Department of Public Health, University of Helsinki, Helsinki, Finland.
Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland.
Scand J Public Health. 2023 Dec;51(8):1144-1152. doi: 10.1177/14034948221094430. Epub 2022 May 10.
Fruit and vegetable consumption is essential in disease prevention. Socioeconomic differences in consumption have been observed but evidence from longitudinal studies incorporating multiple socioeconomic indicators is lacking. We examined long-term fruit and vegetable consumption trajectories and multiple socioeconomic circumstances as their determinants.
We used survey data from the Helsinki Health Study (phase 1 in 2000-2002, =8960, response rate 67%; phases 2-4 in 2007, 2012 and 2017) among initially 40- to 60-year-old employees of City of Helsinki, Finland. Fruit and vegetable consumption was measured by a food frequency questionnaire and consumption times per month were calculated. Childhood (parental education, economic difficulties), conventional (own education, occupational class, household income) and material (housing tenure, wealth, current economic difficulties) socioeconomic circumstances were included. We used group-based trajectory modelling for identifying fruit and vegetable consumption trajectories and multinomial logistic regression for examining associations between socioeconomic circumstances and the trajectories.
Four fruit and vegetable consumption trajectories were identified: increasing higher (12%), decreasing higher (10%), stable moderate (43%) and stable low (35% of participants). Childhood, conventional and material socioeconomic circumstances were all associated with the trajectories: belonging to a lower socioeconomic group was associated with belonging to the stable low and moderate trajectories. In multivariate models, the strongest associations were found for occupational class and household wealth.
Disadvantageous childhood and adulthood socioeconomic circumstances were associated with lower long-term fruit and vegetable consumption. Socioeconomic circumstances should be considered in attempts to promote fruit and vegetable consumption, and people with disadvantageous circumstances need to be targeted in future interventions.
水果和蔬菜的消费对疾病预防至关重要。尽管已经观察到消费方面存在社会经济差异，但缺乏包含多种社会经济指标的纵向研究证据。我们研究了长期水果和蔬菜消费轨迹以及多个社会经济环境作为其决定因素。
我们使用了来自芬兰赫尔辛基市（City of Helsinki）员工的赫尔辛基健康研究（第 1 阶段在 2000-2002 年，n=8960，应答率为 67%；第 2-4 阶段在 2007、2012 和 2017 年）的调查数据。水果和蔬菜的消费通过食物频率问卷进行测量，并计算每月的消费次数。纳入了童年（父母教育、经济困难）、传统（自身教育、职业阶层、家庭收入）和物质（住房所有权、财富、当前经济困难）社会经济环境。我们使用基于群组的轨迹建模来识别水果和蔬菜消费轨迹，并使用多项逻辑回归来检验社会经济环境与轨迹之间的关联。
确定了四种水果和蔬菜消费轨迹：不断增加的高消费（12%）、不断减少的高消费（10%）、稳定的中等消费（43%）和稳定的低消费（35%的参与者）。童年、传统和物质社会经济环境都与轨迹有关：属于较低社会经济群体与稳定的低消费和中等消费轨迹有关。在多变量模型中，职业阶层和家庭财富的关联最强。
不利的童年和成年社会经济环境与长期低水果和蔬菜消费有关。在促进水果和蔬菜消费的尝试中应考虑社会经济环境，未来的干预措施需要针对处境不利的人群。
