- In 2012, adults consumed an average of 3.1 portions of fruit and vegetables per day (3.0 portions for men and 3.2 portions for women).
- One fifth of adults (19% of men and 21% of women) ate the recommended number of portions of fruit and vegetables, 5-a-day, in 2012. One in ten adults consumed no portions of fruit or vegetables.
- There has been very little change in fruit and vegetable consumption among adults since 2003.
- Fruit and vegetable consumption varied significantly by age. In general, older people tended to eat the most fruit and vegetables. Those aged 65-74 consumed an average of 3.4 portions per day, while those aged 16-24 consumed an average 2.8 portions per day.
- The age-related pattern in consumption levels was different for men and women. The pattern by age for women was comparable to that for all adults. Among men, mean consumption in the 16-44 age group was similar (between 2.8 and 2.9 portions), increasing to 3.0 at age 45-54. It continued to rise to 3.4 among those aged 65-74, before decreasing to 3.2 for the oldest age group.
- In 2012, children aged 2-15 consumed an average of 2.7 portions of fruit and vegetables per day. Just one in seven (13%) children aged 2-15 consumed the recommended 5 or more portions of fruit or vegetables per day.
- The proportion of children aged 5-15 meeting the 5-a-day target has not changed significantly since 2003 (12% in 2003 and 11% in 2012).
- Although mean portion consumption for children has remained steady since 2003 (fluctuating between 2.6 and 2.7), a decrease in boys' consumption (from 2.6 in 2003 to 2.4 in 2012) and an increase for girls (from 2.6 to 2.8 portions) resulted in a significant difference between boys and girls consumption in 2012.
- Younger children tended to eat more fruit and vegetables than older children in 2012. Children aged between 2 and 4 ate an average of 3.1 portions per day, compared with those aged 13-15 who consumed an average of 2.5 portions. Similarly, younger children were more likely to meet the 5-a-day target (17% of those aged 2-4, compared with 10%-13% of those in the older age groups).
- There have been few changes to adults' wider eating habits since 2008. The only significant change identified is a reduction in the proportion consuming red meat twice a week or more (from 61% in 2008 to 56% in 2012).
A lack of fruit and vegetables in people's diet has been shown to be a risk factor in a range of serious health problems, such as heart disease, cancer, type II diabetes, hypertension and obesity. The World Health Organisation (WHO) recommends adults eat at least five varied portions - where a portion is defined as 80g - of fruit and vegetables a day.
Scotland's unhealthy diet is widely cited as a factor in its poor health record. Previous research has shown that children and young people in Scotland follow a diet that falls short of national recommendations and is less healthy than that of children in other European countries.
Each year, in addition to presenting the most up-to-date data on diet, the Scottish Health Survey (SHeS) annual report also provides a broad overview of recent policy initiatives and developments relating to diet. In addition to the ongoing committment to promote the WHO '5-a-day' recommendation, other recent policy initiatives and actions taken by the Scottish Government and NHS Scotland in relation to improving diet in the population have included:
- Eating for Health: A Scottish Diet Action Plan, which outlined the Scottish dietary targets. (1996)
- The White Paper Towards a Healthier Scotland.
- The Scottish Executive's Improving Health in Scotland - the Challenge paper.
- The Hungry for Success initiative.
- A framework for implementing the Diet Action Plan: Eating for Health - Meeting the Challenge.
- The Scottish Government's Better Health, Better Care Action Plan.
- Healthy Eating, Active Living: An action plan to improve diet, increase physical activity and tackle obesity (2008-2011).
- The Scottish Government's Obesity Route Map, and associated Obesity Route Map Action Plan.
Detailed measures of fruit and vegetable consumption were introduced to SHeS in 2003 and have been included annually since 2008. This chapter updates adult and child trends in fruit and vegetable consumption since 2003. The trend in adults' wider eating habits since 2008 is also explored.
