Article thumbnail
Location of Repository

Environmental determinants of fruit and vegetable consumption among adults: a systematic review

By Carlijn B. M. Kamphuis, Katrina M. Giskes, Gert-Jan de Bruijn, Wanda Wendel-Vos, Johannes Brug and Frank J. Van Lenthe


The current ecological approach in health behaviour research recognises that health behaviour needs to be understood in a broad environmental context. This has led to an exponential increase in the number of studies on this topic. It is the aim of this systematic review to summarise the existing empirical evidence pertaining to environmental influences on fruit and vegetable (FV) consumption. The environment was defined as ‘all factors external to the individual’. Scientific databases and reference lists of selected papers were systematically searched for observational studies among adults (18–60 years old), published in English between 1 January 1980 and 31 December 2004, with environmental factor(s) as independent factor(s), and fruit intake, vegetable intake or FV intake combined as one outcome measure as dependent factor(s). Findings showed there was a great diversity in the environmental factors studied, but that the number of replicated studies for each determinant was limited. Most evidence was found for household income, as people with lower household incomes consistently had a lower FV consumption. Married people had higher intakes than those who were single, whereas having children showed mixed results. Good local availability (e.g. access to one's own vegetable garden, having low food insecurity) seemed to exert a positive influence on intake. Regarding the development of interventions, improved opportunities for sufficient FV consumption among low-income households are likely to lead to improved intakes. For all other environmental factors, more replicated studies are required to examine their influence on FV intake

Topics: 111700 PUBLIC HEALTH AND HEALTH SERVICES, 110000 MEDICAL AND HEALTH SCIENCES, 111199 Nutrition and Dietetics not elsewhere classified, Systematic review, Environmental determinants, Fruit consumption, Vegetable consumption
Publisher: Cambridge University Press
Year: 2006
OAI identifier:

