Low fruit and vegetable (FV) intake is a public health concern in Malta, where more than one in four adults are living with obesity and only approximately 12% meet the recommended five-a-day intake (1) . Socioeconomic disparities can contribute to a poor diet, with international evidence pointing to disadvantaged groups consuming fewer FV (2) . The main aims of this local study were to assess FV intakes, perceptions and drivers including barriers, among adults residing in Malta. This cross-sectional study used an anonymised, convenience sampling design with an online survey (via Google Forms) disseminated on social networks in April-June 2024. The questionnaire (33 items) covered demographics, FV consumption frequency, barriers and suggested improvements. Ethical approval was obtained from the University’s Faculty Research Ethics Committee (FREC ID: FHS-2023-00664). Chi-square tests (or Fisher- Freeman-Halton Exact tests) and Spearman’s correlations were utilised for analysis, and with cross-tabulations used for suggestions for increased consumption. 315 respondents returned the survey (mean age 44.5 years, range 18–65 years; 72% female) and with a mean body mass index (BMI) of 26.4 kg/m 2 (SD= 5.66). Mean daily consumption was 1.7 and 1.8 FV portions respectively. Age was positively correlated with fruit intake (p=0.001), with older adults consuming fruit more frequently, but vegetable intake showed no significant correlation with age (p=0.39). Participants in lower income brackets were significantly more likely to report cost as a barrier to FV consumption (p=0.001) than those in higher-incomes. Comparing two districts with contrasting high and low-at-risk-of-poverty (ARP) rates classified according to 2022 statistics (National Statistics Office, NSO, 2023) (3) , higher proportions of Northern Harbour respondents had higher incomes despite living in a higher ARP district, and reported earning over €50.1k annually (30.7%) compared to 21.9% in the South Eastern (low-ARP) district, whereas participants earning between €15.1–€20k were more represented in the South Eastern district (21.9%) than in Northern Harbour (1.8%). These income differences were significant (p=0.005). Suggested community improvements for FV access based on income levels revealed that a majority of lower-income participants looked for lower prices (55.6% in €50.1k bracket) and a quarter reported no community improvements needed. Cost was more frequently reported as a barrier to FV consumption (p<0.001) among non-EU participants (44.4%) and Maltese participants (41.3%) compared to other EU nationals (14.3%). In conclusion, Maltese adults’ FV intakes fall short of dietary recommendations, and affordability barriers affect those in less affluent groups, reflecting socioeconomic barriers exist for FV consumption. There is a need to focus on targeted approaches such as providing subsidies for low-income pockets and different age groups within communities and different nationalities, regardless of district, in an effort to improve FV consumption in Malta.
Reci et al. (Fri,) studied this question.