5.2 Methods And Definitions
5.2.1 Measures of eating habits
Two different modules of questions were used to assess eating habits in the survey. The first module assessed fruit and vegetable consumption, and was designed with the aim of providing sufficient detail to monitor the 5-a-day policy effectively. This module has been asked of all adults since 2003 and children aged 2 and over annually since 2008. The second module, gathering information on eating habits more generally, is asked of children each year (since 2008), and a sub-sample of adults biennially (2008, 2010 and 2012). It uses a modified version of the Dietary Instrument of Nutrition Education (DINE) questionnaire. The DINE questionnaire was developed by the Imperial Cancer Research Fund's General Practice Research Group to assess usual intake of a wide range of nutrients, including protein, starch, fat and fibre.
To determine the total number of portions that were consumed in the 24 hours preceding the interview, the fruit and vegetable module included questions about consumption of the following food types: vegetables (fresh, frozen or canned); salads; pulses; vegetables in composites (e.g. vegetable chilli); fruit (fresh, frozen or canned); dried fruit; and fruit in composites (e.g. apple pie). A portion was defined as the conventional 80g of a fruit or vegetable. As 80g is difficult to visualise, a 'portion' was described using more everyday terms, such as tablespoons, cereal bowls and slices. Examples were given in the questionnaire to aid the recall process, for instance, tablespoons of vegetables, cereal bowls full of salad, pieces of medium sized fruit (e.g. apples) or handfuls of small fruits (e.g. raspberries). In spite of this, there may be some variation between participants' interpretation of a portion. These everyday measures were converted back to 80g portions prior to analysis. The following table shows the definitions of the portion sizes used for each food item included in the survey:
|Food item||Portion size|
|Vegetables (fresh, frozen or canned)||3 tablespoons|
|Pulses (dried)||3 tablespoons|
|Salad||1 cereal bowlful|
|Vegetables in composites, such as vegetable chilli||3 tablespoons|
|Very large fruit, such as melon||1 average slice|
|Large fruit, such as grapefruit||Half a fruit|
|Medium fruit, such as apples||1 fruit|
|Small fruit, such as plum||2 fruits|
|Very small fruit, such as blackberries||2 average handfuls|
|Dried fruit||1 tablespoon|
|Fruit in composites, such as stewed fruit in apple pie||3 tablespoons|
|Frozen fruit/canned fruit||3 tablespoons|
|Fruit juice||1 small glass (150 ml)|
Since the 5-a-day policy stresses both volume and variety, the number of portions of fruit juice, pulses and dried fruit was capped so that no more than one portion could contribute to the total number of portions consumed. Interviewers recorded full or half portions, but nothing smaller.
5.3 Fruit And Vegetable Consumption
5.3.1 Trends in adult fruit and vegetable consumption since 2003
Data on adult (aged 16 and over) fruit and vegetable consumption from 2003 to 2012 are presented in Table 5.1. The proportion of adults who met or exceeded the recommended daily consumption guideline of at least five portions of fruit and vegetables is presented alongside the proportion failing to eat any. Figures for mean and median portion consumption are also presented in the table.
Average daily fruit and vegetable intake for adults has changed very little since 2003. There was a slight increase, from 3.1 portions in 2003, to 3.3 portions in both 2008 and 2009. By 2012, average mean portion consumption per person had returned to 2003 levels (3.1 portions). The trends in consumption were very similar for both men and women, with the average portions consumed in 2012 the same as in 2003 for both genders (3.0 portions in 2003 and 2012 for men and 3.2 for women in both years).
The proportion of adults consuming at least 5-a-day, the recommended daily intake, has also remained stable since 2003. In 2012, one in five adults ate at least five portions in the 24 hours prior to interview, similar to the level in 2003 (21%). There was a two percentage point decline between 2011 and 2012 but this was not statistically significant. The lack of change in adherence was evident among both men and women (in 2003 20% of men and 22% women met the target; the equivalent figures in 2012 were 19% and 21% respectively).