Suggested articles


  1. (2002a) Socioeconomic differences among Australian adults in consumption of fruit and vegetables and intakes of vitamins A, C and folate.
  2. (2002b) Socio-economic differences in fruit and vegetable consumption among Australian adolescents and adults.
  3. (2000). A structural model of health behavior: a pragmatic approach to explain and influence health behaviors at the population level.
  4. (1999). Asian students change their eating patterns after living in the United States.
  5. (2001). Association of awareness, intrapersonal and interpersonal factors, and stage of dietary change with fruit and vegetable consumption: a national survey.
  6. (1998). Behavioral and social influences on food choice. Nutr Rev 56, S50–S64, discussion S64-S74.
  7. (2005). Causes of cancer in the world: comparative risk assessment of nine behavioural and environmental risk factors.
  8. (2001). Choose a variety of fruits and vegetables daily: understanding the complexities.
  9. (2005). Cochrane Handbook for Systematic
  10. (2005). (accessed 26
  11. (1990). Cost and availability of healthy food choices in a London health district.
  12. (2002). Diet quality and major chronic disease risk in men and women: moving toward improved dietary guidance.
  13. (1995). Dietary intake of fruits and vegetables in Norway: influence of life phase and socio-economic factors.
  14. (1999). Dietary intake of vegetables and fruits among adults in five regions of Spain. EPIC Group of Spain. European Prospective Investigation into Cancer and Nutrition.
  15. (1994). Diets for disease? Intraurban variation in reported food consumption in Glasgow.
  16. (1994). Differences in reported food frequency by season of questionnaire administration: the 1987 National Health Interview Survey.
  17. (1999). Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity.
  18. (2001). Do ’Food Deserts’ Exist? A Multi-level, Geographical Analysis of the Relationship Between Retail Food Access, Socio-economic Position and Dietary Intake. Project Report N09010. London: Food Standards Agency.
  19. (2000). Does the inclusion of grey literature influence estimates of intervention effectiveness reported in meta-analyses?
  20. (2002). Ecological models of health behaviour.
  21. (2001). Environmental and societal factors affect food choice and physical activity: rationale, influences, and leverage points. Nutr Rev 59, S21–S39, discussion S57–S65.
  22. (2005). Environmental Determinants and Interventions for Physical Activity, Nutrition and Smoking: A Review. The Hague: ZonMW.
  23. (2002). Environmental factors associated with adults’ participation in physical activity: a review.
  24. (2005). Environmental influences on food choice, physical activity and energy balance.
  25. (2002). Factors affecting food choice in relation to fruit and vegetable intake: a review.
  26. (2006). Food environments and obesity – neighbourhood or nation?
  27. (2003). Food insecurity and low income in an English inner city.
  28. (2000). Fruit and vegetable availability among ten European countries: how does it compare with the ‘five-a-day’ recommendation? DAFNE I and II projects of the European Commission.
  29. (2002). fruit and vegetable consumption 633Cummins
  30. (1997). Fruit and vegetables, and cardiovascular disease: a review.
  31. (1999). Healthy dietary habits in relation to social determinants and lifestyle factors.
  32. (2005). Healthy nutrition environments: concepts and measures.
  33. (2003). Income and health behaviours. Evidence from monitoring surveys among Finnish adults.
  34. (2004). Increasing fruit and vegetable intake by changing environments, policy and pricing: restaurant-based research, strategies, and recommendations.
  35. (2003). Increasing the health promotive capacity of human environments.
  36. (2005). Is personality related to fruit and vegetable intake and physical activity in adolescents?
  37. (1999). Lifecourse events and experiences: association with fruit and vegetable consumption in 3 ethnic groups.
  38. (2001). Lifestyle factors affecting fruit and vegetable consumption in the UK Women’s Cohort Study.
  39. (2003). Lowincome consumers’ attitudes and behaviour towards access, availability and motivation to eat fruit and vegetables.
  40. (1997). Mortality by cause for eight regions of the world:
  41. (1989). Negative studies.
  42. (1999). Neighbourhood differences in diet: the Atherosclerosis Risk in Communities (ARIC)
  43. (2005). Neighbourhood inequalities in physical inactivity: the role of neighbourhood attractiveness, proximity to local facilities and safety in the Netherlands.
  44. (2003). Obesity and the environment: where do we go from here?
  45. (2000). Overview of the health benefits of fruit and vegetable consumption for the dietetics professional: selected literature.
  46. (1993). Patterns of food and nutrient intake in a suburb of Dublin with chronically high unemployment.
  47. (2006). Perceived environmental determinants of physical activity and fruit and vegetable consumption among low and high socioeconomic groups in the Netherlands. Health Place (Epublication ahead of print version).
  48. (2004). Psychological and social predictors of changes in fruit and vegetable consumption over 12 months following behavioral and nutrition education counseling.
  49. (2002). Psychosocial factors and dietary habits associated with vegetable consumption.
  50. (1995). Psychosocial factors associated with fruit and vegetable consumption.
  51. (2003). Relative influences of individual, social environmental, and physical environmental correlates of walking.
  52. (1993). Scotland’s health – a more difficult challenge for some? The price and availability of healthy foods in socially contrasting localities in the west of Scotland.
  53. (1986). Seasonal variation in food intake, pattern of physical activity and change in body weight in a group of young adult Dutch women consuming self-selected diets.
  54. (2005). Seasonal variation in intake of carotenoids and vegetables and fruits among white men in New Jersey.
  55. (2002). The behavioral ecological model.
  56. (2002). The impact on eating habits of temporary translocation from a Mediterranean to a Northern European environment.
  57. (1981). The relationship between dysfunctional family environments and family member food intake.
  58. (2002). The relative influence of individual, social and physical environment determinants of physical activity.
  59. (1994). The theory of triadic influence: a new theory of health behavior with implications for preventive interventions.
  60. (1999). Variation in fruit and vegetable consumption among adults in Britain. An analysis from the dietary and nutritional survey of British adults.
  61. (1996). Vegetables, fruit, and cancer prevention: a review.
  62. (2003). Walking, bicycling, and urban landscapes: evidence from the San Francisco Bay Area.
  63. (1998). Who eats 5 a day?: intake of fruits and vegetables among Norwegians in relation to gender and lifestyle.
  64. (2002). Wing S & Diez Roux A

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.