British Journal of Nutrition

Research Article

Quality of life and self-rated health in relation to changes in fruit and vegetable intake and in plasma vitamins C and E in a randomised trial of behavioural and nutritional education counselling

Andrew Steptoea1 c1, Linda Perkins-Porrasa1, Sean Hiltona2, Elizabeth Rinka2 and Francesco P. Cappuccioa2

a1 Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK

a2 Department of General Practice and Primary Care, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK


We have carried out a randomised trial comparing brief behavioural counselling with nutritional education counselling to increase fruit and vegetable consumption and associated biomarkers in adults from a low-income neighbourhood. The objective of the present analysis was to assess the impact of interventions on quality of life and health status, and associations between changes in fruit and vegetable consumption, plasma vitamins C and E, and quality of life. Behavioural counselling and nutritional education counselling were carried out in 271 adults in two 15 min sessions in a primary-care setting. Physical and mental health status (medical outcome study short form 36) and self-rated health were assessed at baseline, 8 weeks and 12 months, and analysed on an intention-to-treat basis. Both groups reported increased fruit and vegetable consumption; plasma vitamin E and β-carotene also increased, with significantly greater changes in consumption and plasma β-carotene in the behavioural counselling condition. Physical and mental health status, and the proportion of participants in good self-rated health, increased in both groups to a similar extent. Individual differences in improvements in physical health status and self-rated health were correlated with increases in fruit and vegetable intake and in plasma vitamins C and E, independently of age, gender, ethnicity, financial status, smoking, BMI and use of vitamin supplements. We conclude that participation in the present study was associated with improved health-related quality of life. Increases in fruit and vegetable intake and plasma vitamin levels may stimulate beneficial changes in physical health status in socio-economically deprived adults.

(Received December 31 2003)

(Revised March 12 2004)

(Accepted March 17 2004)


c1 *Corresponding author: fax +44 20 7916 8542, Email