Elsevier

Nutrition

Volume 28, Issue 5, May 2012, Pages 504-508
Nutrition

Applied nutritional investigation
Consumption of, and factors influencing consumption of, fruit and vegetables among elderly Chinese people

https://doi.org/10.1016/j.nut.2011.07.023Get rights and content

Abstract

Objective

There is substantial evidence that the low intake of fruit and vegetables (FV) is a major risk factor for many nutrition-related non-communicable diseases. The purpose of our study was to assess FV consumption and the variables that influence FV consumption among Chinese people age 60 and older.

Methods

Twenty-four-hour dietary recall data from the 1991, 1993, 1997, 2000, 2004, 2006, and 2009 China Health and Nutrition Surveys were used to collect the FV intake and sociodemographic variables examined in this article. Data were analyzed using t tests, χ2 tests, and logistic regression.

Results

Between 1991 and 2009, elderly Chinese adults experienced an improvement in dietary FV intake. The FV consumption increased from 325.7 g/d in 1991 to 379.0 g/d in 2009. During this 18-y period, the proportion of daily consumers increased from 11.0% to 32.5% for fruit and remained over 95% for vegetables. Age, gender, educational attainment, community, activity level, marital status, and drinking were significantly associated with FV consumption.

Conclusion

The findings of this study indicated that FV intake among elderly adults in China was lower than the minimum of 400 g/d recommended by the World Health Organization. Greater public health efforts and approaches are needed to promote FV consumption in elderly Chinese adults.

Introduction

China has experienced extremely rapid economic growth over the past three decades. After economic reforms were initiated in 1978, China’s gross national product and gross domestic product increased remarkably by over 8.0% annually [1]. Along with its economic growth, China is also undergoing major changes in its population structure. According to recent estimates by the United Nations, elderly people composed 10.1% of China’s population in 2000, and this proportion is projected to increase dramatically in the coming decades to reach 30% in 2050 [2]. In addition, China accounts for 20% of the global population with a total population of more than 1.3 billion and the largest absolute number of elderly people in the world.

Aging populations in any country are associated with a great social, economic, and public health burden. Many studies have demonstrated that cancer, stroke, and coronary heart disease (CHD) are leading causes of death [3], and these diseases are more prevalent among elderly populations [4]. There is substantial evidence that low consumption of fruit and vegetables (FV) is a major risk factor for these diseases [5]. Several studies have shown that adequate FV consumption is associated with a reduced risk of cancer [6] and CHD [7]. Furthermore, previous studies have shown that there are strong negative relationships between FV intake and hypertension [8], obesity [9], and diabetes [10]. Despite these benefits, people do not eat the minimum recommended amount of 400 g of FV per day [11]. Data on FV intake derived from food balance sheets in 21 countries showed that the FV intake only met the minimum World Health Organization (WHO) recommended consumption in three countries [12].

Numerous variables influence FV consumption among elderly populations worldwide [13], [14], including social, cultural, and economic circumstances [15], food costs, accessibility, and knowledge about how to design a healthy diet [16], [17]. However, little is known about the frequency, distribution, and determinants of FV consumption among elderly people in China. A previous study reported that the FV consumption among middle-aged and elderly adults (over 45 y old) in China was 308.5 g/d in males and 325.3 g/d in females [18]. The total mean energy intake was mainly obtained from carbohydrates, such as rice and wheat [19].

Chronic diseases are the main causes of mortality and morbidity in China, and these rates are rising [19]. In China, the most common cause of death is cerebral vascular disease, which accounts for 22.45% of deaths, and the second most common cause of death is cancer (22.32%) [20]. Moreover, 33.2% of the population age 60 y and older is overweight and obese [20]. China’s health status profile could be improved in part if those in higher risk groups, such as elderly people, ingested adequate amounts of FV.

The purpose of this study was to examine the factors that contribute to FV intake by elderly people in China. We evaluated the impact of the following determinants: age, gender, education, physical activity, marital status, dwelling, economic status, smoking, drinking, and body weight index (BMI) on the consumption of FV.

Section snippets

Sampling and design

The China Health and Nutrition Surveys (CHNS) were designed to meet several objectives. One of them was to examine how the social and economic transformation of Chinese society is affecting the health and nutritional status of the population. The surveys involved an extensive interviewer-administered questionnaire and a set of anthropometric and clinical measurements. The CHNS were conducted in 1989, 1991, 1993, 1997, 2000, 2004, 2006, and 2009. The interviewers were physicians who worked for

Participant profile

The characteristics of the study population during each year of the CHNS are presented in Table 1. A total of 13 465 observations were included in the sample. Slightly more than half (51.9–53.7%) of the participants were female in all seven surveys. Most participants were married (54.5–74.5) and rural residents (53.9–64.5%). In terms of economic status, the proportions of people categorized as having low-, medium-, and high-income levels varied significantly in each year’s survey (P < 0.0001).

Discussion

FV are an important part of a balanced diet, and they are an important source of vitamins, minerals, dietary fiber, and phytochemicals. They are high in moisture and low in energy. Studies have shown that a diet rich in FV is very important for maintaining normal intestinal function, improving immunity, and reducing the risk of obesity [26], [27], diabetes [28], hypertension [29], CHD [30], and lung cancer [31]. Therefore, FV consumption is an important, indispensable component of a balanced

Acknowledgments

This project was supported by the Department of Epidemiology, First Hospital of Jilin University, China.

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