Determinants of Fruit and Vegetable Intake in England: A Re-examination based on Quantile Regression

OBJECTIVE: To examine the sociodemographic determinants of fruit and vegetable (F&V) consumption in England and determine the differential effects of socio-economic variables at various parts of the intake distribution, with a special focus on severely inadequate intakes. // DESIGN: Quantile regression, expressing F&V intake as a function of sociodemographic variables, is employed. Here, quantile regression flexibly allows variables such as ethnicity to exert effects on F&V intake that vary depending on existing levels of intake. // SETTING: The 2003 Health Survey of England. // SUBJECTS: Data were from 11 044 adult individuals. // RESULTS: The influence of particular sociodemographic variables is found to vary significantly across the intake distribution. We conclude that women consume more F&V than men; Asians and blacks more than whites; co-habiting individuals more than single-living ones. Increased incomes and education also boost intake. However, the key general finding of the present study is that the influence of most variables is relatively weak in the area of greatest concern, i.e. among those with the most inadequate intakes in any reference group. // CONCLUSIONS: Our findings emphasise the importance of allowing the effects of socio-economic drivers to vary across the intake distribution. The main finding, that variables which exert significant influence on F&V intake at other parts of the conditional distribution have a relatively weak influence at the lower tail, is cause for concern. It implies that in any defined group, those consuming the least F&V are hard to influence using campaigns or policy levers