In spite of the numerous health benefits from adequate consumption of F&V, the dietary behavior of many individuals with respect to F&V consumption is below the daily recommended level. A large and growing literature has examined the determinants of F&V consumption. Nonetheless, most previous studies are based on standard multiple linear or binary choice regressions. The findings from these estimation methods may lead to wrong policy intervention measures if individuals' F&V consumption responds differently to changes in the covariates at different regions of the F&V consumption distribution. Accordingly, we use a quantile regression to examine the disparities in F&V consumption frequency by socio-demographic and lifestyle characteristics along different parts of the F&V consumption distribution.
Both the conditional and unconditional analyses show significant disparities in F&V consumption frequency among people with different socio-demographic and lifestyle features. We find that F&V consumption is relatively lower among males, middle aged, singles, smokers, individuals with weak social interaction and households with no children. The results also reveal the existence of a SES gradient in F&V consumption where, low income-education groups consume F&V less often than the high income-education group. Estimates from the quantile regression show that socio-demographic and lifestyle factors exert different effects on F&V consumption frequency across the conditional quantiles of the F&V distribution. There is no statistically significant difference in F&V consumption between immigrants and natives. There are significant differences in F&V consumption between provinces, where the Atlantic, Western, British Columbia and Ontario provinces consume F&V less frequently compared to Quebec. This result could be due to cultural influence, since Quebec is a predominantly a French-speaking province. Quebec also has a long history of farming most notably in fruit, vegetable and dairy products.
Several explanations have been used in the literature to justify the disparities in F&V consumption by socio-demographic characteristics [e.g. [16–22]]. For example, it has been suggested that educational attainment affects nutritional knowledge and awareness about the risks associated with inadequate consumption of F&V. One potential explanation for the disparities in F&V consumption by income level is due to the high price of F&V. The difference in F&V consumption by marital status may be due to family or household size, where individuals tend to consume more F&V when eating meals with others .
The findings of this paper are consistent with several previous studies which find that men consume less F&V than women [18, 20–22], smokers consume less than non-smokers [21, 22], singles consume less than married people [16, 18] and that there is no significant difference by ethnicity [16, 25]. The existence of a socioeconomic gradient in F&V consumption is in line with the findings of several studies which find a positive association between income, level of education and F&V consumption [16–19]
The current study has some limitations. First, the cross-sectional design of the data set limits ability to infer causality and does not allow us to control for unobserved factors that may affect the consumption of F&V, such as preferences. This calls for further research using longitudinal data. Second, due to data set limitations, F&V consumption data are based on a survey question that measures the number of times daily, respondents reported that they consumed F&V. This F&V consumption frequency may not reflect the actual quantity consumed .
Understanding the socio-demographic and lifestyle characteristics of individuals with low F&V consumption frequency helps to identify the targeted groups for nutrition promotion policies aimed at encouraging F&V consumption. Intervention measures need to take into account the potential heterogeneous effect of F&V consumption determinants along the different quantiles of the F&V distribution. There is no one-size-fits-all strategy to promote healthy eating behavior; a multifaceted approach would be required to address low consumption of F&V successfully. For example, increasing people's awareness about the benefits of F&V consumption, through the media and other community-organized nutrition programs, as well as subsidizing the cost of F&V may be helpful in encouraging the consumption of F&V, especially among people in low socioeconomic strata.