Behavioural counselling to increase consumption of fruit and vegetables in low income adults: Randomised trial

Abstract

Objective: To measure the effect of brief behavioural counselling in general practice on patients' consumption of fruit and vegetables in adults from a low income population. Design: Parallel group randomised controlled trial. Setting: Primary health centre in a deprived, ethnically mixed inner city area. Participants: 271 patients aged 18-70 years without serious illness. Intervention: Brief individual behavioural counselling based on the stage of change model; time matched nutrition education counselling. Main outcome measures: Self reported number of portions of fruit and vegetables eaten per day, plasma β carotene, α tocopherol, and ascorbic acid concentrations, and 24 hour urinary potassium excretion. Assessment at baseline, eight weeks, and 12 months. Results: Consumption of fruit and vegetables increased from baseline to 12 months by 1.5 and 0.9 portions per day in the behavioural and nutrition groups (mean difference 0.6 portions, 95% confidence interval 0.1 to 1.1). The proportion of participants eating five or more portions a day increased by 42% and 27% in the two groups (mean difference 15%, 3% to 28%). Plasma β carotene and α tocopherol concentrations increased in both groups, but the rise in β carotene was greater in the behavioural group (mean difference 0.16 μmol/1, 0.00] μmol/l to 1.34 μmol/l). There were no changes in plasma ascorbic acid concentrations or urinary potassium excretion. Differences were maintained when analysis was restricted to the 177 participants with incomes ≤£400 (€596, $640) a week. Conclusions: Brief individual counselling in primary care can elicit sustained increases in consumption of fruit and vegetables in low income adults in the general population.