBJECTS: A total of 2978 Dutch adults aged 25-75 years. RESULTS: Respondents with the lowest income in 2004 were more likely to report a decrease in intake of cooked vegetables (P-trend<0·001) and raw vegetables (P-trend<0·001) between 2004 and 2011, compared with those with the highest income level. Respondents with the lowest education level in 2004 were more likely to report a decrease in intake of fruits (P-trend=0·021), cooked vegetables (P-trend=0·033), raw vegetables (P-trend<0·001) and fruit juice (P-trend=0·027) between 2004 and 2011, compared with those with the highest education level. Financial barriers partially mediated the association between income and education and the decrease in fruit and cooked vegetable intake between 2004 and 2011. CONCLUSIONS: These results show a widening of relative income and educational differences in fruit and vegetable intake between 2004 and 2011. Financial barriers explained a small part of this widening. KEYWORDS: Change; Education; Fruits; Income; Longitudinal; Socio-economic position; Vegetables PMID: 29458442 DOI: 10.1017/S1368980017004219