F&V availability at home
Whether the quality and amount of food intake are a private matter or a Public health issue may be debated. It is part of anyone’s freedom to eat what and when he wishes to do so… in theory. There are several reasons why this issue has limits:
- The natural history of nutrition teaches us that all populations around the world have managed to reach nutritional balance using local resources: starches, sources of nutrients, proteins and fat, fruits and vegetables (F&V)may vary. At the end of the day a balance which has given the better chance of survival has been found. In extreme cases such as in Inuit groups, genetic or epigenetic changes were the price for adaptation.
- Public health studies such as those reported by Ong in this issue clearly show that health status is improved by an ad hoc consumption of fruit and vegetable.
- Eating a less than desirable daily amount of F&V is not a voluntary choice but an economical constraint supported by the poorest in Western countries. In pregnant women, there is a double or even triple burden: less ad hoc nutrients available during and after pregnancy, for example during lactation and less opportunity offered to the baby and toddler to integrate these tastes into his eating pattern. This last point is a personal paediatric addition to the excellent work presented by Nunnery.
- In countries where children get an opportunity to choose what they want to eat, education plays a key role. Uneducated children will prefer starchy and fatty foods and be left with narrow spontaneous food choices, typical of the high cardiovascular, obesity and cancer risk diet profiles. Padilla reminds us clearly of this evidence.
Fruit and vegetable consumption have to be supported: adults and especially parents have to know about their benefits and the mandatory role of education in the eating pattern of young children. In low income population, Public health action should allow F&V sustainability, especially during pregnancy and childhood.
The decision of eating or not F&V cannot be considered as a voluntary issue in the absence of information, education and availability.