Prevalence and associated factors of insufficient vegetable and fruit intake among adults: a cross-sectional study

Abstract

Abstract Insufficient intake of vegetables and fruits is a major modifiable risk factor for diet-related diseases worldwide. This study evaluated the intake patterns and associated factors among Hong Kong adults. A cross-sectional survey was conducted in 2024–2025. Data on demographic characteristics, socioeconomic status, lifestyle, and dietary habits were collected from adults aged 18 and above. The primary outcomes were insufficient vegetable intake and insufficient fruit intake, defined as not meeting the recommended daily intake for vegetables and fruits, respectively. Associations were examined using univariable and multivariable logistic regression analyses. Among 4,290 participants (mean age 41.64 years; 60.6% female), the prevalence of insufficient intake was 78.1% ( n  = 3,350) for vegetables and 82.4% ( n  = 3,534) for fruits. In multivariable analysis, male gender was positively associated with both insufficient vegetable intake (adjusted odds ratio [aOR] = 2.204, 95% confidence interval [CI]: 1.783–2.726, p  < 0.001) and insufficient fruit intake (aOR = 1.665, 95% CI: 1.307–2.120, p  < 0.001). Sufficient physical activity was negatively associated with insufficient vegetable intake (aOR = 0.624, 95% CI: 0.520–0.748, p  < 0.001) and insufficient fruit intake (aOR = 0.556, 95% CI: 0.455–0.680, p  < 0.001). Furthermore, older age (aOR = 0.991, 95% CI: 0.983–0.999, p  = 0.033) was negatively associated with insufficient vegetable intake, although the effect size was small. For fruit intake specifically, tertiary education (aOR = 1.814, 95% CI: 1.107–2.973, p  = 0.018) and smoking (aOR = 1.617, 95% CI: 1.239–2.111, p  < 0.001) were associated with higher odds of insufficient fruit intake. Most adults in Hong Kong consumed vegetables and fruits below recommended levels. Insufficient intake was associated with gender, physical activity, education level, and smoking status. These findings highlight the need for targeted public health interventions, particularly for men and individuals with insufficient physical activity. Nutrition education should be integrated with broader health promotion strategies that encourage physical activity and support smoking cessation.