There has been little change in the proportion of adults not eating any fruit and vegetables over the years. The proportion who ate no portions in the day prior to interview has consistently stayed at around 10% (ranging between 9% and 10%) since 2003 (10% in 2012). Table 5.1
5.3.2 Adult fruit and vegetable consumption, 2012, by age and sex
Adult fruit and vegetable consumption in 2012 is broken down by age and sex in Table 5.2. Average portion consumption did not vary significantly between men and women (3.0 portions and 3.2 portions respectively).
Average portion consumption did, however, vary significantly by age, typically increasing in line with age, up to age 65-74. The youngest age group (those aged 16-24) ate fewest portions (an average of 2.8 portions a day). Consumption was higher among those aged 25-54 (between 3.0 and 3.1 portions) and higher still among those aged 55-64 (3.3 portions) and 65-74 (3.4 portions). Those aged 75 and over ate an average of 3.0 portions a day.
Mean portion consumption patterns by age were slightly different for men and women (Figure 5A). For women, the association was similar to that seen for all adults. Consumption was lowest among the youngest age group (2.6 portions) and higher for all the remaining age groups (3.2 to 3.5 portions) with the exception of those aged 75 and over (2.9 portions). For men, average portion consumption among those under the age of 55 was very similar (ranging between 2.8 and 3.0 portions) while those aged 65-74 had the highest consumption levels (3.4 portions).
In 2012, there was no significant difference in the proportion of men and women meeting the 5-a-day target (19% and 21% respectively).
One in six (16%) 16-24 year olds ate at least five portions of fruit and vegetables in the day prior to interview. The equivalent figures for 25 to 74 ranged between 20% and 23%. Among the oldest age group, those aged 75 or over, 18% met the target. While the association with age was not significant for all adults, there were some interesting age-related patterns for men and women separately (See Figure 5A). For women, adherence followed a similar pattern to that seen for all adults. Those in the youngest and oldest age groups were least likely to meet the target (13% and 15% respectively) and those aged 45-54 were most likely to eat at least five portions a day (26%). For men, adherence to the target was very similar among those aged 16 to 54 (ranging between 17% and 18%). Men aged 55 and above were more likely than younger men to meet the target with those aged 65-74 most likely to do so (25%).
One in ten adults did not eat any fruit or vegetables in the day prior to interview (11% of men and 9% of women). As with the mean unit consumption pattern, the proportion failing to consume any fruit and vegetables varied significantly with age. Young people (aged 16-24) were most likely to eat no fruit or vegetables (14%) whereas between 5% and 8% of those aged 55 and over ate none. Figure 5A, Table 5.2
5.3.3 Trends in child fruit and vegetable consumption since 2003
Data on fruit and vegetable consumption for children are collected in the same way as for adults on the survey. Children aged 13-15 (or a parent if the child is aged between 2 and 12) are asked a series of questions to determine how many varied portions of fruit and vegetables they have eaten in the 24 hours prior to interview. Prior to 2008, information on fruit and vegetable consumption was not collected for children under the age of five. Therefore trends, since 2003, in proportions consuming the recommended daily amount of fruit and vegetables and mean consumption levels are shown for the 5 to 15 age group only (Table 5.3). Data for children aged 2-15 from 2008 onwards are also shown.
There was very little change in average daily portion consumption among those aged 5-15 between 2003 and 2012 (a mean of 2.6 portions per day in both 2003 and 2012). Since 2003, the average number of portions consumed by boys has declined by 0.2 portions, from 2.6 to 2.4 portions in 2012. For girls, the opposite occurred - an increase from 2.6 portions in 2003 to 2.8 portions in 2012. As a result, a significant difference between boys' and girls' mean portion consumption emerged for the first time in 2012 (see Section 5.3.4). Since 2008, the mean portions consumed by 2 to 15 year olds was typically around 0.1 portions higher than for those aged between 5 to 15 (ranging between 2.6 and 2.8 portions during this period).
