an age - group stratified ( 1824 , 2534 , 3544 , 4554 , 5564 , 6574 , and 7584 y ) geographically representative random sample of 2,604 swedish inhabitants with an equal number of women and men was selected by swedish national tax agency in 2007 .
the respondents were divided into equally large summer and autumn groups to cover the possible seasonal variation in f&v consumption . a questionnaire enclosed with an invitation letter
the respondents were also given a web - based questionnaire as an alternative measure ; this was done to encourage respondents who find a traditional pen - and - paper questionnaire too time - consuming to complete the survey . as compensation ,
the respondents could receive a short report of the main results of the study , if they wished .
a few weeks after the first circular , a reminder letter was sent to the non - responders . to increase the response rate ,
a second reminder was sent to all non - respondents in january 2008 . for a detailed picture of the study design ,
the returned questionnaires were treated confidentially , the respondents gave their informed consents , and the swedish research council 's guidelines for good research practice ( 30 ) were followed in conducting the present study .
detailed information regarding consumption of different kinds of f&v was collected using a 13-item self - administered 24-h recall and a 12-item food frequency questionnaire ( ffq ) .
respondents were asked to report consumed amounts either in deciliters or number of portions in the self - administered 24-h recall ( e.g.  did you eat apples yesterday and , if yes , how many? ) .
the ffq included eight response categories for each item (  never,  less than once / week ,  once / week,  24 times / week,  56 times / week,  once / day, two times / day, and  more than twice a day ) , indicating the average consumption frequencies for salad / raw and cooked vegetables as well as for fresh fruit and fruit juice ( e.g.  how often do you usually eat fresh fruit? ) .
both the ffq and the self - administered 24-h recall were based on a validated questionnaire where no differences were observed between the 24-h recall and one - day weighed food record of f&v ( 31 ) . in addition , the ffq showed a correlation coefficient of 0.73 for total f&v with a seven - day food record ( 31 ) .
the present questionnaire was also pre - tested on 20 swedish adults , and one focus group interview ( n=5 ) was held in which respondents discussed f&v .
mean daily consumption of different types of fruits , vegetables , as well as total consumption ( including berries and juice , excluding potatoes ) on a population - level was calculated from the self - administered 24-h recall .
data on different sociodemographic variables ( gender , age , household size , country of birth , and level of education ) are presented in table 1 .
level of pa was measured by asking how many hours per week the respondents engage in exercise that causes them to perspire or become breathless .
respondent characteristics and fruit and vegetable consumption ( portions / day ) according to the self - administered 24-h recall note : groups with significantly ( p0.01 ) higher consumption with bolded figures . 
								
tukey hsd post test : 0.5 h vs. 1.12.5 h , p<0.001 ; 0.5 h vs. > 2.5 h , p<0.001 . 
								
the analyses were undertaken separately for women and men as well as for different demographic groups .
means and 99% confidence intervals [ 99% cis ] were calculated for daily f&v consumption ( portions / day ) .
respondents reporting unusually high consumption of > 15 f&v portions / day were excluded from the analyses ( five men and five women ) .
two - sample t - tests and one - way anova were used to determine whether mean f&v consumption from the self - administered 24-h recall differed between subgroups . where needed
based on normality tests and regarding the large sample size , the variable was used in its original form . mann 
whitney test was used to analyze consumption data from the ffq . due to the large number of significance tests conducted ,
a p - value < 0.01 ( two - sided ) was considered statistically significant throughout the study .
detailed information regarding consumption of different kinds of f&v was collected using a 13-item self - administered 24-h recall and a 12-item food frequency questionnaire ( ffq ) .
respondents were asked to report consumed amounts either in deciliters or number of portions in the self - administered 24-h recall ( e.g.  did you eat apples yesterday and , if yes , how many? ) .
the ffq included eight response categories for each item (  never,  less than once / week ,  once / week,  24 times / week,  56 times / week,  once / day, two times / day, and  more than twice a day ) , indicating the average consumption frequencies for salad / raw and cooked vegetables as well as for fresh fruit and fruit juice ( e.g.  how often do you usually eat fresh fruit? ) . both the ffq and the self - administered 24-h recall
were based on a validated questionnaire where no differences were observed between the 24-h recall and one - day weighed food record of f&v ( 31 ) . in addition , the ffq showed a correlation coefficient of 0.73 for total f&v with a seven - day food record ( 31 ) .
the present questionnaire was also pre - tested on 20 swedish adults , and one focus group interview ( n=5 ) was held in which respondents discussed f&v .
mean daily consumption of different types of fruits , vegetables , as well as total consumption ( including berries and juice , excluding potatoes ) on a population - level was calculated from the self - administered 24-h recall .
data on different sociodemographic variables ( gender , age , household size , country of birth , and level of education ) are presented in table 1 .
level of pa was measured by asking how many hours per week the respondents engage in exercise that causes them to perspire or become breathless .
respondent characteristics and fruit and vegetable consumption ( portions / day ) according to the self - administered 24-h recall note : groups with significantly ( p0.01 ) higher consumption with bolded figures . 
								
