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aAt the dawn of the new year, newspaper headlines announced that the UK and Ireland were ranked “best in the world for fruit and vegetable intake”. And this was surprising to me as a public health professional. For economic reasons alone, the UK imports 50% of its vegetables and 84% of its fruit, mainly from Europe, Africa and the Americas. These foods are relatively expensive in the UK, averaging £11.79 per 1,000 kcal compared to £5.82 per 1,000 kcal for processed foods. And now we are at a time when household income is being restricted. For example, cucumber prices rose by more than 50% from 2022 to 2023.
And of course, the UK and Ireland aren’t known for having the healthiest diets. Scotland invented the fried Mars bar. Do Brits really eat more fruit and vegetables than their European neighbors such as Italy, Spain, France, Denmark and Greece? I had to investigate.
I traced this story back to the linked report produced by the OECD called Health at a Glance 2023. This report compares health performance across OECD countries and selected emerging economies. And yes, Figure 4.10 shows that the UK and Ireland have the highest proportion of what the OECD calls “consumption of five or more portions of fruit and vegetables per day in 2019 or the nearest year”. However, it is worth noting that this data is from before Brexit was finalized. Brexit has caused overall food prices to rise by 6%, with fruit and vegetable shortages being described as the ‘new normal’ in recent years. This dietary data should therefore first be seen as a snapshot of the past: pre-Brexit, pre-Covid-19 and pre-cost of living crisis.
Furthermore, the quality of research lies in its methodology. Ask senior researchers which two parts of the study they read first, their methodology and subsequent funding. That is, we ask how the author found the answer and how it was paid for. The OECD study is based on the earlier European Health Interview Survey (EHIS), in which people from different countries self-report their health status. People were asked various answers to the question “How many fruits and vegetables do you eat per day?” and their answers provided the data.
Self-report methods are the standard method for dietary surveys. However, other studies have found that there is systematic misinformation when comparing what people claim they eat with objective measurements of the nutrients they consume. People misunderstand the question, misunderstand the sometimes arcane rules about what counts as a fruit or vegetable, misjudge how much they actually eat, or even misunderstand complete dietary fiber. There is a possibility. Simply put, what people say they eat is not necessarily what they eat.
Health research focuses heavily on diet, as an unhealthy diet is a major risk factor for obesity and chronic disease. The 2021 Health Survey for England estimated that 25.9% of UK adults were obese, and a further 37.9% were overweight. These numbers have increased over the past decade. The UK also has much higher levels of obesity than Greece, Spain, Germany, France and Italy. In addition to the rise in obesity, related diseases such as diabetes, heart disease, high blood pressure, and cancer are also on the rise.
In addition, more than 800,000 people in England and Wales will be hospitalized with malnutrition or nutritional deficiencies in 2022. Most of these patients were people who were deficient in essential nutrients (such as protein, vitamins, and minerals) despite eating high-calorie diets. ). There is clear evidence that childhood nutritional deficiencies are reflected in height, and that “the greater the poverty, the shorter the child.” Children in the UK are shorter than their peers in other countries, data shows, with the average height of five-year-olds in the UK likely to have fallen due to rising child poverty and Tory austerity policies. has been done.
This means that the UK has (but is not limited to) a major diet-related public health problem. I don’t think anyone would object to that.
If you want a more reliable and valid measure of a country’s health, children’s height and overall well-being are probably the best. Before you get excited about the UK being ‘world leading’ in another area, the headline specifically says ‘British and Irish people claim to be the best in the world for fruit and vegetable intake before Brexit’ It should have been “there is.” As we know from public health research, just because someone says they ate something doesn’t mean they actually ate it.
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