how can the consumption of vegetables in europe be increased ?
DESCRIPTION
Everyone is aware nowadays that it is advisable to consume ‘at least 5 portions of fruit and vegetables per day’. Consumer information is not the issue: it is necessary to ask oneself what other factors are limiting consumption. More cases studies on : http://www.fondation-louisbonduelle.org/france/en/health-professionals/cases-studies.htmlTRANSCRIPT
How canthe consumption of vegetables in Europebe increased ?
Increased consumption of fruit and
vegetables is a major issue for public health and is
the subject of nutritional recommendations throughout
Europe. Yet despite the policies which have been
implemented and the knowledge amongst consumers
regarding the virtues of fruit and vegetables, there is
no way of avoiding the fact: the majority of Europeans
do not follow the recommendations. In Europe, the
average consumption of fruit and vegetables is only
220g per person per day for adults instead of the
400g minimum recommended by the World Health
Organisation (WHO). What are the driving factors
behind this consumption and the obstacles to be
confronted and, most importantly, overcome? For
many years now, numerous measures have been
implemented throughout the EU in response to
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increasing the consumption of fruit and vegetables.
Without attempting to deliver a comprehensive
analysis, over the following few pages the Louis
Bonduelle Foundation will present an overview of the
consumption of fruit and vegetables in Europe… and
suggest a few ways by which it might be increased.
Today in Europe, six of the seven major risk factors re-
garding premature death in adults are linked to the way
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and vegetables is associated with these six factors. A re-
vealing statistic: just 27% of European mothers consume
over 400g of these foodstuffs per day, in line with the re-
commendations of the World Health Organisation (WHO).
Of course, this is only an average and there are wide va-
riations, not only between regions, with those in the south
showing better results than those in the north, but also in
terms of individual socio-economic status. Such variations
give an insight into the scale of the problem: there are
multiple determinant factors regarding the consumption of
fruit and vegetables and numerous obstacles. In order to
be effective, action taken to increase consumption must
work on several different levels at the same time.y
«Everyone is aware nowadays that it is advisable to consume
‘at least 5 portions of fruit and vegetables per day’. Consumer
information is not the issue: it is necessary to ask oneself what other
factors are limiting consumption.»
www.fondation-louisbonduelle.org
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Sustainable evolution
of eating habits
p. 2 - How can the consumption of vegetables in Europe be increased ?www.fondation-louisbonduelle.org
Observations Evolution of the level of fruit and vegetable
consumption
In the majority of countries in Europe, the average
daily consumption of fruit and vegetables has been cal-
416#$!&"#$"7789"5!'"#&16$%"#"3"91'!" :(4:"(0" !66";!6+ "$:!"
WHO recommendations of 400g minimum [1]. For children,
on average they only eat 80g of fruit and vegetables per
day: it is estimated that only between 6% and 24% of them
reach the level recommended by the WHO. But behind this
average we observe a wide variation amongst EU member
states, and also within the various countries themselves.
FRANCE, AN AVERAGE PUPIL REPRESENTATIVE
OF EUROPEAN TRENDS
2001 saw the birth of the PNNS (national programme for
nutrition and health), launched by French authorities, and
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tion to “eat at least 5 portions of fruit and vegetables per
day”."=#$#" 2'+," $:!"3"'0$" >?@/" A)#$(+)#6" ()&(-(&1#6"&(!$#'B"
consumption) survey, collected between 1998 and 1999,
showed that about 60% of adults then consumed less than
two portions of vegetables and less than one-and-a-half
portions of fruit per day. Eight years later, the INCA 2 sur-
vey carried out between 2006 and 2007 shows that these
consumption levels have remained broadly stable in both
adults and children, although a slight increase in consump-
tion by adult females was observed during the period. Ve-
getable consumption amongst the French has stagnated
at around 170g per person per day for adults and 100g for
children.
But although remaining broadly constant, vegetable
consumption demonstrates many different variability fac-
tors which are to be found in most European countries.