tukey hsd post test : 0.5 h vs. 1.12.5 h , p<0.001 ; 0.5 h vs. > 2.5 h , p<0.001 . 
								
the analyses were undertaken separately for women and men as well as for different demographic groups .
means and 99% confidence intervals [ 99% cis ] were calculated for daily f&v consumption ( portions / day ) .
respondents reporting unusually high consumption of > 15 f&v portions / day were excluded from the analyses ( five men and five women ) .
two - sample t - tests and one - way anova were used to determine whether mean f&v consumption from the self - administered 24-h recall differed between subgroups . where needed
based on normality tests and regarding the large sample size , the variable was used in its original form .
whitney test was used to analyze consumption data from the ffq . due to the large number of significance tests conducted ,
a p - value < 0.01 ( two - sided ) was considered statistically significant throughout the study .
a total of 1,304 questionnaires were returned and properly filled out , giving a response rate of 51% . approximately one - third of the respondents chose the web - based questionnaire .
roughly one - third ( 37% ) had a university - level education , and 49% had been employed during the past six months .
about 12% of the respondents were born outside sweden , compared to roughly 17% in the total swedish population ( 33 ) .
sociodemographic characteristics of the respondents and total f&v consumption in each subgroup are presented in table 1 . according to the self - administered 24-h recall ,
total f&v consumption was 2.2 ( 99% ci 2.02.4 ) portions per day in the lowest quartile among women ( n=187 ) and 1.9 ( 1.72.1 ) daily portions among men ( n=201 ) .
the highest quartile of women ( n=159 ) consumed 9.9 ( 9.310.4 ) portions on the examined day compared to 9.4 ( 8.410.5 ) portions among men ( n=143 ) .
mean number of total f&v portions varied from 4.9 to 5.8 among women and 4.2 to 5.0 among men in different age groups , but consumption did not differ statistically across age groups .
men born in sweden had lower total f&v consumption than did men born in another country ( p=0.006 ) .
women with 0.5 h self - reported pa / week had lower f&v consumption than those reporting 1 h pa / week ( p<0.001 ) . also among men , those reporting 0.5 h pa / week had lower f&v consumption than those reporting 2.5 h pa / week .
consumption of different types of f&v , based on the self - administered 24-h recall , by gender and age group is presented in table 2 .
fresh fruits , as well as raw vegetables and salad , were consumed in the greatest amounts , and more by women than by men ( p<0.001 ) .
comparisons between women and men within each age group showed that 55- to 74-year - old women consumed more fruits in total ( p0.001 ) , and more fresh fruits ( p0.002 ) , than men .
women between 55 and 64 years also had higher total vegetable consumption than men in the same age group ( p=0.002 ) .
overall consumption of berries and cooked vegetables was relatively low , and no gender differences were shown . 
 
mean consumption of different fruit and vegetable types ( n of self - reported portions / day , [ 99% confidence interval ] ) by gender and age group ( 24-h recall ) note : p - values for gender differences within age group .
the ffq also showed that fresh f&v were consumed most often ( table 3 ) .
more women than men in all age groups consumed fresh fruit every day ( 63.5% vs. 38.9% for all age groups combined , respectively ; p<0.001 ) ) .
almost one half of women ( 48.3% ) consumed salad or raw vegetables every day compared to 28.8% among men ( p<0.001 ) .
men reported a higher consumption frequency only for canned fruit ( p=0.002 ) , although the overall consumption frequency was very low . 
 
percentages of daily users of different fruit and vegetable types and gender differences in f&v consumption frequencies within age groups ( food frequency questionnaire ) note : bolded figures are statistically significant differences . 
								
once / day + two times / day + more than twice a day . 
								