In 2012, 11% of 5 to 15 year olds consumed the recommended daily amount of at least five portions per day, similar to the level in 2003 (12%). The proportion of boys and girls meeting the 5-a-day target has not changed significantly over time. Since 2008 there has been similar stability to the proportion of 2 to 15 year olds meeting the 5-a-day recommendation (13% in both 2008 and 2012). Table 5.3
Fruit and vegetable consumption data for children aged 2-15 in 2012 are presented by age and gender in Table 5.4 showing consumption of an average of 2.7 portions of fruit and vegetables per day, considerably lower than the recommended five or more portions. There was a significant difference in average portion consumption for boys and girls, with girls consuming an average of 0.4 portions more per day than boys (2.9 compared with 2.5 portions). This is the first time, since the data have been collected, that a significant difference between boys' and girls' mean portion consumption has emerged. Data from future years will help confirm if this is part of a trend, or simply a one-off finding.
There was also a clear association between fruit and vegetable intake and age in 2012 (Figure 5B). Children aged between 2 and 4 consumed most portions (3.1 portions per day). Average consumption was lower among those aged 5-7 (2.7 portions) and 8-12 (between 2.6 and 2.7 portions). Intake was lowest among older children aged 13-15 (2.5 portions).
In 2012, just 13% of children aged 2-15 consumed the daily recommended amount of fruit and vegetables (12% of boys and 14% of girls). In line with average portion intake, younger children (2-4 years old) were most likely to meet the 5-a-day target (17% compared with 10% to 13% for older age groups).
Looking at the other extreme - eating no fruit or vegetables - reinforces the suggestion that older children eat less fruit and vegetables than younger children. One in six (16%) children aged 13-15 did not eat any fruit or vegetables in the 24 hours prior to interview (18% of boys in this age group and 13% of girls). This was particularly striking among boys aged 13-15 who were twice as likely to eat no fruit and vegetables than meet the 5-a-day target (18% compared with 9%). Figure 5B, Table 5.4
5.4 Adult Eating Habits
5.4.1 Trends in adult eating habits since 2008
In addition to questions about fruit and vegetables, adults were also asked a series of questions about their consumption of a variety of other food and drink items. The module was based on the Dietary Instrument of Nutrition Education (DINE), developed by the Imperial Cancer Research Fund's General Practice Research Group. These questions have been asked of adults aged 16 and over biennially since 2008. Trends for consumption of a number of the food and drink items from the DINE questionnaire are presented in Table 5.5.
Sugary foods and snacks
Between 2008 and 2012 there was very little change in adult consumption of sugary foods and snacks. In 2012, consumption of sweets or chocolates (29%), biscuits (32%) and crisps (17%) once a day or more, ice cream once a week or more (26%), and cakes twice a week or more (35%) were all at similar levels to those recorded in 2008. There were no significant differences between male and female consumption of these items.
Adult consumption of non-diet soft drinks (once a day or more) did not change significantly between 2008 and 2012 (25% in 2012), but men were more likely than women to consume such items on a daily basis (28% versus 22%, in 2012).
Fibre and starch
In 2012, a third (32%) of adults reported that they ate high fibre/low sugar cereals at least five times a week, and four in ten (41%) said they consumed at least two slices of high fibre bread per day. These levels of consumption were very similar to those seen in 2008.
The apparent decrease in the consumption of potatoes, pasta and rice over this period from 55% consuming these starchy foods five times or more a week in 2008 to 51% in 2012 was not statistically significant. The proportion of adults eating chips at least twice a week (31%) has not changed since 2008, and men are still significantly more likely than women to eat chips this frequently (36% and 26% respectively in 2012).
Meat and fish
Levels of fish consumption did not change between 2008 and 2012 for men or women. In 2012, half of adults (51%) ate white fish, 26% consumed oily fish and 30% consumed tuna once a week or more. The observed difference in tuna consumption levels for men and women was not significant (29% and 32% respectively).