“It is higher in the south of France than in the north, rises
with higher levels of education and varies in line with age,
between generations, according to income, etc.”, explains
Lionel Lafay, the manager of the dietary consumption and
epidemiology monitoring unit at Anses (formerly Afssa), the
French agency for food, environmental and occupational
health and safety. Accordingly, the overall consumption
of fruit and vegetables varies between 280g and 700g per
person per day. This spread is mainly due to the variation
in vegetable consumption which is more pronounced than
for fruit, the end result being that one adult in two is in the
“low consumption” category (i.e. consuming less than two
portions per day, or 160g). Furthermore, while older people
(55-79 years old) consume on average 202g of vegetables
per day, young adults (18-34) consume about one-third
less (133g per day on average).
VARIATIONS BETWEEN THE COUNTRIES OF EUROPE
Let us now turn to the variations across Europe in fruit
and vegetable consumption. Dietary reports by the Uni-
ted Nations Food and Agriculture Organisation (FAO),
which present the observable total consumption of fruit
and vegetables, highlight the large differences
National recommendations for the
consumption of fruit and vegetables
vary considerably from one European
region to another. Many countries have
opted for a combined recommended
consumption of fruit and vegetables,
without distinguishing between the two,
of between 3-5 portions per day and
5-9 portions per day. On the other hand,
some countries do differentiate between
fruit and vegetables. Whatever the situa-
tion, many countries, like France, lead
a national campaign to encourage the
consumption of fruit and vegetables:
“5-a-day” in the UK, “6 om dagen” in
Denmark, “5 am Tag” in Germany, “2 +
2 a day” in the Netherlands, etc. “Howe-
ver, target levels for fruit and vegetable
consumption in the national nutrition po-
licies of certain Nordic and Western Eu-
ropean countries are too low ”, bemoans
Laura Fernandez-Celemin, the manager
!"#$%&'()&*#%#+ +&"$#+)#,-./0#1,2"!3'+(#
Food Information Council).
As reported at the Louis Bonduelle Founda-
tion Conference, Paris, June 2010.
Recommendations are not always consistent across Europe
Due to their nutritional make-up, vegetables are a
weak source of calories and fat and make a significant
contribution to the intake of fibre and micronutrients.
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+(:#)5'#$'%!(:#&(#+:29)$#1;?=>#+ )'"#8"'+:#3"!:2%)$@#
At the same time, they are the main source of beta-
carotene and vitamin B9 for both adults and children.
They are also one of the five main sources for B1,
B5, B6 and C vitamin intake in adults. And finally, ve-
getables are the number one source of potassium in
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for copper, iron, magnesium and manganese for both
+:29)$# +(:# %5&9:"'(@# 45'6# +9$!# %!()"&82)'# <=#! # )5'#
adult calcium intake.
As reported at the Louis Bonduelle Foundation Conference,
Paris, June 2010.
Nutritional intake from vegetables
amongst the French population
>>
How can the consumption of vegetables in Europe be increased ? - p. 3 www.fondation-louisbonduelle.org
DUTOURDUMONDE - FOTOLIA.COM
In Poland, in adults the daily consumption of vegetables
amounts to 295g and 282g for fruit.
In the UK, the average consumption of fruit and vege-
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In Portugal, children consume 112g of vegetables per
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Spain and 80g in France.
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fruit and vegetables per day.
The average amount of processed fruit and vegetables
consumed is 26g per person per day in France, as
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As reported at the Louis Bonduelle Foundation Conference, Pa-
ris, June 2010, and the EGEA Conference in Brussels, May 2010.
A few consumption
statistics by country
between countries in the south of Europe, who show
high consumption levels, and the countries in the north
and east of Europe who have low consumption levels.
The EPIC study, carried out at 27 health centres spread
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consumption of fruit and vegetables is highest in Mediter-
ranean countries and that the lowest consumption levels
are recorded in Scandinavia and the Netherlands, in both
men and women [2]. This north-south divide in Europe is
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chases [3]. However, consumption studies carried out in
the Scandinavian countries such as the Monica study in
Sweden [4], the AVTK survey in Finland [5] or the national
individual dietary consumption study in Denmark [6], show
an increase in the consumption of fruit and vegetables in
these traditionally low consumption countries. In the long
term, the north-south divide may shrink if this trend per-
sists.
