Behavioural counselling to increase consumption of fruit and vegetables in low income adults: randomised trial |
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| Authors: | Andrew Steptoe Linda Perkins-Porras Catherine McKay Elisabeth Rink Sean Hilton Francesco P Cappuccio |
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| Institution: | aDepartment of Epidemiology and Public Health, University College London, London WC1E 6BT, bDepartment of General Practice and Primary Care, St George''s Hospital Medical School, London SW17 0RE |
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| Abstract: | ObjectiveTo measure the effect of brief behavioural counselling in general practice on patients'' consumption of fruit and vegetables in adults from a low income population.DesignParallel group randomised controlled trial.SettingPrimary health centre in a deprived, ethnically mixed inner city area.Participants271 patients aged 18-70 years without serious illness.InterventionBrief individual behavioural counselling based on the stage of change model; time matched nutrition education counselling.ResultsConsumption 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/l, 0.001 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.ConclusionsBrief individual counselling in primary care can elicit sustained increases in consumption of fruit and vegetables in low income adults in the general population. What is already known on this topicBrief interventions can be effective in increasing consumption of fruit and vegetablesBiomarkers and intention to treat analyses have seldom been used in such interventions, and few studies have targeted low income populationsWhat this study addsCompared with nutritional counselling, brief behavioural counselling carried out by nurses in primary care led to greater increases in fruit and vegetable intake and in plasma β carotene concentrationFavourable effects were observed in low income adults living in a deprived inner city area |
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