Objective: To evaluate the differences in the consumption of fruit and vegetables between groups with different socio-economic status (SES) in the adult population of European countries. Design: A systematic review of published and unpublished surveys of food habits conducted between 1985 and 1999 in 15 European countries. Educational level and occupational status were used as indicators of SES. A pooled estimate of the mean difference between the highest and the lowest level of education and occupation was calculated separately for men and women, using DerSimonian and Laird's random effects model. Setting: The inclusion criteria of studies were: use of a validated method for assessing intake at the individual level; selection of a nationwide sample or a representative sample of a region; and providing the mean and standard deviation of overall fruit and vegetable consumption for each level of education or occupation, and separately for men and women. Subjects: Participants in the individual surveys had to be adults (18 ± 85 y). Results: Eleven studies from seven countries met the criteria for being included in the meta-analysis. A higher SES was associated with a greater consumption of both fruit and vegetables. The pooled estimate of the difference in the intake of fruit was 24.3 gapersonaday (95% con®dence interval (CI) 14.0 ± 34.7) between men in the highest level of education and those in the lowest level of education. Similarly, this difference was 33.6 gapersonaday for women (95% CI 22.5 ± 44.8). The differences regarding vegetables were 17.0 gapersonaday (95% CI 8.6 ± 25.5) for men and 13.4 gapersonaday (95% CI 7.1 ± 19.7) for women. The results were in the same direction when occupation instead of education was used as an indicator of SES. Conclusions: Although we cannot exclude over-reporting of intake by those with highest SES, it is unlikely that this potential bias could fully explain the differences we have found. Our results suggest that an unhealthier nutrition pattern may exist among adults belonging to lower socio-economic levels in Europe. Sponsorship: The present study was supported by the European Union's FAIR programme .

Objective: To investigate whether there is an association between socioeconomic status and a healthy diet, taking the possible influence of other social variables such as age, gender, income and household composition into consideration. Design: Cross-sectional study. Setting: Nationwide study in Denmark, 1995. Subjects: Random sample from the civil registration system. A total of 852 men and 870 women aged 18-80 y participated, a response rate of 58%. Interventions: A 7 day estimated dietary record was used to obtain information about the diet. Information about social background was gained through face-to-face interview. Results: The intake of fruit and vegetables and the percentage energy (E%) from fat in the diet were significantly associated with the educational level of both men and women. For men with only basic schooling, the mean intake of vegetables and fat was 84 g=10 MJ and 41 E% respectively. Men with long higher education had a mean intake of 119 g=10 MJ of vegetables and 37 E% of fat. For women, the corresponding figures for the intake of vegetables and fat were 131 g=10 MJ and 38 E% and 175 g=10 MJ and 37 E%, respectively. For women, age, income and household composition were also significantly associated with the intake of fruit and vegetables. Conclusions: Education seems to be the most important social variable to explain social differences in dietary habits. Additional variables are needed to explain dietary habits of women. Differences are seen for both foods and nutrients. Sponsorship: The data analysis was financially supported by the Health Insurance Fund.

The present study revealed a significant increase from 1995 to 2000-2002 in mean BMI for boys and girls for all age groups and a significant increase in the prevalence of overweight when all Danish children and adolescents (4-18 years) were analysed.

Under-reporting of energy intake (EI) is a well-known problem when measuring dietary intake in free-living populations. The present study aimed at quantifying misreporting by comparing EI estimated from the Danish pre-coded food diary against energy expenditure (EE) measured with a validated position-and-motion instrument (ActiReg w ). Further, the influence of recording length on EI:BMR, percentage consumers, the number of meal occasions and recorded food items per meal was examined. A total of 138 Danish volunteers aged 20 -59 years wore the ActiReg w and recorded their food intake for 7 consecutive days. Data for 2504 participants from the National Dietary Survey 2000 -2 were used for comparison of characteristics and recording length. The results showed that EI was underestimated by 12 % on average compared with EE measured by ActiReg w (PreMed AS, Oslo, Norway). The 95 % limits of agreement for EI and EE were 26·29 and 3·09 MJ/d. Of the participants, 73 % were classified as acceptable reporters, 26 % as under-reporters and 1 % as over-reporters. EI:BMR was significantly lower on 1-3 consecutive recording days compared with 4-7 recording days (P,0·03). Percentage consumers of selected food items increased with number of recording days. When recording length was 7 d, the number of reported food items per meal differed between acceptable reporters and under-reporters. EI:BMR was the same on 4 and 7 consecutive recording days. This was, however, a result of under-reporting in the beginning and the end of the 7 d reporting. Together, the results indicate that EI was underestimated at group level and that a 7 d recording is preferable to a 4 d recording period.