Behavioural counselling is effective at increasing consumption of fruit and vegetables in low-income adults
- Most, Marlene M. PhD, RD, FADA
- Bowen, Deborah J. PhD
BACKGROUND
Increasing the consumption of fruit and vegetables is believed to result in significant health benefits. A number of interventions directed toward increasing fruit and vegetable intake have been tested, although their effectiveness in low-income, deprived populations is uncertain.
OBJECTIVE
To assess the effect of behavioural counselling on the consumption of fruit and vegetables in adults from a low-income population.
SETTING
A UK primary health-care centre in a deprived, ethnically mixed inner city area; randomisation of participants from 25 June 1999 to 3 November 2001.
METHOD
Randomised controlled trial.
PARTICIPANTS
Two hundred and seventy-one people aged 18 to 70 years in a deprived, low-income population (Jarman deprivation score of 40.3). Only one person per household was included. Exclusion criteria included serious illness and women who were pregnant or were planning to become pregnant within the next 12 months.
INTERVENTION
One of two counselling conditions directed toward increasing the consumption of fruit and vegetables from baseline levels: nutrition counselling where participants received education about the biological effects and associated health benefits, or behavioural counselling where participants received an individually tailored stage-based intervention strategy. A research nurse delivered two 15-minute counselling sessions spaced 2 weeks apart to each participant. Follow-up was at 12 months.
OUTCOMES
Changes in self-reported fruit and vegetable intake; alterations in plasma biomarker concentrations (β-carotene, α-tocopherol and ascorbic acid); 24 hour potassium urinary excretion, and urinary potassium to creatine ratio.
MAIN RESULTS
The daily consumption of fruit and vegetables increased in both groups. Behavioural counselling was more effective than nutritional counselling at: increasing fruit and vegetable consumption (mean difference 0.62 portions, 95% CI 0.09 to 1.13); increasing the number of people eating five or more portions a day (difference 15%, 95% CI 3% to 28%) and increasing plasma β-carotene levels (difference 0.16 μmol/L, 95% CI 0.001 to 1.34 μmol/L).
AUTHORS' CONCLUSIONS
Brief, individual counselling sessions can significantly increase the consumption of fruit and vegetables in an ethnically mixed, low-income population group.