Furthermore, while the consumption of fruit and ve-
getables remains too low in most EU countries, this is
particularly true amongst the lowest income groups. For
example, the daily consumption of fruit and vegetables
for people at the lower end of the income scale in France
is just 2.1 portions (1.2 portions of fruit and 0.9 of vege-
tables, a total of 170g) [7], and is just below 2.5 portions
(200g) in the UK, where only 9% of young women follow
the recommendations [8].z
>>
“Everyone is aware nowadays that it is advisable
to consume ‘at least 5 portions of fruit and vegetables
per day.’ Consumer information is not the issue: it is
necessary to ask oneself what other factors are limiting
consumption”, observes Prof. Pierre Combris. Experts
are beginning to understand these factors. Age, sex and
socio-economic status must be combined with other de-
terminants, such as food preferences, culinary knowle-
dge and skill, and product accessibility. And without for-
getting other personal factors such as time constraints,
personal values, the concept of a balanced diet or a lack
of control over one’s diet. Added to this are factors lin-
ked to the social environment such as other people’s
attitudes, social pressure or family mealtime ha-
Determinants and obstacles
to the consumption of fruit and vegetable
>>
Sustainable evolution
of eating habits
p. 4 - How can the consumption of vegetables in Europe be increased ?www.fondation-louisbonduelle.org
Not all countries in Europe share the position where
people with high levels of education eat more vege-
tables than those in lower socio-economic groups. A
Finnish team [22] compared the relationship between
socio-economic status and consumption of vege-
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Spain, Estonia, Finland, France, Italy, Latvia and Li-
thuania). In France, Italy and Spain, the level of edu-
cation turns out to reveal little about the consumption
of vegetables: those with the highest qualifications
consume slightly fewer vegetables than the rest. On
the other hand, in the Nordic and Baltic countries, the
relationship is a strong one and, conversely, those
with the highest qualifications are daily consumers
of vegetables. These results suggest that a positive
association between the level of education and the
consumption of vegetables is dependent on the avai-
lability and accessibility of vegetables. In fact, it is in
those countries where there is a low availability and a
high price of vegetables that the level of education is
a positive influence on consumption.
Variable determinantsaccording to context
bits, all of which influence dietary preferences and
guide dietary choices and behaviour [9]. And while the
consumption of fruit and vegetables is stagnating des-
pite public promotional campaigns about nutrition and
health, it must be concluded that a number of obstacles
lay behind these factors.
AGE AND HOUSEHOLD COMPOSITION:
TWO KEY FACTORS
According to data collected in France by TNS World-
panel in 2007, the variables which have the greatest ef-
fect on vegetable consumption are age and household
composition. Regarding the second of these factors, in
France we can observe that families with children and
single men consume fewer vegetables than single wo-
men and couples without children [10]. As for age, with
adults there is a positive correlation between the quanti-
ties and the type of fruit and vegetables consumed. “The
effect of age is more marked in the case of fresh fruit and
vegetables than for tinned and frozen produce, but the
graphs show very similar evolution patterns: consump-
tion increases consistently until about 60-65 and then
falls off”, says Prof. Combris. “The important point is to
make a clear distinction between life cycle effects and
those which are generational: at the same age, the youn-
ger generations now consume fewer fruit and vegetables,
especially fresh produce, than preceding generations.”
And these age and generation related effects are not only
observed in France. In the United Kingdom [11] and also
in Sweden [12], for example, we can observe a lower
consumption of fruit and vegetables by young adults than
by older people. Accordingly, if today’s young Europeans
maintain their specific dietary habits, their consumption
of fruit and vegetables will remain much lower than that
of preceding generations. It is therefore vital to combat
this long-term trend towards a significant reduction in the
average consumption level of these healthy foodstuffs.
SOCIO-ECONOMIC STATUS: A DETERMINANT
OF THE CONSUMPTION OF FRESH VEGETABLES
The socio-economic status of the household, namely its
income and educational level, also constitutes a strong
determinant of the quantity and variety of vegetables
consumed [13-14]. Purchasing data for French house-
holds by TNS Worldpanel 2007 reveals that 15% of the ri-
chest households buy more than 12kg of extra vegetables
per person per year compared to the poorer households
(the average amount of vegetables - fresh and processed
excluding potatoes – consumed being 64kg per person
per year) [10]. But this effect of socio-economic status
is not the same for all types of vegetables. With the help
of this data, a team at INRA has attempted to assess
whether the consumption of fresh and processed vege-
tables is governed by the same determinants [10]. The
result: the consumption of fresh vegetables follows the
same determinants as vegetables in total (namely age,
household structure and income), while the purchase
of processed products remains at similar levels for all
households. So it is the consumption of fresh vege-
tables which determines the main differences in the to-
tal consumption of vegetables, even though researchers
discovered a reduction in the proportion of processed
vegetables linked with the advance of age, and also with
higher income and higher qualifications.
