title: Impact of fruit and vegetable vouchers and dietary advice on fruit and vegetable intake in a low-income population.
abstract: OBJECTIVE
  Lower-income subgroups consume fewer servings of fruit and vegetables (FVs) compared with their more advantaged counterparts. To overcome financial barriers, FV voucher delivery has been proposed.
  
  
  METHODS
  In a 12-month trial, 302 low-income adults 18-60 years old (defined by evaluation of deprivation and inequalities in health examination centers, a specific deprivation score) were randomized into two groups: dietary advice alone ('advice'), or dietary advice plus FV vouchers ('FV vouchers') (10-40 euros/month) exchangeable for fresh fruits and vegetables. Self-reported data were collected on FV consumption and socioeconomic status at baseline, 3, 9 and 12 months. Anthropometric and blood pressure measurements were conducted at these periods, as well as blood samples obtained for determination of vitamins. Descriptive analyses, multiple linear regression and logistic regression were performed to evaluate the impact of FV.
  
  
  RESULTS
  Between baseline and 3-month follow-up, mean FV consumption increased significantly in both the 'advice' (0.62±1.29 times/day, P=0.0004) and 'FV vouchers' groups (0.74±1.90, P=0.002), with no difference between groups. Subjects in the FV vouchers group had significantly decreased risk of low FV consumption (<1 time/day) compared with those in the advice group (P=0.008). No change was noted in vitamin levels (vitamin C and β-carotene). The high number of lost-to-follow-up cases did not permit analysis at 9 or 12 months.
  
  
  CONCLUSIONS
  In the low-income population, FV voucher delivery decreased the proportion of low FV consumers at 3 months. Longer-term studies are needed to assess their impact on nutritional status.
authors: UMR U557 INSERM; U1125 INRA; Université Paris 13; Centre de Recherche en Nutrition Humaine IdF, Bobigny, France. h.bihan@uren.smbh.univ-paris13.fr
authors: H
authors: H
authors: Bihan
authors: C
authors: C
authors: Méjean
authors: K
authors: K
authors: Castetbon
authors: H
authors: H
authors: Faure
authors: V
authors: V
authors: Ducros
authors: A
authors: A
authors: Sedeaud
authors: P
authors: P
authors: Galan
authors: H
authors: H
authors: Le Clésiau
authors: S
authors: S
authors: Péneau
authors: S
authors: S
authors: Hercberg
mesh_terms: D000293:Adolescent; D000328:Adult; D003376:Counseling; D004032:Diet / Q000191:economics* / Q000592:standards; D005260:Female; D005522:Food Services; D005523:Food Supply; D005638:Fruit; D006266:Health Education; D006801:Humans; D007182:Income; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011203:Poverty; D057566:Self Report; D012923:Social Class; D012946:Social Welfare; D014675:Vegetables; D055815:Young Adult