Primary care Behavioural counselling to increase consumption of fruit and vegetables in low income adults: randomised trial

Objective To measure the effect of brief behavioural counselling in general practice on patients’ consumption of fruit and vegetables in adults from a low income population. Design Parallel group randomised controlled trial. Setting Primary health centre in a deprived, ethnically mixed inner city area. Participants 271 patients aged 18-70 years without serious illness. Intervention Brief individual behavioural counselling based on the stage of change model; time matched nutrition education counselling. Main outcome measures Self reported number of portions of fruit and vegetables eaten per day, plasma carotene, tocopherol, and ascorbic acid concentrations, and 24 hour urinary potassium excretion. Assessment at baseline, eight weeks, and 12 months. Results Consumption of fruit and vegetables increased from baseline to 12 months by 1.5 and 0.9 portions per day in the behavioural and nutrition groups (mean difference 0.6 portions, 95% confidence interval 0.1 to 1.1). The proportion of participants eating five or more portions a day increased by 42% and 27% in the two groups (mean difference 15%, 3% to 28%). Plasma carotene and tocopherol concentrations increased in both groups, but the rise in carotene was greater in the behavioural group (mean difference 0.16 mol/l, 0.001 mol/l to 1.34 mol/l). There were no changes in plasma ascorbic acid concentrations or urinary potassium excretion. Differences were maintained when analysis was restricted to the 177 participants with incomes ≤ £400 (€596, $640) a week. Conclusions Brief individual counselling in primary care can elicit sustained increases in consumption of fruit and vegetables in low income adults in the general population.