Abstract
Objective: To clarify the relationship between the proportion of severely insufficient vegetable intake frequency and 1) vegetable cultivation, 2) frequency of receiving vegetable among non-cultivators.
Materials and Methods: Residents aged 20 to 74 years in three areas of a city in Gunma Prefecture, Japan, were invited to participate. In September 2016, two sets of self-administered questionnaires were mailed to all 2,260 households in the three areas. The survey items covered the frequency of vegetable intake, vegetable cultivation (as a farmer, as a non-farmer, or no-cultivation), frequency of receiving vegetable, and basic characteristics. For vegetable cultivators, we asked the proportion of cultivated vegetables for home consumption and for giving to neighbors. Binomial logistic regression models were used to analyze the data collected. The respondents were classified into two groups according to their vegetable intake frequency: fewer than three times per day (severely insufficient), and at least three times per day.
Results: We had 796 valid responses. Using the no-cultivation group as reference, both of the other groups —vegetable cultivation as a farmer, and as a non-farmer— had a significantly smaller proportion of severely insufficient vegetable intake frequency. Among the no-cultivation group, using those who had never received vegetable in the past month as reference, those who rarely, sometimes, or often received vegetables had a significantly smaller proportion of severely insufficient vegetable intake frequency. These associations were similar in cases where vegetable juice was or was not included. The proportion of those who cultivated vegetables for home consumption was 96% among farmers and 100% among non-farmers, respectively, and for giving to neighbors was 84% among farmers and 62% among non-farmers, respectively.
Conclusion: A negative association of the proportion of severely insufficient vegetable intake with vegetable cultivation, and with receiving vegetable among non-cultivators, was suggested.
Keywords: vegetable cultivation, receiving vegetables, vegetable intake, locally grown vegetables
Introduction
Increased fruit and vegetable intake reduces the risk of chronic diseases or of all-cause mortality1, 2). Meta-analyses of prospective cohort studies indicated a negative relationship between total fruit and vegetable intake and cardiovascular disease1, 2) or all-cause mortality2). In the meta-analyses, it was commonly reported that people with severely insufficient fruit and vegetable intake have a particularly high risk of cardiovascular disease or all-cause mortality1, 2). Therefore, it is particularly important to implement countermeasures for people with severely insufficient fruit and vegetable intake.
It has been suggested that fruit and vegetable cultivation increase fruit and vegetable intake3,4,5,6,7,8,9,10,11,12,13,14). The relationship between fruit and/or vegetable intake and fruit and/or vegetable cultivation has been studied in 11 cross-sectional studies3,4,5, 7,8,9,10,11,12,13,14) and 1 pre-post designed study6) among adults living in developed countries. With the exception of one13), all the studies reported a positive relationship between fruit and/or vegetable cultivation and fruit and/or vegetable intake3,4,5,6,7,8,9,10,11,12, 14). Two among these studies also examined the relationship between fruit and/or vegetable intake and receiving fruit and/or vegetables that might have been acquired from fruit and/or vegetable cultivation from neighbors; both the studies have reported a positive relationship13, 14). However, these previous studies3,4,5,6,7,8,9,10,11,12,13,14) did not focus specifically on the impact on people with severely insufficient fruit and/or vegetable intake.
In Japan, we need to focus primarily on vegetable intake rather than fruit intake. This is because, even though there is more intake15) and cultivation16, 17) of vegetables than that of fruits in Japan, the mean vegetable intake among Japanese adults15) is not enough as per the recommended amount18).
In the present study, we sought to determine the relationship between severely insufficient vegetable intake frequency and vegetable cultivation. Among those who did not cultivate vegetables, we sought to determine the relationship between severely insufficient vegetable intake frequency and receiving vegetable from neighbors. Overall, we discuss the relationship of vegetable cultivation and the proportion of severely insufficient vegetable intake, both directly and indirectly.
Materials and Methods
Study participants and design
We used the same dataset as that described in a previous article19). The participants in this cross-sectional study were residents aged 20 to 74 years living in three areas of a city within Gunma Prefecture, Japan. This city is located in the center of Gunma, covers 459.2 km2, and has a population of approximately 370,000 residents. Within this city, we identified three geographic regions, each with a population of about 1,000 people aged 20 to 74 years, which could be classified as rural, suburban, and urban, respectively.