Fact: processed products have been adapted to consump-
tion habits and pricing trends have put fresh products at a
disadvantage. “Between 1960 and 2005, the price of fresh
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compared to this average”, explains Prof. Pierre Combris.
As a result, “fresh fruit and vegetables have now become
a real ‘social indicator’ ”, the researcher notes.
But beware. Although many countries in Europe confirm
this trend [15-16], it cannot be generalised to include
countries with high levels of fruit or vegetable produc-
tion, such as Greece, Spain, Portugal, Poland and Hun-
gary, where the highest levels of consumption are to be
found. In these countries it is even possible to observe
the opposite trend, namely higher consumption of fruit
and vegetables amongst those of low socio-economic
status [9].
BETWEEN RATIONAL CHOICE
AND EMOTIONAL NEED…
To the effects of age, generation, household composi-
tion and socio-economic status we must add those fac-
tors associated with the individual or the products. >>
>>
How can the consumption of vegetables in Europe be increased ? - p. 5 www.fondation-louisbonduelle.org
MBT_STUDIO - FOTOLIA.COM
Increasing the consumption of fruit and vege-tables is a public health priority and therefore consti-
tutes the main objective of numerous initiatives across
Europe. Practical experience has highlighted a number of
key elements in terms of the effectiveness of such inter-
ventions. Accordingly, conclusions from the INRA collec-
tive scientific assessment suggest an effective approach
is “an approach which takes different components into
account, based not only on personal factors but also on
variations in the living space and social environment of
the target group, the support and commitment shown by
decision-makers and representatives of the target popu-
lation regarding the planning and implementation of the
initiative, and its durability over the long term.” [9].
Interventions Removing obstacles to consumption
ACTION AT THE INDIVIDUAL LEVEL
A number of strategies can be used to encourage be-
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playing on consumer preferences and motivations. It in-
volves initiatives in the areas of nutritional education, infor-
mation marketing and “5-a-day” campaigns which aim to
increase consumer demand. Experience shows that they
play a positive role by improving the understanding and
perception of fruit and vegetables. However, “they are not
able to overcome all obstacles to consumption”, observes
Prof. Combris. And the reason: they do not take into ac-
count the fact that individual determinants of consumption
(knowledge, intentions, attitudes, motivations) and fac-
tors linked to social environment play an equally im-
>>
>>
Amongst product-related factors, we think first of all
of price. Compared to that of many energy-rich foods-
tuffs which provide sugars and fats at the same time as
giving immediate satisfaction, the price level of fruit and
vegetables puts them at a disadvantage, which may part-
ly explain the low consumption amongst the poor. And,
because what we decide to eat is not determined simply
by our physiological or nutritional requirements, choo-
sing often presents a dilemma between reason, which
demands a fruit salad, and emotion, which encourages
you to succumb to a chocolate cake.
Much more than the price of the product, where sensiti-
vity is affected by hedonistic and social factors [ 17], it is
the “cost/sacrifice” relationship which plays a role in our
motivation to consume more fruit and vegetables. Within
the “cost/sacrifice” balance the senses also play a part,
including bitterness [18] and the cooking odours of some
vegetables [19], which have been clearly identified as
presenting a barrier to consumption. And finally, another
factor in the equation: time, which not only includes the
time available to the consumer, often put forward as a
barrier to the consumption of fruit and vegetables [20],
but also the amount of time the product can be kept for.
Accordingly, alongside shopping habits and the consu-
mer’s storage facilities, the perishability of the product
may also present an obstacle to the act of purchase [21].
