Prospective studies assessing the association between fibre intake or fibre-rich food consumption and the risk of CVD have often been limited by baseline assessment of diet. Thus far, no study has used yearly repeated measurements of dietary changes during follow-up. Moreover, previous studies included healthy and selected participants who did not represent subjects at high cardiovascular risk. We used yearly repeated measurements of diet to investigate the association between fibre intake and CVD in a Mediterranean cohort of elderly adults at high cardiovascular risk. We followed-up 7216 men (55–80 years) and women (60–80 years) initially free of CVD for up to 7 years in the PREvención con DIeta MEDiterránea study (registered as ISRCTN35739639). A 137-item validated FFQ was repeated yearly to assess diet. The primary end point, confirmed by a blinded ad hoc Event Adjudication Committee, was a composite of cardiovascular death, myocardial infarction and stroke. Time-dependent Cox’s regression models were used to estimate the risk of CVD according to baseline dietary exposures and to their yearly updated changes. We found a significant inverse association for fibre (Pfor trend=0·020) and fruits (Pfor trend=0·024) in age-sex adjusted models, but the statistical significance was lost in fully adjusted models. However, we found a significant inverse association with CVD incidence for the sum of fruit and vegetable consumption. Participants who consumed in total nine or more servings/d of fruits plus vegetables had a hazard ratio 0·60 (95 % CI 0·40, 0·96) of CVD in comparison with those consuming <5 servings/d.

The present study examined whether infants show an acceptance for extreme sour tastes and whether acceptance of sour taste is related to infants' fruit intake. Fruit intake of fifty-three infants at 6, 12 and 18 months was assessed using 3 d food records. Sour acceptance of these infants was studied at 18·1 (sd1·5) months. Acceptance for four solutions differing in citric acid concentrations (0·00 m, 0·013 m, 0·029 m and 0·065 m) was measured by allowing infants ad libitum ingestion of each solution over brief time periods. The base solution to which citric acid was added was blackcurrant squash diluted in water. Infants' relative intake of each solution was used as a measure of sour acceptance. At 18 months, twelve infants readily accepted the two highest citric acid concentrations, whereas the remaining infants rejected these. Infants who accepted the most sour solutions had a significantly higher fruit intake (P = 0·025) and a higher fruit variety (P = 0·015) at 18 months than the infants who rejected the highly sour taste. Furthermore, infants who accepted the most sour solutions consumed fruits more frequently at 18 months (χ2 5·1; P = 0·024). Infants who accepted the sourest solutions also had a higher fruit intake at 6 months, and a significantly higher increase in their fruit intake from 12 to 18 months. This is the first scientific study that demonstrates the acceptance of sour tastes in some infants at the age of 18 months. Furthermore, the present results suggest a relationship between acceptance of sour tastes and infants' fruit intakes.

The current ecological approach in health behaviour research recognises that health behaviour needs to be understood in a broad environmental context. This has led to an exponential increase in the number of studies on this topic. It is the aim of this systematic review to summarise the existing empirical evidence pertaining to environmental influences on fruit and vegetable (FV) consumption. The environment was defined as ‘all factors external to the individual’. Scientific databases and reference lists of selected papers were systematically searched for observational studies among adults (18–60 years old), published in English between 1 January 1980 and 31 December 2004, with environmental factor(s) as independent factor(s), and fruit intake, vegetable intake or FV intake combined as one outcome measure as dependent factor(s). Findings showed there was a great diversity in the environmental factors studied, but that the number of replicated studies for each determinant was limited. Most evidence was found for household income, as people with lower household incomes consistently had a lower FV consumption. Married people had higher intakes than those who were single, whereas having children showed mixed results. Good local availability (e.g. access to one's own vegetable garden, having low food insecurity) seemed to exert a positive influence on intake. Regarding the development of interventions, improved opportunities for sufficient FV consumption among low-income households are likely to lead to improved intakes. For all other environmental factors, more replicated studies are required to examine their influence on FV intake.

The National School Fruit Scheme (NSFS) provides one free piece of fruit each school day to children, aged 4 to 6 years, attending state schools in England. The aims of the present study were to determine if NSFS was associated with a higher fruit consumption in infant school children (4–6 years old), and to assess whether fruit consumption was higher in junior school children (7–8 years old) who had received free fruit as infants compared with those who had not. The present cross-sectional study involved seventeen schools, eight in the NSFS (study schools) and nine not in the NSFS (control schools). Study and control schools were selected in areas of similar levels of deprivation. All schools were on the outskirts of London in Southeast England. A retrospective 24 h food tick list was given to each pupil in Reception to Year 4 to take home for their parents to complete and return. Response rate was 51 %. Median total fruit consumption (excluding fruit juice) in infants receiving free fruit was 117 g/d compared with 67 g/d in infants not receiving free fruit (P<0·001). Median consumption in juniors who had received free fruit at school as infants did not differ from those who had not (83 g/d v. 86 g/d). The NSFS has increased fruit consumption in infant school children. It does not appear to have longer-term effects in junior school children. If the scheme is to affect dietary habits and improve health in the long term, further interventions will be needed.