We collected the survey data in September and October 2016 via a self-administered questionnaire. We mailed two sets of questionnaires to all households in the three areas on September 12, using Town Plus by Japan Post Co., Ltd.; this service makes it possible to send mail to all households in selected areas, even without knowing the specific addresses. An explanatory letter and a stamped, self-addressed return envelope were enclosed with the questionnaire. The explanatory letter stated the following: “(1) there is no need to reply if there are no residents aged 20 to 74 years in the household; (2) two residents should reply if there are three or more residents aged 20 to 74 years in the household; (3) the survey is anonymous, and we regard the submission of a response to the questionnaire as consent”. In addition, we numbered each questionnaire so that we could identify from which of the three geographic areas each response was received.
This study was approved by the Gunma University Ethical Review Board for Medical Research Involving Human Subjects (submission no. 160074, approved August 16, 2016).
Survey tool
Dependent variables: Vegetable intake frequency was assessed using four items, based on the Behavioral Risk Factor Surveillance System (BRFSS)20). We carefully selected four items appropriate for evaluating the vegetable intake of Japanese people (vegetable juice; dark green vegetables; red, yellow, and orange vegetables; and other vegetables), because the BRFSS was originally developed for the American context. For each vegetable category, the questionnaire asked, “How many times per day, on average, have you eaten the following vegetables for the past month?” Participants were provided with examples of the vegetables included in each of the four categories; however, they were not given a definition of the serving size. The examples were based on the categories of the Japanese National Health and Nutrition Examination Survey15). Among the yellow and green vegetables, the green ones were referred to as “dark green vegetables”, and red, yellow, and orange vegetables were referred to as “red, yellow, and orange vegetables”. Other vegetables were referred to as “other vegetables”. BRFSS categorized “green beans” as an independent item20). However, in the present study, “green beans” was excluded as an independent item because there is not much intake of this product in the Japanese population and was included in the category of “dark green vegetables”. Vegetable juice was counted among “other vegetables” by the BRFSS20). Here, however, it was regarded as an independent item to allow for an analysis excluding juice. From these responses, we created two indexes of vegetable intake (total number of times per day). One was termed the “vegetable intake frequency” and was created by summing the intake data for all the four items. The other was “vegetable intake frequency excluding juice”, created by summing the intake data for the three items excluding vegetable juice.
We divided the data on the frequency of vegetable intake into the following two categories: fewer than three times per day (severely insufficient), and at least three times per day. Average vegetable intake of Japanese adults was 276.5 g15). The proportion of those who did not reach 140 g that was about a half of the average intake was 21.7%15). According to the distribution of the vegetable intake frequency in this survey, the proportion of those with less than three times per day of “vegetable intake frequency” was 12.9%, and of “vegetable intake frequency excluding juice” was 14.6%. Here, therefore, we regarded fewer than three times per day as severely insufficient.
Primary independent variables: To understand self-perceptions about vegetable cultivation, we asked participants, “Do you or your household members grow vegetables?” Participants who answered “yes” were further asked whether they grew the vegetables as a farmer, home gardener, or community gardener or in some other role. From these responses, we divided the respondents into three groups: vegetable cultivation as a farmer, vegetable cultivation as a non-farmer, or no-cultivation. We also asked the participants, “During the past month, how often have you received vegetables?” Participants gave responses in one of four categories (never, rarely, sometimes, and often).
Other variables: We assessed subjective difficulty in food-store access by using a single item from a previous study, which asked the participants about their subjective difficulty in food-store access on a scale from 0 (very difficult) to 3 (very easy)21). We assessed the respondents’ economic circumstances by using a single item that asked them to indicate their economic situation on a scale of 1 (very poor) to 5 (very good). This item was confirmed as having a positive relationship with household income in a previous study22). We assessed health attitude using a single item: “Are you usually health-conscious?” Participants answered on a scale of 0 (not at all) to 3 (often or all the time). Demographic questions covered the respondents’ sex (women, men), age group (in years: 20–29, 30–39, 40–49, 50–59, 60–69, 70–74), educational background (elementary or junior high school, high school, vocational school or junior college, university or graduate school), and employment status (unemployed or retired, part-time, full-time).
In addition, we asked the vegetable cultivators about the proportion of vegetables cultivated for home consumption, and for giving to neighbors.