Adults' consumption of red meat has decreased since 2008. In 2012, 56% of adults ate red meat at least twice a week compared with 61% in 2008. This decline was observed among both men and women, although over the years, men have consistently consumed red meat more often than women (59% versus 53% in 2012).
Overall, there was very little change in the proportions of adults consuming meat products twice a week or more (28% in both 2008 and 2012), although it has slightly decreased for men (39% to 36%) and slightly increased for women (18% to 21%).
In 2012, the proportion of adults drinking skimmed or semi-skimmed milk was the same as in 2008 (74%). Women remain more likely than men to drink these types of milk (77% compared with 71% in 2012). Table 5.5
|Aged 16 and over||2003 to 2012|
|Portions per day||2003||2008||2009||2010||2011||2012|
|5 portions or more||20||20||22||20||20||19|
|Standard error of the mean||0.06||0.07||0.05||0.06||0.05||0.08|
|5 portions or more||22||24||25||23||23||21|
|Standard error of the mean||0.05||0.06||0.05||0.05||0.05||0.05|
|5 portions or more||21||22||23||22||22||20|
|Standard error of the mean||0.05||0.05||0.04||0.04||0.04||0.05|
|Aged 16 and over||2012|
|Portions per day||Age||Total|
|Less than 1 portion||6||5||5||4||5||4||4||5|
|1 portion or more but less than 2||23||21||22||22||19||17||18||21|
|2 portions or more but less than 3||15||22||18||17||18||20||22||18|
|3 portions or more but less than 4||16||12||13||16||14||18||15||15|
|4 portions or more but less than 5||10||9||12||11||12||13||12||11|
|5 portions or more||18||18||17||18||21||25||22||19|
|Standard error of the mean||0.24||0.22||0.14||0.13||0.14||0.12||0.15||0.08|
|Less than 1 portion||4||2||4||5||1||5||6||4|
|1 portion or more but less than 2||17||16||18||18||19||16||20||18|
|2 portions or more but less than 3||21||20||21||20||20||16||23||20|
|3 portions or more but less than 4||22||17||16||14||17||19||17||17|
|4 portions or more but less than 5||8||10||11||8||13||20||14||12|
|5 portions or more||13||24||22||26||24||18||15||21|
|Standard error of the mean||0.16||0.14||0.13||0.12||0.12||0.13||0.12||0.05|
|Less than 1 portion||5||4||4||5||3||4||5||4|
|1 portion or more but less than 2||20||18||20||20||19||16||19||19|
|2 portions or more but less than 3||18||21||19||18||19||18||23||19|
|3 portions or more but less than 4||19||14||14||15||16||19||16||16|
|4 portions or more but less than 5||9||10||11||10||12||17||13||11|
|5 portions or more||16||21||20||22||23||21||18||20|
|Standard error of the mean||0.15||0.14||0.10||0.10||0.10||0.10||0.10||0.05|
|Aged 2-15||2003 to 2012|
|Portions per day||2003||2008||2009||2010||2011||2012|
|Total 5 - 15|
|5 portions or more||12||14||13||11||12||11|
|Standard error of the mean||0.07||0.11||0.07||0.10||0.09||0.10|
|Total 2 - 15|
|5 portions or more||n/a||14||14||12||13||12|
|Standard error of the mean||n/a||0.09||0.06||0.09||0.08||0.09|
|Total 5 - 15|
|5 portions or more||13||14||15||12||11||12|
|Standard error of the mean||0.07||0.10||0.09||0.09||0.09||0.10|
|Total 2 - 15|
|5 portions or more||n/a||13||16||13||12||14|
|Standard error of the mean||n/a||0.09||0.08||0.08||0.08||0.09|
|Total 5 - 15|
|5 portions or more||12||14||14||12||12||11|
|Standard error of the mean||0.05||0.08||0.06||0.07||0.07||0.08|
