Five fruits and vegetables a day: less than a quarter of French people follow this recommendation, according to a study

"Eat at least 5 fruits and vegetables a day." A message that is widely disseminated, but far from having become part of the French eating habits. According to a double study published this Tuesday, April 29, in the Weekly Epidemiological Bulletin (BEH) of Public Health France, 71% of French people are aware of this recommendation. But only a quarter of women, and less than a fifth of men, report having an adequate consumption of fruits and vegetables, with at least five portions of fruits and vegetables per day.

To obtain these results, the authors of the study relied on the 2021 results of the Public Health France Barometer , conducted among more than 30,000 people in France and overseas. They examined the gap between, on the one hand, the recommendations of the National Nutrition and Health Program (PNNS), which since 2001 has aimed to improve the health of the entire population by acting on diet, and on the other hand, the declared diet of the French.

Several food groups were studied: fruits and vegetables, whole grains, dried vegetables and sugary drinks.

Result: "In mainland France, in 2021, 19.3% of men and 25.2% of women aged 18 to 85 reported fruit and vegetable consumption in line with the recommendations (at least five fruits and vegetables per day)."

In detail, the consumption of at least five fruits and vegetables per day is associated with being a woman, having a high school diploma or higher, and holding a higher intellectual or intermediate profession. According to the study, these disparities reflect a higher level of "general knowledge about nutrition among women and the most highly educated."

"We know that women have a higher social desirability bias when it comes to diet and health. Therefore, they are more likely to want to be good students," says Valérie Deschamps, a nutrition expert at Santé publique France and one of the study's authors.

Adherence to nutritional recommendations varies primarily by age. Only 17% of 18- to 24-year-olds say they eat at least five fruits and vegetables a day, nearly half as many as 65- to 74-year-olds, the "model" age group with 30.1% of good performers.

The older you are, the more you tend to respect the recommendation and there is a fairly marked social gradient, meaning that the most educated people are more likely to respect it, summarizes Valérie Deschamps.

But these percentages remain low, and they are falling. The Environmental Health Study, Biomonitoring, Physical Activity, and Nutrition (Esteban) for the period 2014-2016 estimated that 30.6% of men met the recommendation of five fruits and vegetables a day. This represents a loss of 11 points, which the new study, conducted jointly by the Nutritional Surveillance and Epidemiology Team (Esen), Public Health France, and Sorbonne Paris Nord University, attributes to the passage of time and to differences in methodologies.

Despite these differences, the percentages of compliance with the described recommendations remain low in 2014-2016 as in 2021, the authors of the study estimate.

They also point out that diet is recognized "as one of the main modifiable risk or protective factors for the most widespread chronic diseases in the industrialized world." A study published in the prestigious journal The Lancet estimated that in 2017, diet was responsible for approximately 1 in 5 deaths worldwide, and thus represented one of the most important risk factors for mortality.

The excess of salty products, the lack of whole grains and fruits were particularly highlighted. Inadequate consumption of fruits and vegetables is "linked to the occurrence of cardiovascular disease or certain cancers," recalls Valérie Deschamps.

To improve the situation in France, the study by Public Health France suggests a change of approach: moving away from the single benchmark of "five fruits and vegetables per day."

"We realized that people who were very far from these recommendations felt so far away that they made no effort to get there. Because it was so far away, so unattainable," explains Valérie Deschamps.

Instead, it recommends moving toward more flexible "every little bit counts" recommendations to promote any increase in fruit and vegetables, "regardless of its magnitude and the initial level of consumption."