Fruit Nutrition Information information, tips and advice

A recent randomized parallel group trial compared brief nutrition counseling with behavioral dietary counseling. Recruitment, assessments, and interventions were carried out by research nurses in a primary care setting. Subjects were between the ages of 18 and 70 years and lived in a deprived inner city area. Individuals with serious illness and women who were pregnant or who planned on becoming pregnant within 12 months were excluded from the study. The subjects consisted of 166 women and 105 men. They were randomized into one of two counseling conditions. Each intervention was a 15-minute individual consultation. Investigators prepared written information to support the consultations, and participants attended a second 15-minute consultation two weeks later.

The nutrition counseling group received basic education regarding the importance of increasing consumption of fruit and vegetables, emphasizing the beneficial health consequences of these foods. Behavioral counseling was founded on social learning theory and the stage of change model. These interventions were tailored to the individual, with personalized specific advice, and short- and long-term goal setting.

A food frequency questionnaire was given to the subjects to assess consumption. Additionally, biomarkers of fruit and vegetable intake were measured (plasma ascorbic acid, alpha-tocopherol, and beta-carotene). Twenty-four hour urine samples were also collected and measured for potassium excretion. Investigators also developed a stage of change questionnaire that gauged subjects' readiness to increase consumption at the start of the study, irrespective of whether they had made changes in the past.

Consumption of fruit and vegetables increased from baseline to 12 months by and portions per day in the behavior and nutrition groups (mean difference portions, 95% confidence interval to ). The proportion of participants eating five or more portions a day increased by 42% and 27% in the two groups, respectively. Plasma beta-carotene and alpha-tocopherol concentrations were found to increase in both groups, however the rise in beta-carotene was greater in the behavior group (mean difference micromol/l, micromol/l to micromol/l). There were no significant changes in plasma ascorbic acid concentrations or urinary potassium excretion. Differences were maintained across the income levels tested.

It appears that both types of brief individual counseling in a primary care setting can elicit substantial increases in fruit and vegetable intake, regardless of income level.

A. Steptoe, L. Perkins-Porras, C. McKay, et al. Behavioural counselling to increase consumption of fruit and vegetables in low income adults: randomized trial. BMJ;326:855-861 (April 19, 2003). [Correspondence: .uk].