Associations of Vegetable and Fruit Consumption and Self-Rated Health Status among Brazilian Adults

Abstract

Introduction:Although Brazil is an important producer of fruits and vegetables worldwide, the consumption of vegetables in the country is insufficient, with a scarce variety of products, and it is worse among individuals with higher consumption of ultra-processed foods. Consuming fruits and vegetables is a critical factor in maintaining a healthy lifestyle, decreasing the risk of developing diet-related chronic diseases, and positively affecting psychological well-being, mental health and overall health. The self-rated health (SRH) is a reliable indicator of overall health status. It is a useful independent predictor of healthy lifestyle behaviours, such as physical activity or healthy eating. This study analyses the association between fruit and vegetable consumption behaviours and self-rated health status in Brazilian adult populations.Methods: Data came from the 2019 Brazilian National Health Survey data. SRH status was evaluated with the classical question: "In general, how would you rate your health status"? and responses were categorized into three ordinal categories from the worst to the best level. Vegetable and fruit consumption, were measured by the question: "How many days a week do you usually eat fruits and at least one type of vegetable. Then, three ordinal categories were built for each variable, from an optimal to a short consumption. The association between SRH status and fruit and vegetables consumption was examined using ordinal regression analysis, adjusted by relevant confounders and stratified by sex.Results: A total of 63,444 adult participants were analysed. The mean age was 48.5 years (SD: 16.67), and 58% were women. Fortyfour per cent and 37% say to have an optimal consumption (6-7 days/week) of vegetables and fruits, respectively. Conversely, 26% and 32% of the surveyed mentioned poor consumption (0-2 days/week) of vegetables and fruits, respectively. Additionally, 61%, 32% and 7% of the respondents reported a "good/very good", "fair", and "bad/very bad" SRH status, respectively. According to the model, men with optimal vegetable intake have a 64% probability of belonging to the SRH "good/very good" status, compared to 61% of women. Conversely, men with short vegetable intake have a 39% probability of belonging to "fair" or "bad/very bad" SRH status, compared to 43% of women. Differences were statistically significant. Similar to vegetable consumption, increased fruit consumption is associated with higher probabilities of a better SRH status in both sexes. Conclusions:The study indicates that optimal and moderate fruit and vegetable consumption are significantly and positive associated with SRH status. This relationship is complex because both are directly affected by some relevant socio-demographic factors, and discriminating against this effect is difficult, becoming a methodological challenge. Furthermore, the SRH status differences associated to fruit and vegetable consumption across main socio-demographic factors represent well socioeconomic inequalities in health in Brazilian popu...