|Total 2 - 15|
|5 portions or more||n/a||13||15||12||13||13|
|Standard error of the mean||n/a||0.07||0.05||0.07||0.06||0.07|
|Boys 5 - 15||1225||618||910||621||686||614|
|Boys 2 - 15||n/a||791||1153||792||881||800|
|Girls 5 - 15||1166||591||867||591||652||588|
|Girls 2 - 15||n/a||736||1108||759||835||759|
|All children 5 - 15||2391||1209||1777||1212||1338||1202|
|All children 2 - 15||n/a||1527||2261||1551||1716||1559|
|Boys 5 - 15||1152||591||923||629||649||580|
|Boys 2 - 15||n/a||764||1153||821||855||761|
|Girls 5 - 15||1170||597||837||532||619||602|
|Girls 2 - 15||n/a||752||1100||708||833||784|
|All children 5 - 15||2322||1188||1760||1161||1268||1182|
|All children 2 - 15||n/a||1516||2253||1529||1688||1545|
|Portions per day||Age||Total 2 - 15|
|Less than 1 portion||6||4||4||6||7||6|
|1 portion or more but less than 2||21||19||22||19||25||22|
|2 portions or more but less than 3||20||28||27||25||18||23|
|3 portions or more but less than 4||17||18||18||15||15||17|
|4 portions or more but less than 5||11||10||6||8||7||9|
|5 portions or more||16||9||12||14||9||12|
|Standard error of the mean||0.17||0.15||0.18||0.18||0.19||0.09|
|Less than 1 portion||1||3||2||4||2||2|
|1 portion or more but less than 2||13||20||18||20||27||19|
|2 portions or more but less than 3||29||21||22||29||16||23|
|3 portions or more but less than 4||24||19||18||14||14||18|
|4 portions or more but less than 5||13||16||16||12||17||15|
|5 portions or more||18||14||11||12||12||14|
|Standard error of the mean||0.15||0.15||0.15||0.20||0.19||0.09|
|Less than 1 portion||3||4||3||5||5||4|
|1 portion or more but less than 2||17||20||20||19||26||21|
|2 portions or more but less than 3||24||24||25||27||17||23|
|3 portions or more but less than 4||20||19||18||14||14||17|
|4 portions or more but less than 5||12||13||11||10||12||12|
|5 portions or more||17||12||11||13||10||13|
|Standard error of the mean||0.13||0.11||0.12||0.14||0.15||0.07|
|Aged 16 and over||2008, 2010, 2012|
|Food type and frequency||Men||Women||All adults|
|Oily fish once a week or more||23||24||25||26||24||26||25||24||26|
|White fish once a week or more||50||51||52||52||49||50||51||50||51|
|Tuna fish once a week or more||27||29||29||33||32||32||30||30||30|
|Red meata 2+ times a week||64||63||59||59||53||53||61||58||56|
|Meat productsb 2+ times a week||39||34||36||18||17||21||28||25||28|
|Drinks skimmed/semi-skimmed milk||70||73||71||77||77||77||74||75||74|
|Sweets or chocolates once a day or more||28||26||28||28||24||29||28||25||29|
|Biscuits once a day or more||36||35||33||33||28||32||34||31||32|
|Cakes 2+ times a week||36||36||36||33||36||33||34||36||35|
|Ice-cream once a week or more||29||24||28||28||24||25||28||24||26|
|Non-diet soft drinks once a day or more||26||29||28||21||23||22||23||26||25|
|Crisps once a day or more||19||17||18||16||14||16||17||15||17|
|Chips 2+ times a week||36||35||36||26||24||26||31||29||31|
|Potatoes, pasta, rice 5+ times a week||55||53||52||54||53||51||55||53||51|
|At least 2-3 slices of high fibre bread a day||42||41||43||42||43||40||42||42||41|
|High fibre/low sugar cereal at least 5-6 times a week||29||24||31||31||28||33||30||26||32|
|a for example beef, lamb or pork|
|b for example sausages, meat pies, bridies, corned beef, or burgers|
Email: Julie Landsberg