Availability and accessibility of fresh fruit and vegetables (F&V) has become the most important issue in understanding why people do not eat enough F&V everyday: no F&V in vending machines, non existent new distribution systems for F&V, lack of availability at schools, lack of preparation knowledge…
The two most considered questions are the affordability for low income populations and the accessibility at schools. As concluded in a recent WHO report, low-income populations do not eat what they want or what they know they should eat, but what they can afford(1). Individuals, particularly those in disadvantaged situations, face structural, social, organisational, financial and other constraints in making healthy choices(2, 3).
The evidence suggests that there is a tendency for poorer populations to eat less healthy than those who are better off, as discussed in the article by N. Darmon. In particular, there appears to be a strong and direct association between socioeconomic status and the consumption of fruit and vegetables (see article by Darmon). Key considerations to make a healthy choice – such as purchasing fruit and vegetables – should thus be accessibility, affordability and practicality(4).
This is confirmed by the articles by E. Bere and D. Herman in this issue. In his paper on promotion of fruit and vegetable at schools in Norway, Bere shows that making fruit and vegetables freely accessible to children on a daily basis is far more effective than only providing information to children and parents (see article by Bere). Herman’s paper describes a study which provided lowincome, nutritionally at-risk women with a weekly economic supplement for purchasing fruit and vegetables at local supermarkets and farmer’s markets: in most cases the recommended daily intake of fruit and vegetables was met, significantly increasing their intake of key micronutrients and dietary fibre (see article by Herman).
As concluded by N. Darmon, it is essential now to focus on national nutrition policies at addressing economic and physical access to fruit, vegetable, particularly for those in the lowest income brackets and for children at school.
- PAHO. Obesity and Poverty. A New Public Health Challenge. Scientific Publication No. 576. Washington DC: Pan American Health Organization; 2000.
- McKee M et al. The Lancet. 2005;365:369-371.
- Kumanyika S. Prev Chronic Dis. 2005;2(4):A02.
- Dowler, E. Public Health Nutr. 2001;4(2B):701-9.