Uncovering intersectional inequalities in fruit and vegetable consumption in the UK using Understanding Society data

Abstract

Objective: Large inequalities in fruit and vegetable consumption (FVC) persist, yet it remains unclear how intersecting factors such as socio-economic status, ethnicity and sex influence FVC in the UK. Using an intersectional framework allows us to explore complex realities and double burdens faced by certain population groups. Design: Cross-sectional data from the UK Household Longitudinal Study Wave 9 (2017-2018) were analyzed. FVC was measured as a binary variable, indicating whether individuals met the recommended five daily portions of fruits and vegetables (400 grams in total). An intersectional Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy was used, nesting participants into forty-eight social strata based on sex, ethnicity, age and educational level. Setting: United Kingdom. Participants: A total of 16 275 individuals from the UK Household Longitudinal Study sample were included, with one adult randomly selected per household. Results: Overall, 69·2 % of the sample did not meet the recommended daily FVC. Inequalities were predominantly explained by additive effects of sex, ethnicity, age and educational level. Men, individuals with lower educational levels, ethnic minority groups and younger participants were at higher risk of insufficient FVC, particularly those experiencing combinations of these factors. Conclusions: Low FVC across the population, combined with strong additive effects of social determinants, underscore the need for proportionate universal interventions. Policies targeting improved access to fruits and vegetables across all neighbourhoods, especially those predominantly inhabited by individuals with lower educational levels, are warranted to reduce these inequalities.