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INRA [9], Patricia Gurviez, a lecturer in marketing and
consumer behaviour at AgroParisTech, sums up the situa-
tion as follows: “It can be stated that for many consumers
in the West, fruit and vegetables are neither cheap, prac-
tical, convenient nor easy to store, and are also perceived
as time-consuming to buy and cook, and require a certain
know-how.” z
Sustainable evolution
of eating habits
p. 6 - How can the consumption of vegetables in Europe be increased ?www.fondation-louisbonduelle.org
The younger generations represent the target of
choice for nutritional initiatives, but why? Firstly,
because they often steer clear of vegetables due to
their sensory properties and low energy value, conse-
quently there is a high risk of the young falling short of
their micronutrient requirements. Secondly, because
dietary habits and preferences are formed in early
childhood, especially in terms of fruit and vegetable
consumption: people who consume most vegetables
during childhood are also those who consume most
in adolescence and adulthood. And lastly, for young
children to accept vegetables, nothing beats repeated
exposure, both during and after introduction to solid
!!:$#PDIQ@#
Why target the young? portant role. Accordingly, nutritional education, irres-
pective of the duration of the initiative and the arguments
used (whether positive or moralising) rarely lead to real
behavioural change [23-24]. The impact of such initiatives
proves even less effective amongst lower income groups
who are unable to implement the recommendations due
to their dietary habits, the constraints of their environment
and their income levels [23].
As for informational marketing tools (dietary pyramids, nu-
trition labels, targeted advertising, promotion of “5-a-day”,
etc.), they all suffer from a major weakness: the recommen-
dations tend to seem unrealistic for the people in ques-
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of culturally-targeted information [26], of varied angles of
attack [27], of promoting consumption frequency rather
than portion size [28] and of leading separate campaigns
for vegetables and fruit [3].
LEADING TARGETED CAMPAIGNS
One way of improving the effectiveness of such initiatives
is to lead nutrition policy campaigns targeted for example
at an age range or a vulnerable subpopulation, and at local
6!-!6%"!.9."#$"#"05!4(3"4"04:++6"+'" ($:()"#"5#'$(416#'"4+,,1<
nity. The objective remains to stimulate demand through
information and education, but such targeting also has a
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In view of the importance of the socio-economic determinant
and the low consumption of fruit and vegetables amongst
vulnerable groups, it is important that they receive priority
treatment as part of such initiatives. In France, one study
therefore assessed the impact on a disadvantaged group gi-
ven “Fruit and vegetable vouchers” [7]. The results demons-
trate the possibility, using this method, of reducing the pro-
portion of consumers with very low consumption of fruit and
vegetables, namely those eating less than one portion a day.
/0"$:!0!"()($(#$(-!0"#'!"-!'B"4+0$6B%"$:!"05!4(3"4"$#'9!$()9"+2"
consumers with the greatest need opens up interesting pos-
sibilities. Similarly, in the UK the Healthy Start Programme
concentrated mainly on women with low incomes, either
pregnant or with young children. The assessment showed
a positive impact: an increase in consumption of fruit and
vegetables to 3.3 portions per day on average, with 18% of
;!)!3"4(#'(!0"'!#4:()9"'!4+,,!)&!&"6!-!60"F7LH."
One other priority target group: the younger generations. To
this end, the school environment constitutes a special acti-
vity area, whether for nutritional education initiatives, for the
distribution of fruit and vegetables, or for introducing garde-
ning projects. Amongst activities carried out with children,
we can cite the ProChildren project which targets children
between the ages of 11-12 in nine European countries. The
chosen tools: the distribution of fruit and vegetables in scho-
ols, the organisation of class-based workshops, the distri-
bution of customised information by computer and activities
to be performed at home within the family environment. The
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fruit and vegetables, an increase which was maintained one
year after the study, and the importance of the availability of
fruit and vegetables at home [30].
N2"&(B#)5'#$'%!(:#(+)&!(+9#&(:&A&:2+9# !!:#%!($273)&!(#$)2:6#1/R0S#E>#%+""&':#!2)#&(#."+(%'#8')C''(#EFFLTEFFUG#
a series of questions was put to participants to assess the extent of food insecurity and to characterise those who
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of food insecurity, namely that they experience inadequate access in terms of quality or quantity to a healthy and
acceptable diet. Even if such people do not always have a low income, they are confronted with extremely difficult
financial challenges. Their consumption of fruit and vegetables is even lower than those from the low income group
C5!#:!#(!)# +99#2(:'"#)5'#%+)'B!"6#! # !!:# &($'%2"&)6G#(+7'96#EU<B#+(:#DEFB#! # "2&)#+(:#A'B')+89'$#"'$3'%)&A'96#
per day. Their diet shows an energy-rich intake which is higher than the rest of the sample group and one which is
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million who receive assistance from the various food charities and organisations, and equates to over five million
people experiencing high dietary vulnerability who do not receive any assistance at all. From which arises the neces-
sity to take action for those who do not benefit from assistance in order to reach everyone who finds themselves in
a position of food insecurity.
