Achieving '5 a day' :an exploratory mixed method investigation of consumers who attain the UK fruit and vegetable recommendation

Abstract

Progress has been made in research identifying relationships between the food we eat, the lifestyles we lead, and the prevention of illness. We should each consume a minimum level of fruit and vegetables, 400g daily, to reduce incidence of ‘chronic lifestyle diseases’, with vast aggregate social and financial implications. Despite political intervention, however, and a focus upon ‘5 A Day: Just Eat More’, there persists a general under consumption, with the concept of ‘Food Choice’ at the explanatory forefront. Most research on fruit and vegetable consumers has focussed on those who do not meet the daily recommended levels, identifying ‘barriers’ that restrict choice. This research however places the investigative emphasis on those who do attain the 5 A Day target, described in this study as ‘High’ fruit and vegetable consumers, exploring the reasons for this success and the management of high levels of fruit and vegetables within the diet. A mixed method approach to investigate consumers in South East Northumberland was employed, using purposeful sampling and integrating research stages. Empirical and policy sources were investigated, and life course model implied as useful. Following discussions with health professionals and clinicians, in-depth exploratory interviews were conducted with mainly High (17/19) fruit and vegetable consumers. Results identified themes: general health, specific ill-health, spousal relationship with food, children, food history, seasonality, shopping, taste and flavour, time, and personal relationship with fruits and vegetables. These affected both quantity and type of vegetables and fruit consumed, and ‘how’ consumption was managed. A series of conceptual ‘reasons’ for high consumption were indicated though not all reasons experienced by all consumers to the same extent at the same time. The main constructs are; ‘Environment(s)’, ‘Information(s)’, ‘Motivation(s)’, ‘Aims & Goals’, ‘Triggers / Trigger Point(s)’, and ‘Strategies and Management’. A typology was also proposed to categorise consumers based on enthusiasm, and consciousness towards High consumption. A consumer survey, based on the identified themes, was completed by 239 respondents (148 High). It included a seven day food frequency questionnaire of nutritionally linked fruit and vegetable items. Factor Analysis was applied to both sections of the questionnaire, and subsequently Cluster Analysis. 34 factors were identified for attitude and behaviour. Of these, 16 exhibited significant mean difference between High and Low consumers. Six clusters were derived, with defining features between clusters being reasons for consumption, general enthusiasm and mood. 12 factors were derived as underlying the fruit and vegetable consumption itself. Both the qualitative and quantitative stages of the research identified distinct types of fruit and vegetable consumer, implying an importance, not only of specific drivers to fruit and vegetable consumption, but also fruit and vegetable “consciousness”, and levels of specific and general enthusiasm. Hence policy needs to recognise and target those influences and benefits specific to groups. It also needs to support both irregular and regular levels of High consumption, as well as the opportunity to target specific fruit and vegetable dietary patterns in relation to, for example, seasonality social consumption. Understanding how high levels of fruit and vegetable consumption is achieved and negotiated amidst other influences has been indicated as of real value to further research.