mann  whitney test for gender differences in consumption frequencies ( eight categories as presented in methods ) .
comparisons between women and men using the web - based or pen - and - paper questionnaire showed no differences in total f&v consumption .
age differences between these two groups could not be seen , whereas women choosing the web - based questionnaire had higher level of education .
according to the self - administered 24-h recall , total f&v consumption was 2.2 ( 99% ci 2.02.4 ) portions per day in the lowest quartile among women ( n=187 ) and 1.9 ( 1.72.1 ) daily portions among men ( n=201 ) .
the highest quartile of women ( n=159 ) consumed 9.9 ( 9.310.4 ) portions on the examined day compared to 9.4 ( 8.410.5 ) portions among men ( n=143 ) .
mean number of total f&v portions varied from 4.9 to 5.8 among women and 4.2 to 5.0 among men in different age groups , but consumption did not differ statistically across age groups .
men born in sweden had lower total f&v consumption than did men born in another country ( p=0.006 ) .
women with 0.5 h self - reported pa / week had lower f&v consumption than those reporting 1 h pa / week ( p<0.001 ) . also among men , those reporting 0.5 h pa / week had lower f&v consumption than those reporting 2.5 h pa / week .
consumption of different types of f&v , based on the self - administered 24-h recall , by gender and age group is presented in table 2 .
fresh fruits , as well as raw vegetables and salad , were consumed in the greatest amounts , and more by women than by men ( p<0.001 ) .
comparisons between women and men within each age group showed that 55- to 74-year - old women consumed more fruits in total ( p0.001 ) , and more fresh fruits ( p0.002 ) , than men .
women between 55 and 64 years also had higher total vegetable consumption than men in the same age group ( p=0.002 ) . overall consumption of berries and cooked vegetables was relatively low , and no gender differences were shown . 
 
mean consumption of different fruit and vegetable types ( n of self - reported portions / day , [ 99% confidence interval ] ) by gender and age group ( 24-h recall ) note : p - values for gender differences within age group .
the ffq also showed that fresh f&v were consumed most often ( table 3 ) .
more women than men in all age groups consumed fresh fruit every day ( 63.5% vs. 38.9% for all age groups combined , respectively ; p<0.001 ) ) .
almost one half of women ( 48.3% ) consumed salad or raw vegetables every day compared to 28.8% among men ( p<0.001 ) .
men reported a higher consumption frequency only for canned fruit ( p=0.002 ) , although the overall consumption frequency was very low . 
 
percentages of daily users of different fruit and vegetable types and gender differences in f&v consumption frequencies within age groups ( food frequency questionnaire ) note : bolded figures are statistically significant differences . 
								
once / day + two times / day + more than twice a day . 
								
