National Food Strategy calls for fruit and veg prescriptions - here are the UK areas where people are least likely to get 5 a day

People in England are more than twice as likely to get their ‘five-a-day’ of fruit and vegetables than those in Scotland and Wales, with barely one in six Scots eating enough portions in some parts of the country.

NationalWorld analysed survey data from Public Health England and the Scottish, Welsh and Northern Irish governments to find where in the UK people are most averse to their greens.

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It comes as England’s National Food Strategy, published on Wednesday (15 July), recommended GPs prescribe fruit and vegetables to encourage healthy eating. It also called for the introduction of a salt and sugar tax for manufacturers.

The figures show Scotland had the worst record for fruit and veg consumption, with just 22% of the population saying they ate at least five portions the day before they were interviewed.

That compared to 25% in Wales, 44% in Northern Ireland, and 55% in England.

Survey methods between the four nations varied. People in Scotland were asked detailed questions on the quantities of salad, pulses, fruits and vegetables consumed – for instance, how many tablespoons of vegetables they ate.

In England, people were simply asked how many portions of fruit and vegetables they ate, with guidance on what did and did not count.

‘Food deserts’

The figures – which also reveal huge disparities between local areas – pre-date the pandemic, with food charity Sustain warning that Covid exacerbated existing inequalities that led to some people being unable to access a healthy diet, such as poverty and disability.

Sofia Parente, campaigns manager at Sustain, said the poorest households would have to spend 42% of their income on food, post-housing costs, to meet Public Health England’s Eatwell Guide.

The result is 3.7 million children in the UK living in households earning less than £15,860 who are unable to afford a healthy diet, she said.

A lack of access also impacts people with mobility issues, she added, with some neighbourhoods dominated by shops selling hot food takeaways leaving people reliant on cars or buses to reach supermarkets selling fruit and vegetables.

“These so-called food deserts are real in many parts of the country and again impact on those on the lowest incomes,” Ms Parente said.

Which areas eat the least fruit and veg?

England

England’s figures, which come from Sport England’s Active Lives Survey for 2019-20, are broken down by council area.

They reveal that people in Stoke-on-Trent in the West Midlands eat the least fruit and veg, with only 41.4% getting their five-a-day.

That was followed by Blackburn with Darwen (43.8%), Knowsley (43.8%), Redcar and Cleveland (44.1%) and Rochdale (44.4%).

The North West region performed the worst, with 51.2% of people eating at least five portions.

The results for each region were:

Scotland

Figures for Scotland are published in the government Scottish Health Survey and are broken down by health board. National figures are for 2019 and local figures are for 2016-19.

The Ayrshire and Arran Health Board and Shetland Health Board areas were ranked worst in Scotland – and the UK – with just 15% saying they eat their five-a-day.

That was followed by Lanarkshire (16%), Western Isles (19%), and Dumfries and Galloway and Grampian (both 20%).

Out of all the councils in England and health board or trust areas in Scotland, Wales and Northern Ireland, 14 of the bottom 25 areas are in Scotland.

Best performing was the Lothian health board area – but even there just 29% of adults ate the recommended portions, far lower than even the worst performing area in England (41%).

Overall, women ate an average of 3.3 portions and men 3.2.

The results for each health board were:

Wales

Wales’s figures were slightly better than Scotland’s, reaching a low of only 26% in the Betsi Cadwaladr Health Board area in North Wales.

Best performing was the Cardiff and Vale area, at 32%, followed by Aneurin Bevan Health Board in Newport and South East Wales, at 30%.

Data for both 2018/19 and 2019/20 are combined for local areas in Wales because of small sample sizes.

The results for each health board were:

Northern Ireland

In Northern Ireland, people living in the Northern Health and Social Care Trust were least likely to get their five-a-day, with 40% saying they ate at least that amount.

The South Eastern and the Southern trust areas were top of the pack on 47%.

The results for each trust were:

Why do people not eat enough fruit and veg?

The NHS says every adult should eat at least five 80g portions of fresh, frozen, canned, dried or juiced fruit and veg a day, excluding potatoes.

Fruit juices and smoothies can only count as one portion no matter how much you drink.

Figures for every region show that men are less likely than women to eat enough fruit and veg, while data for England, Wales and Northern Ireland show the most deprived areas lagging far behind the least deprived.

In England, 48.8% of people in the bottom 10% of council areas by deprivation ate five portions compared to 60.1% in the top 10%.

In Wales, the gap was 19% in the poorest fifth of neighbourhoods compared to 30% in the richest fifth, and Northern Ireland it was 39% compared to 54%.

England’s figures meanwhile show 52.1% of disabled people ate five portions versus 56.4% of non-disabled people, while black people were far less likely than average to hit the daily recommendation – 45.7% versus the national average of 55.4%.

“There are many issues that influence access to fruit and vegetable consumption at the heart of these inequalities,” Ms Parente said.

“Calorie for calorie, the price of food high in fat, sugar and salt are a third of the cost of vegetables.

“Convenience is another major issue. In the UK almost 50% of our shopping basket is made of ultra-processed foods which are low in vegetables.

“Food advertising on all media is dominated by foods high in fat, sugar and salt.

“Covid has further exacerbated these inequalities. It became quickly evident during the pandemic that for those on low incomes or not able to access free school meals or fruit and vegetables, consumption of vegetables dipped below already existing low levels.

“We try and fight this state of affairs but I would say we need bolder action by governments.”

Author of the National Food Strategy report Henry Dimbleby said: “The food system is a logistical miracle, full of amazing, inventive people.

“With the right leadership from government, it is well within our power to change the system so it makes both us and the planet healthier.

“Currently, however, the way we produce food is doing terrible damage to the environment and to our bodies, and putting an intolerable strain on the NHS.

“Covid-19 has been a painful reality check.

“Our high obesity rate has been a major factor in the UK’s tragically high death rate.

“We must now seize the moment to build a better food system for our children and grandchildren.”

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