CPHN
Presenting Nutrition Series

‘Report on the consumption of
vegetables and fruit
in NSW : 2003’
Authors:
Debra Hector
Liz Story
Vicki Flood


Presenting Nutrition Series
Introduction for Users
o The presentations are designed to assist professionals throughout
NSW disseminate information on public health nutrition
o Each presentation is based on an existing CPHN report
o Users are requested to provide full acknowledgement of the authors,
CPHN and the Department of Health
o Notes version of the ppt gives table/figure and page numbers, for easy
reference to the report
o Further information and explanation of each slide should be sought
from the report. Visit
o Users should use Excel to prepare slides with data for other areas,
modelled on the sample provided
o Any questions can be referred to Lesley King on 02 9351 8015.


The Report
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•
•
•

Rationale for the promotion of fruit and
vegetable consumption
Risks and burden of disease associated with
low consumption
Recommended levels of consumption
Current levels of consumption of V & F in NSW
Recommendations for monitoring V & F
consumption in NSW


Conceptual framework
for monitoring
vegetables & fruit
consumption

Dietrelated
diseases/
conditions

Biomedical risk factors

Nutrient intakes
Food and supplement
consumption habits
Food purchasing / acquisition
F&N–related ‘literacy’ (knowledge, attitudes, beliefs)

Food supply / community access
Food / nutrition policy and action
Adapted from: Webb K in Marks et al Monitoring food habits in the Australian population using short questions 2001


Association between V & F Intake and
Chronic Disease – Evaluation of the Evidence
Disease

Strength of Evidence

Assessment of Evidence

Neural Tube Birth Defects

Substantial, proven

Proven

Cancer – number of sites

Substantial, growing

Extremely convincing

Cardiovascular diseases

Substantial, growing

Very convincing


Diverticulosis

Strong

Convincing

Cataracts/Macular Disease

Growing

Convincing

Type 2 Diabetes

Mixed, Indirect

Convincing

Stroke

Limited, Building

Becoming convincing

Hypertension

Limited

Suggestive


COPD

New

Suggestive

Overweight and Obesity

Sparse, Indirect

Convincing as part of
treatment/prevention
Source: 5+A Day New Zealand


Protective effects of eating vegetables
and fruit …
the MORE the better
the more VARIETY the better
consume WHOLE
vegetables and fruit
the EARLIER the better


Recommended Intakes for Protective
Effects
Quantity and Variety

Exposure period


Dose-Response
↑intake ↓risk

High consumption of V & F
should begin in childhood

‘Extra 50g vegs and fruit
each day could cut risk of
premature death by 20%’
(EPIC)

‘Women consuming at least
2.5 serves daily of V & F as
adolescents were 46% less
likely to develop ovarian
cancer’ (Fairfield et al, 2001)


Burden of Disease
Burden of disease is the amount of ill health
and disability attributable to a given factor

‘Inadequate intake of vegetables and
fruit accounts for around 3% of the total
burden of disease in Australia*’ (Mathers
et al 2000)
*compared to 2% from alcohol and 10% from tobacco – note,
3% is very likely to be an underestimate of the true burden of
disease related to inadequate vegetable and fruit consumption



Burden of disease attributable to
inadequate V & F consumption,
Australia, 1995
Persons
Number
Deaths
YLL
YLD
DALYs

Per Cent

4 057

3.2

55 963

4.2

12 114

1.0

98 077

2.7


Source: AIHW 1999(Mathers et al 2000)

Most of the burden of disease is attributable to cancers
and cardiovascular disease


Burden of cancer related to inadequate
V & F consumption
(in Australia, 1995)









Inadequate V & F consumption accounts for 11% of the total
cancer burden
Low V intake (<4 serves/day) accounts for 17% of risk of
colorectal cancer, 9% lung and prostate cancer, 2% breast
cancer (Marks et al 2001)
Total health care costs associated with low consumption of
vegetables for these 4 cancers is $59 million per year

Increasing average V intake by one serve/day
would potentially save the health care system
$24 million/year for cancer treatment costs alone



Consumption Recommendations
Australian Dietary Guidelines 2003
(children, adolescents, adults and older people)

‘Eat plenty of …. vegetables
(including legumes) and fruit’
Minimum daily serves:

5 vegetables and 2 fruit


Consumption Recommendations
Australian Guide to Healthy Eating
– how many serves?
Vegetables
Adults
Children (4-7 yrs)
Children (8-11yrs)
Adolescents (12-18yrs)

