Low fruit and vegetable consumption (Indicator 16)
Updated
The indicator describes the following: Percentage of population aged 18+ years who eat less than five servings of fruit and/or vegetables on average per day.
The updated dietary guidelines from the Norwegian Directorate of Health (2024) recommend eating at least five and preferably eight daily servings of fruits, berries, and vegetables, with 100 grams considered as one serving. The indicator reflects the percentage of the population whose intake is below the recommended level of 500 grams per day.
Results
The proportion who consumed less than the recommended amount of fruit and vegetables is 88 percent among men and 83 percent among women (Figure 1). This is shown by data from the fourth nationally representative dietary survey among adults in Norway, carried out in 2022-2023 (Norkost 4).
A comparison with the corresponding numbers from the previous nationally representative dietary survey among adults, Norkost 3 (2010-2011), indicates that the proportion who eat less than five daily servings has increased (Figure 2).
Findings from the 7th survey of the Tromsø Study conducted in 2015-2016 showed that in the population aged 40 years and older in Tromsø, 83% of men and 70% of women ate less than five servings per day (Figure 3).
Further reading, see The Public Health Report - Diet in Norway (only available in Norwegian).
Data sources
The data sources for this indicator are the national dietary surveys in adults (Norkost 3 and 4) and the Tromsø Study.
Descriptions and definitions of the studies follow below.
Data source: National Dietary Surveys (Norkost)
Description
The National Dietary Surveys of Adults (Norkost) provide data at the individual level about the intake of food and drink among a nationally representative sample of the population of Norway. National dietary surveys among adults were conducted in 1993, 1997, 2010-2011 and 2022-2023. The surveys have been carried out by the Department of Nutrition at the University of Oslo in collaboration with the Norwegian Directorate of Health, the Norwegian Institute of Public Health and the Norwegian Food Safety Authority.
Norkost 4 was conducted in 2022-2023 among a nationally representative sample of adults aged 18-80 years with a 40 percent participation rate (a total of 1964 individuals participated). The method used was a combination of repeated 24-hour dietary recall interviews and a food propensity questionnaire. The same method was used in the previous survey, Norkost 3, which was conducted in 2010-2011 in a nationally representative sample of adults aged 18-70 years with a 37 percent participation rate (1787 participants).
Effect measure
Percentage of adults who eat less than five servings of fruit and/or vegetables per day.
The results are based on two 24-hour dietary recall interviews.
One serving is defined as 100 grams of vegetables, fruit or berries. The data is calculated to show the daily intake of vegetables, fruit and berries, which includes a maximum of 100 grams of juice per day. (Potatoes, dried fruits, sugar-sweetened canned fruits, and jams are not included.)
The age distribution of the population of Norway has not been taken into account which means that the data are not age-standardised.
Interpretation and sources of error
Since the intake for each person is the average of two days of data collection, this does not provide sufficient basis on which to comment on the individual’s normal intake.
Data source: The Tromsø Study
Description
The Tromsø Study was initiated in 1974 and consists of repeated health examinations of whole birth cohorts and random samples of the population in Tromsø municipality (Tromsø 1-7). The last two surveys are particularly relevant to the period that is subject to reporting from the member states to the World Health Organization; 2010-2025. Tromsø 6 (2007-2008) included almost 13 000 adults between the ages of 30 and 87 years, with an attendance rate of 66 per cent. Tromsø 7 (2015-2016) included more than 21 000 adults aged 40 years and older, with an attendance rate of 65 per cent.
Effect measure
The proportion of men and women aged 40 years and older in the Tromsø Study who consume less than five daily servings of fruit and vegetables, defined as at least 250 grams per day of vegetables and 250 grams per day of fruit and berries. Beverages (juice) and potatoes are not included. The proportions are age standardised according to the population of Norway 2016.
Interpretation and sources of error
The results from the Tromsø Study are estimated from a validated food frequency questionnaire with questions about consumption of 261 different foods, beverages, dishes and food supplements. Respondents were asked to indicate the frequency (how often do you eat …) and amount (how much…) of each food item, having one’s habitual diet (previous year) in mind. The food frequency questionnaire was handed out at attendance in Tromsø 7 and 72% of the 21,083 participants returned the questionnaire. Valid results from 11,425 respondents have been included. Possible sources of error in this type of data may be related both to the sample (selection of participants where the healthiest and highly educated attend to a larger degree) and to the variables (over- and underreporting of healthy and unhealthy foods, respectively).
Reference
Nilsen L, Hopstock LA, Grimsgaard S, Carlsen MH, Lundblad MW. Intake of Vegetables, Fruits and Berries and Compliance to "Five-a-Day" in a General Norwegian Population-The Tromsø Study 2015-2016. Nutrients. 2021 Jul 18;13(7):2456.
Global indicator definition
Indicator 16 Age-standardised prevalence of persons (aged 18+ years) consuming less than five total servings (400 grams) of fruit and vegetables per day.
National adaptation to global indicators
In the context of Norway, five servings are defined as 500 grams.
In the figures from Tromsø 7, at least 250 grams of vegetables and 250 grams of fruit was required to fulfil the recommendation.
The figures shown from Tromsø 7 apply to the ages 40 years and older.
The figures shown from Norkost 4 and Norkost 3 include ages 18 years and older, but they represent the age distribution in the dietary survey and are not age-standardised.