European Commission - Public Health: healthindicators.org

Consumption/availability of fruit, excluding juice

Definition of indicator

Average amount of fruits available per person, per year (in grams).

Calculation (numerator, denominator)

(1) Average amount of fruits consumed (grams) per person per day, as obtained from household budget surveys (HBG)

(2) Average amount of fruits consumed (grams) per person per day, as obtained from national food consumption surveys using food diary.

(3) Percentage of people eating fruits (excluding juice) at least daily, derived from EHIS question FV.1. How often do you eat fruits (excluding juice)? 1. Twice or more a day / 2. Once a day / 3. Less than once a day but at least 4 times a week / 4. Less than 4 times a week, but at least once a week / 5. Less than once a week / 6. Never. Precise operationalisation to be formulated.

Additional underlying concepts

WHO recommendation: daily availability of at least 2 portions (approx.150 g/p/d) of fruits per day. Although food availability and consumption both provide relevant information, food availability and consumption are often not synonyms and that needs to be reported and taken into account when interpreting the data.

Relevant dimensions (subgroups)

Country (also region), calendar year, gender, age group

Preferred data sources

(1) DAFNE-databank (Eurostat)

(2) National food consumption surveys

(3) EHIS, national HIS.

Rationale

Important health promoting food item. The consumption of fruits and vegetables is a good proxy for a healthy diet. Fruits and vegetables are a major dietary protective factor for tobacco related and several other cancers. Use declining in many countries. Amenable to interventions.

Data availability, quality and periodicity

- Eurostat: data source is the DAFNE-databank, which includes data Household Budget Surveys of 24 countries: Austria, Belgium, Croatia, Cyprus, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Luxembourg, Malta, Montenegro, Norway, Poland, Portugal, Slovak Republic, Slovenia, Serbia, Spain, Sweden and the United Kingdom. 7 countries to be added next: Albania , Armenia , Estonia, Lithuania, Hungary, Poland and Portugal. Vegetables and fruits separately. Also available by 4 socio-demographic groups: degree of urbanisation, household composition, education and occupation.

- WHO-HFA, OECD: The main data source is the FAO Nutrition database: FAOSTAT. WHO source has the advantage of being a consistent system that produces information annually for most countries in the world. It is more based on production and imports of goods than on household surveys. However, consumption of fruits and vegetables grouped together, cannot be separated from each other. Thus not recommended.

- EFCOSUM: The project revealed that consumption/availability of fruits is difficult to measure, country level data are not directly comparable.

-> EFCOSUM HIS recommendation: any country that will carry out a national food consumption survey includes the minimum amount of 24-hours recalls that allows a calibration with other countries.

References

- Eurostat /DAFNE (DAta Food NEtworking)

-WHO-HFA, OECD: www.fao.org / faostat.fao.org / fao statistics division

- European food consumption survey method, EFCOSUM

- EHIS standard questionnaire (version of 11/2006)

Work to do

• Imprtant to decide: Fruits and vegetables separately (HBG, EHIS) or together ( WHOHFA, OECD)?
• Separatele, NO: WHO source has the advantage of being a consistent system that produces information annually for most countries in the world. It is more based on production and imports of goods than on household surveys.
• Separately, YES: preferably if one has the sources of information that are reliable and will provide continuous data.
• Decide on the method: Availabilty (=purchases) in the household vs consumption (food diary) vs how often (EHIS)? Not recommended to use EHIS?
• Check again the DAFNE web-page, EFCOSUM,