Analyses
We used binomial logistic regression models. We used the responses without it had missing values for these models. If two people responded in a household and both of them had no missing value, we used both of the two responses. We adjusted for all the other variables. Adjusted odds ratios (AORs) and 95% confidence intervals (95% CI) were calculated, using the respondents with a vegetable intake frequency of at least three times per day as the reference group. Prior to the logistic regression analyses, we assessed univariate relationships between vegetable cultivation status and participants’ characteristics using the chi-square test. We then analyzed the relationship between vegetable cultivation and proportion of severely insufficient vegetable intake using binomial logistic regression models. Additionally, within the no-cultivation group, we analyzed the relationship between frequency of receiving vegetable from neighbors and proportion of severely insufficient vegetable intake using binomial logistic regression models. Geographic area (reference: rural), sex (reference: women), age group (reference: 20–29 years), educational background (reference: elementary or junior high school), employment status (reference: unemployed or retired), vegetable cultivation (reference: no-cultivation), and frequency of receiving vegetables (reference: never) were used as categorical scales for the binomial logistic regression models. For the subjective difficulty in food-store access, economic circumstances, and health attitude, it was confirmed that the absolute value of skewness and kurtosis was less than 2; hence, they were used as interval scales for the binomial logistic regression models. Statistical models were checked for interactive effects between geographic areas and with all independent variables, and they were found to be acceptable. A two-tailed p-value less than 0.05 was considered statistically significant.
The proportion of vegetables cultivated for home consumption and for giving to neighbors was calculated for vegetable cultivation as a farmer and as a non-farmer. Since two copies of the questionnaire were distributed to each household, if two people responded in a household, only one answer was randomly selected and was used for the calculation. Therefore, they were not weighted on the households who responded from two people.
All analyses were performed using the statistical software package IBM SPSS Statistics, version 23.
Results
We mailed questionnaires to 2,260 households and received responses from 586 households (household response rate: 25.9%). 873 individual residents provided information (295 rural, 295 suburban, 283 urban). We excluded responses that contained missing data (total: 73 (8 for sex, 7 for age group, 26 for educational background, 29 for employment status, 13 for subjective difficulty in food-store access, 10 for economic circumstance, 18 for health attitude, 23 for frequency of receiving vegetables, 9 for vegetable cultivation, and 20 for vegetable intake frequency)) or were provided by people older than age 74 years (4), leaving 796 responses (261 rural, 264 suburban, 271 urban) for statistical analysis.
The results of the chi-square tests (Table 1) showed significant relationships with the vegetable cultivation status for the variables of geographic area (p < 0.001), age group (p < 0.001), educational background (p < 0.001), employment status (p = 0.001), economic circumstances (p = 0.016), and subjective difficulty in food-store access (p = 0.025).
Table 1. Participants’ characteristics according to vegetable cultivation.
| No-cultivation (n = 399) |
Cultivation as a non-farmer (n = 290) |
Cultivation as a farmer (n = 107) |
p-value* | |||||
|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | |||
| Area | ||||||||
| Rural | 64 | 16 | 120 | 41 | 77 | 72 | < 0.001 | |
| Suburban | 113 | 28 | 124 | 43 | 27 | 25 | ||
| Urban | 222 | 56 | 46 | 16 | 3 | 3 | ||