mann  whitney test for gender differences in consumption frequencies ( eight categories as presented in methods ) . comparisons between women and men using the web - based or pen - and - paper questionnaire showed no differences in total f&v consumption .
age differences between these two groups could not be seen , whereas women choosing the web - based questionnaire had higher level of education .
on average , respondents in the present study reported slightly higher f&v consumption than expected based on earlier findings in sweden ( 13 , 14 ) .
some other recent studies ( 25 ) have also reported changes in dietary habits during the past decade .
however , the methodology used in the present study differed from the latest national food intake survey ( 13 ) , and the results are not directly comparable with each others . in line with our findings , previous studies have also shown that men tend to have lower f&v consumption than women ( 1518 ) .
a study from finland showed that gender differences in vegetable consumption have actually increased ( 34 ) .
both the self - administered 24-h recall and ffq showed higher f&v consumption in women when all age groups were combined , while the data from the ffq showed larger differences between women and men within different age groups .
earlier studies have shown that men slightly underestimate their f&v consumption , whereas the opposite applies to women ( 33 ) .
thus , the gender differences revealed here may turn out to be slightly less significant , but the similar findings from two measures indicate that these differences actually exist .
the self - administered 24-h recall showed higher consumption of fresh fruit particularly for middle - aged and older women , which is in line with results from a recent finnish study ( 18 ) . on the other hand
, the ffq showed that women in many age groups were more frequent consumers of not only fruit , but also salad and other raw vegetables . f&v
it seems that swedes are not used to including f&v in mixed dishes , but rather eat them separately as they are . on the other hand ,
the authors are aware of the limitations of the study questionnaire , where only one open - ended item on mixed dishes was included .
this may have led to some underreporting , indicating that actual consumption may be higher than reported .
the present study further showed some interesting differences between women and men in factors associated with f&v consumption .
men born outside sweden had higher f&v consumption than men born in sweden did , which may reflect the different habits associated with other food cultures .
for instance , non - western immigrants in denmark have been reported to have higher odds for daily consumption of cooked and raw vegetables ( 35 ) , and iranians living in sweden also show higher consumption of f&v ( 36 ) . however , because the specific country of birth is not reported in the present study , no conclusions regarding specific food cultures can be drawn .
pa was the only variable of those investigated that was associated with total f&v consumption in both genders .
therefore , we may speculate that f&v consumption is an integrated part of a lifestyle in which pa also plays an important role . however , the limitations of only using a single question to measure level of pa are recognized ( 25 ) , and more detailed assessments are encouraged to gain better understanding on the associations between pa and consumption of f&v . from a methodological point of view , the ffq may enable better prediction of average consumption over a longer time period , whereas the self - administered 24-h recall was used to more accurately assess consumption over a specified period .
also , there is a certain risk of over - reporting actual consumption in the ffq , but this was not regarded as a problem when ranking individuals and subgroups according to their consumption ( 37 ) . in addition , although consumption has not been reported in grams , consumption frequency as such is a good measure of consumption , because portion sizes have not been reported to differ between high and low consumers ( 12 ) .
we are aware of the possibility of a type i error for false significant findings ( 38 ) due to the many significance tests conducted . however , because the main findings are significant at a level well below 1% , and both dietary assessment measures showed similar findings , this is not regarded as a problem . in the present study , all days of the week were equally represented in the data ( data not shown ) , which eliminates the possible bias caused by consumption differences across the weekdays .
seasonal consumption variation can also be excluded as a confounding factor , because the data consist of roughly equally large groups of participants in different seasonal groups .
the aim was to show an average consumption of the population over one year and not to compare seasonal variation as such .
the present results have to be interpreted with caution owing to the relatively large proportion of non - respondents ( 49% ) , although the drop - out rate was nearly as high in the latest nationwide dietary survey used as a reference here ( 13 ) .
men in general , and the youngest age group ( 1824 years ) , but also the oldest women ( 7584 years ) were somewhat underrepresented in the present survey .
however , the relatively high total number of respondents should be representative of actual f&v consumption levels in sweden , although in most cases , respondent selection in postal surveys probably leads to overrepresentation of people who are more interested in the topic , or who already have healthier dietary habits .
the cross - sectional design limits conclusions about the temporal or causal nature of the findings , but the study design can provide answers that address the study aims . from a data collection perspective
, the present study gives valuable experience in using a web - based questionnaire as an alternative response measure .
giving respondents the opportunity to choose between a traditional pen - and - paper and a web - based questionnaire was intended to increase the response rate and attract particularly younger respondents , but age differences could not be identified in the present study ( data not shown ) . in accordance with danish experiences ( 39 ) , the majority of respondents preferred the paper version to the web - based questionnaire . however , using the internet may still be worthwhile , as it saves both environmental and labor resources .
the present study showed average f&v consumption close to the recommended level of five portions per day .
fresh f&v showed the highest consumption , whereas berries and processed f&v products were less popular .
university education was positively associated with higher f&v consumption for women , and men born outside sweden showed higher consumption than did men born in sweden .
respondents who reported more hours per week engaged in doing pa had higher f&v consumption in both genders .
although total consumption seems to have increased , the role of other underlying factors besides the sociodemographic factors and pa studied here remains unclear .
in addition , other perspectives on f&v consumption , such as possible seasonal variation in availability of different f&v types , should be taken into consideration when implementing new dietary interventions or guidelines .
the authors have not received any funding or benefits from industry to conduct this study .
 backgroundfruit and vegetables ( f&v ) are strongly associated with health . 
 the latest swedish national dietary survey from a decade ago showed that consumption of f&v was below recommended levels . 
 however , current consumption in different subgroups is not well known.objectiveto investigate the consumption of various f&v types in swedish adults grouped according to sociodemographic factors and self - reported physical activity ( pa).designa cross - sectional survey using a quantitative pen - and - paper or web - based questionnaire in a population - based random sample of adults 1884 years ( final n=1,304 ; 51% ) . 
 a self - administered 24-h recall and a food frequency questionnaire ( ffq ) were used to measure f&v consumption . 
 data on gender , age , education level , country of birth , and pa ( hours / week ) were included as grouping variables . besides descriptive data , two - sample t - tests and non - parametric tests were performed . 
 a p - value < 0.01 was regarded as significant.resultsmean f&v consumption based on the self - administered 24-h recall was close to the recommended five portions / day : 5.4 ( 99% ci 5.15.6 ) portions / day among women and 4.7 ( 4.45.0 ) portions / day among men ( p<0.001 ) . 
 also the ffq showed that women generally consumed more f&v than men did . 
 consumption was lowest among respondents with  0.5 h self - reported pa / week ( p0.001 ) , as well as among men born in sweden ( p=0.006 ) . 
 f&v were consumed in almost equal amounts , and fresh f&v were most popular . 
 intake of berries and cooked f&v was relatively low.conclusionthe present study shows a relatively high f&v consumption close to the recommended five portions per day . 
 gender differences still exist . 
 also pa and country of birth were significantly associated with f&v consumption . 