4-8
2-4
3-5
4-9

Fruit
2-4
1-2
1-2

3-4

Note - AGHE includes fruit juice and potatoes as part of the
recommended serves, some other guides exclude these items


How much do we eat?
Two main surveys in the last decade:
• National Nutrition Survey,1995 (n=2881for NSW)
– 24 hr recall, FFQ and short questions
• NSW Health Surveys (1997/1998 in this report)
– Short questions (n=35,025 adults in 97/98)


Usual consumption of VEGETABLES by
FEMALES - results of 2 surveys
NNS 1995 and NSW HS 1997/98
70
56.6

60

%

NSW HS

47.6

50
40

30

NNS

31.2
22.1

22.2

21.2

20
10
0
1 or less

2-3 serves

Number of serves

4 or more


Usual consumption of VEGETABLES by
MALES - results of 2 surveys
NNS 1995 and NSW HS 1997/98
70
57.3

60


%

50

42.4

NNS

NSW HS

40.7

40
30

28.5

20

13.3

16.9

10
0
1 or less

2-3 serves


Number of serves

4 or more


70

Usual consumption of FRUIT by FEMALES
- results of 2 surveys
NNS 1995 (NSW) and NSW HS 1997/98
NNS

60

%

50

43.0

48.4

49.3

NSW HS

44.7

40
30

20
7.5

10

7.0

0
1 or less

2-3 serves

Number of serves

4 or more


Usual consumption of FRUIT by MALES results of 2 surveys
NNS 1995 (NSW) and NSW HS 1997/98
70
60

57.6

60.5

NNS

NSW HS


%

50
35.4

40

32.2

30
20
6.3

10

7.3

0
1 or less

2-3 serves

Number of serves

4 or more


Proportion of adult MALES consuming
serves of VEGETABLES (per day) in NSW,
by AGE (NSW HS 1997/98)

40

All

% consuming

35

18-24

30

25-34

25

35-44

20

45-54

15

55-64

10

65-74


5

75+

0
<1

1<2

2<3

3<4

number of serves

4<5

5+


40

Proportion of adult FEMALES consuming
serves of VEGETABLES (per day) in NSW, by
age (NSW HS 1997/98)
All

% consuming

35


18-24

30

25-34

25

35-44

20

45-54

15

55-64

10

65-74

5

75+

0
<1


1<2

2<3

3<4

number of serves

4<5

5+


Proportion of adult MALES consuming
serves of FRUIT (per day) in NSW, by age
(NSW HS 1997/98)
40
All

% consuming

35

18-24

30

25-34

25


35-44

20

45-54

15

55-64

10

65-74

5

75+

0
<1

1<2

2<3
number of serves

3<4

4<5



Proportion of adult FEMALES consuming
serves (per day) of FRUIT in NSW, by age
(NSW HS 1997/98)

% consuming

45
40
35

All

30

25-34

25
20

35-44

15

55-64

10
5


65-74

18-24

45-54

75+

0
<1

1<2

2<3
number of serves

3<4

4<5


Mean serves of VEGETABLES consumed by
male and female adults in NSW, by age
(NSW HS 1997/98)
3.5

Mean number of serves

3.0


2.9
2.7

2.5

2.5

2.5
2.3

2.2
2.0

2.0

2.1

2.0

2.4

2.7
2.4

2.5

2.4 2.4

2.1


Males
Females

1.5
1.0
0.5
0.0
All

18-24

25-34

35-44

45-54

Age (years)

55-64

65-74

75+


Mean serves of FRUIT consumed by male and
female adults in NSW, by age
(NSW HS 1997/98)


Mean number of serves

2.5
2.0

1.9

1.8
1.6

1.6 1.6

1.5

1.6
1.4

1.7
1.5

1.6

1.9
1.6

1.9
1.7

1.9
1.7


Males
Females

1.0
0.5
0.0
All

18-24

25-34

35-44

45-54

Age (years)

55-64

65-74

75+


VEGETABLE consumption in Central Coast AHS
compared to NSW overall (NSW HS 1997/98)
40
35

% consuming

30
CC Males
NSW Males
CC females
NSW females

25
20
15
10
5
0
<1

1<2

2<3

3<4

Number of serves

4<5

5+


FRUIT consumption in Central Coast AHS

compared to NSW overall (NSW HS 1997/98)
40

% consuming

35
30
CC Males
NSW Males
CC females
NSW females

25
20
15
10
5
0
<1

1<2

2<3

3<4

Number of serves

4+