| Sex | ||||||||
| Women | 215 | 54 | 164 | 57 | 57 | 53 | 0.743 | |
| Men | 184 | 46 | 126 | 43 | 50 | 47 | ||
| Age group | ||||||||
| 20–29 | 14 | 4 | 8 | 3 | 3 | 3 | < 0.001 | |
| 30–39 | 65 | 16 | 16 | 6 | 12 | 11 | ||
| 40–49 | 126 | 32 | 41 | 14 | 14 | 13 | ||
| 50–59 | 95 | 24 | 63 | 22 | 18 | 17 | ||
| 60–69 | 67 | 17 | 118 | 41 | 45 | 42 | ||
| 70–74 | 32 | 8 | 44 | 15 | 15 | 14 | ||
| Educational background | ||||||||
| Elementary/junior high | 15 | 4 | 25 | 9 | 12 | 11 | < 0.001 | |
| High school | 114 | 29 | 135 | 47 | 52 | 49 | ||
| Vocational/junior college | 109 | 27 | 74 | 26 | 26 | 24 | ||
| University/graduate school | 161 | 40 | 56 | 19 | 17 | 16 | ||
| Employment status | ||||||||
| Unemployed/retired | 104 | 26 | 112 | 39 | 43 | 40 | 0.001 | |
| Part-time | 63 | 16 | 50 | 17 | 15 | 14 | ||
| Full-time | 232 | 58 | 128 | 44 | 49 | 46 | ||
| Economic circumstances | ||||||||
| Very poor | 17 | 4 | 9 | 3 | 2 | 2 | 0.016 | |
| Poor | 76 | 19 | 59 | 20 | 19 | 18 | ||
| Fair | 140 | 35 | 99 | 34 | 41 | 38 | ||
| Good | 106 | 27 | 99 | 34 | 40 | 37 | ||
| Very good | 60 | 15 | 24 | 8 | 5 | 5 | ||
| Health attitude (“Are you health-conscious?”) | ||||||||
| Not at all | 20 | 5 | 6 | 2 | 4 | 4 | 0.133 | |
| Little | 110 | 28 | 66 | 23 | 27 | 25 | ||
| Occasionally | 183 | 46 | 138 | 48 | 44 | 41 | ||
| Often/all the time | 86 | 22 | 80 | 28 | 32 | 30 | ||
| Subjective difficulty in food-store access | ||||||||
| Very difficult | 13 | 3 | 4 | 1 | 4 | 4 | 0.025 | |
| Difficult | 98 | 25 | 73 | 25 | 30 | 28 | ||
| Easy | 176 | 44 | 140 | 48 | 60 | 56 | ||
| Very easy | 112 | 28 | 73 | 25 | 13 | 12 | ||
| Frequency of receiving vegetables | ||||||||
| Never | 97 | 24 | 48 | 17 | 22 | 21 | 0.075 | |
| Rarely | 113 | 28 | 77 | 27 | 38 | 36 | ||
| Sometimes | 121 | 30 | 109 | 38 | 29 | 27 | ||
| Often | 68 | 17 | 56 | 19 | 18 | 17 | ||
* Chi-square test.
As for the results of the binomial logistic regression models when using the vegetable intake frequency as a dependent variable (Table 2), among respondents engaged in vegetable cultivation as a non-farmer, the AOR of severely insufficient vegetable intake was 0.55 (95% CI: 0.32–0.96). For those involved in vegetable cultivation as a farmer, the AOR of severely insufficient vegetable intake was 0.38 (95% CI: 0.16–0.93). Similar trends were also obtained when using the vegetable intake frequency excluding juice as a dependent variable (non-farmer: AOR = 0.56, 95% CI: 0.33–0.96; farmer: AOR = 0.40, 95% CI: 0.17–0.94).
Table 2. Relationship between vegetable cultivation and severely insufficient vegetable intake frequency.
| Severely insufficient | ||||||
|---|---|---|---|---|---|---|
| n | % | AOR | 95% CI | p-value | ||
| Vegetable cultivation | (Vegetable intake frequency) | |||||
| No cultivation | 64 | 16 | 1.00 | Reference | ||
| Cultivation as a non-farmer | 31 | 11 | 0.55 | 0.32–0.96 | 0.036 | |
| Cultivation as a farmer | 8 | 7 | 0.38 | 0.16–0.93 | 0.035 | |
| (Vegetable intake frequency excluding juice) | ||||||
| No cultivation | 73 | 18 | 1.00 | Reference | ||
| Cultivation as a non-farmer | 35 | 12 | 0.56 | 0.33–0.96 | 0.033 | |
| Cultivation as a farmer | 9 | 8 | 0.40 | 0.17–0.94 | 0.035 | |
N = 796. Severely insufficient: vegetable intake < 3 times per day. AOR: adjusted odds ratio, 95% CI: 95% confidence interval. Adjusted for area: rural (ref), suburban, urban. Sex: women (ref), men. Age group: 20–29 (ref), 30–39, 40–49, 50–59, 60–69, 70–74 years. Educational background: elementary/junior high (ref), high school, vocational/junior college, university/graduate school. Employment status: unemployed/retired (ref), part-time, full-time. Economic circumstance: very poor = 1, very good = 5. Health attitude (“Are you health-conscious?”): not at all = 0, often/all the time = 3. Subjective difficulty in food-store access: very difficult = 0, very easy = 3. Frequency of receiving vegetable: never (ref), rarely, sometimes, often.