12,2 % of people in France are in a position of food insecurity
>>
>>
How can the consumption of vegetables in Europe be increased ? - p. 7 www.fondation-louisbonduelle.org
MONKEY BUSINESS - FOTOLIA.COM
In order to increase the consumption of fruit and vege-
tables, some companies, such as the Dutch cooperative
Hoogsteder, are developing more attractive products for
the consumer. Based on the observation that consumers
are never attracted by a product if they don’t know how
ripe it is or how to prepare it, and often make impulsive
purchases based on their own experiences, the cooperative
has developed a range of fully ripe fruit. These come under
the category of ready-to-eat foodstuffs and help to guide
consumers as they make their purchases. But this way of
marketing products has its limits: it is only suitable for a
9&7&)':#(278'"#! #3"!:2%)$#1'W!)&%# "2&)$G#3'+"$G#3'+%5'$G#
etc.), mainly affects only customers of the large supermarket
chains and suffers from higher prices.
Source: “Nutrition & Health Village” conference during SIAL,
Paris, October 2010.
Innovative ways of improving productsFurthermore, a study performed in Norway highlights
the importance during such initiatives of the free distribu-
tion of produce in order to encourage the involvement of
the most disadvantaged groups [31]. Accordingly, in the
United States, a pilot programme introduced by the USDA
AM)($!&"N$#$!0"=!5#'$,!)$" +2" /9'(416$1'!O" ;!)!3$!&" 2'+,"
six million dollars for the school year 2002/2003. The ob-
jective: to encourage the consumption of fresh fruit and
vegetables in 107 primary and secondary schools in four
0$#$!0" ($:"#)"!P5!)&($1'!"+2"QLR"5!'"515(6."E:(0"0(9)(34#)$"
subsidy, combined with the strong commitment of the pu-
pils, parents, head teachers and teachers, as well as that
of the catering staff, all contributed to the programme’s
success [32].
VARIETY OF PRODUCE
/)&"3)#66B%"+)!"+$:!'" #B"+2"()4'!#0()9"$:!"4+)01,5$(+)"+2"
fruit and vegetables: greater product variety. To this end,
everyone involved in the sector (producers, processors,
distributors) has their own distinctive role to play: improve
the sensory and nutritional properties of the produce; make
them easier to use by adapting them to consumer behaviour
and habits; and all the while making sure they are affordable.
But the complexity lies in combining these three rules.
Accordingly, fruit and vegetables can be adapted to snac-
king trends, with healthy products which can be consu-
med without cutlery and between meals. But while this ap-
proach may work in the Netherlands and Germany where
the availability of fruit and vegetable snacks for consump-
tion in the middle of the day has become fairly common-
place over recent years, this concept has not been so easy
to establish in France. Several trials have been set up, but
only destalked radishes have met with any success. Price
probably remains a barrier. We can therefore see the im-
portance of always adapting the product to the culture of
the country and the context in which it is marketed: where
raw fresh vegetables are a luxury, their promotion has
less impact on buying patterns than in producer countries
where they are generally more affordable. Another solution
>>
to encourage the purchase of fruit and vegetables is to
adapt the packaging to the modern family unit, in order to
reduce waste and reduce the price. There is therefore an
enormous amount of work to be done, but it is worth the
!22+'$%" #0";B" '!,+-()9"0!)0+'B";#''(!'0"#)&"&(23416$(!0"+2"
utilisation, according to Prof. Combris, “in the long term,
innovation in terms of variety and product remain the most
promising avenues for adapting the fruit and vegetables on
offer to the tastes and practices of the consumer.”
In summary, to increase the consumption of fruit and ve-
getables, products must be available everywhere and ac-
cessible in all senses of the word: physically present, at
affordable prices, and people must know how to use them,
all of which involves them becoming part of their normal
repertoire of foodstuffs which can then be integrated into
their diet. Accordingly, it is not enough to simply improve
access to fruit and vegetables, consumers need support.z
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Sustainable evolution
of eating habits