Associations between low consumption of fruits and vegetables and nutritional deficiencies in Brazilian schoolchildren

Abstract

Objective: We examined associations between the frequency of fruit and vegetable (F&V) consumption and nutritional deficiencies among Brazilian schoolchildren.

Design: A cross-sectional, population-based study was performed. A short FFQ was used to assess consumption of fruits and vegetables (F&V) over the past month. The prevalence ratios (PR) and 95 % confidence intervals for stunting, obesity, anaemia, vitamin A and folate deficiencies, vitamin E and vitamin D insufficiencies were estimated for low F&V consumption frequency (vegetables ≤ 3 times/month and fruits ≤ 3 times/week) and compared with children with usual F&V consumption frequency (vegetables ≥ 1 time/week and fruits ≥ 4 times/week).

Setting: Acrelândia, Western Brazilian Amazon.

Subjects: A total of 702 children aged 4-10 years.

Results: Only 5 % of children consumed F&V ≥ 5 times/d. Prevalence of deficiency was 31 %, 15 %, 9 % and 2 % for vitamins D, A, E and folate, respectively. Overall, 6.3% of children were anaemic, 3.3% were stunted, 2.7% were obese and 33 % had multiple nutritional deficiencies. Low frequency of F&V consumption was associated with lower plasma concentrations of carotenoids and vitamin E. Nutritional deficiencies were higher among non-consumers of F&V when compared with usual consumers: anaemia (PR=1.9; 95 % CI 1.0, 3.7), vitamin E insufficiency (PR=2.5; 95% CI 1.5, 4.2), vitamin D insufficiency (PR=1.5; 95% CI 1.1, 1.9) and stunting (PR=2.6; 95% CI 1.1, 6.1).

Conclusions: In our study, the occurrence of nutritional deficiencies in children with low F&V consumption was twice as high as in children with usual F&V consumption, reinforcing the importance of effective actions to promote the consumption of F&V.

Keywords: Nutritional status.

Fig. 1

Prevalence of each nutritional disturbance and prevalence ratio (PR; with 95 % confidence interval in parentheses) for children with no/rare consumption of fruits and vegetables (FFI₀; ) compared with children with regular consumption of fruits and vegetables (FFI_1–4; ); Brazilian children aged 4–10 years (n 702), Acrelândia, Western Brazilian Amazon, December 2007. Stunting defined as height-for-age Z-score<−2; anaemia defined as Hb<110·0 g/l for children under 5 years and Hb<115·0 g/l for children aged 5–10 years; VEI, vitamin E insufficiency, defined as serum tocopherol<11·61 µmol/l; VAD, vitamin A deficiency, defined as serum retinol<0·70 µmol/l; VDI, vitamin D insufficiency, defined as serum vitamin D<75 nmol/l; ND, nutritional disorders, defined as having at least one of the nutritional disturbances except for VDI; FFI, Food Frequency Index for fruit and vegetable consumption; FFI₀, consumption of vegetables never or ≤3 times/month and fruits ≤3 times/week; FFI_1–4, consumption of vegetables ≥1 time/week and fruits ≥4 times/week