The results of the analyses of the relationship between the frequency of receiving vegetable from neighbors and the proportion of severely insufficient vegetable intake frequency among the no-cultivation group are shown in Table 3. People who rarely, sometimes, and often received vegetables had smaller proportions of severely insufficient vegetable intake frequency than those who never received vegetables (never: reference, rarely: AOR = 0.43 (95% CI: 0.19–0.97), sometimes: AOR = 0.35 (95% CI: 0.16–0.79), often: AOR = 0.37 (95% CI: 0.14–0.98)). Similar trends were also found when vegetable intake frequency excluding juice was taken as a dependent variable (never: reference, rarely: AOR = 0.36, 95% CI: 0.17–0.81; sometimes: AOR = 0.43, 95% CI: 0.21–0.90; often: AOR = 0.31, 95% CI: 0.12–0.82).
Table 3. Relationship between frequency of receiving vegetables and severely insufficient vegetable intake frequency among no cultivation group.
| Severely insufficient | ||||||
|---|---|---|---|---|---|---|
| n | % | AOR | 95% CI | p-value | ||
| Frequency of receiving vegetable | (Vegetable intake frequency) | |||||
| Never | 25 | 26 | 1.00 | Reference | ||
| Rarely | 14 | 12 | 0.43 | 0.19–0.97 | 0.042 | |
| Sometimes | 16 | 13 | 0.35 | 0.16–0.79 | 0.011 | |
| Often | 9 | 13 | 0.37 | 0.14–0.98 | 0.045 | |
| (Vegetable intake frequency excluding juice) | ||||||
| Never | 28 | 29 | 1.00 | Reference | ||
| Rarely | 15 | 13 | 0.36 | 0.17–0.81 | 0.013 | |
| Sometimes | 21 | 17 | 0.43 | 0.21–0.90 | 0.025 | |
| Often | 9 | 13 | 0.31 | 0.12–0.82 | 0.018 | |
N = 399. Severely insufficient: vegetable intake < 3 times per day. AOR: adjusted odds ratio, 95% CI: 95% confidence interval Adjusted for area: rural (ref), suburban, urban. Sex: women (ref), men. Age group: 20–29 (ref), 30–39, 40–49, 50–59, 60–69, 70–74 years. Educational background: elementary/junior high (ref), high school, vocational/junior college, university/graduate school. Employment status: unemployed/retired (ref), part-time, full-time. Economic circumstance: very poor = 1, very good = 5. Health attitude (“Are you health-conscious?”): not at all = 0, often/all the time = 3. Subjective difficulty in food-store access: very difficult = 0, very easy = 3.
The results of the calculation of the proportion of vegetables cultivated for home consumption and for giving to neighbors are shown in Table 4. We used responses of 287 households that were cultivators (vegetable cultivation as a farmer: n = 75, vegetable cultivation as a non-farmer: n = 212). The average proportion of vegetables cultivated for home consumption was 42.2% among vegetable cultivation as a farmer, and 77.6% as a non-farmer. The number of those who cultivated vegetables for home consumption was 72 (96%) among vegetable cultivation as a farmer, and 212 (100%) among as a non-farmer. The average proportion of vegetables cultivated for giving to neighbors was 15.3% among vegetable cultivation as a farmer, and 17.3% as a non-farmer. The number of those who cultivated vegetables for giving to neighbors was 63 (84%) among vegetable cultivation as a farmer, and 131 (62%) among as a non-farmer.
Table 4. The uses of cultivated vegetables.
| Cultivation as a farmer (n=75) | Cultivation as a non-farmer (n=212) | ||||
|---|---|---|---|---|---|
| Mean (n) | SD (%) | Mean (n) | SD (%) | ||
| For home consumption | 42.2 | 4 | 77.6 | 1.7 | |
| 0% | (3) | (4) | (0) | (0) | |
| more than 0% | (72) | (96) | (212) | (100) | |
| For giving to neighbors | 15.3 | 2.2 | 17.3 | 1.4 | |
| 0% | (12) | (16) | (81) | (38) | |
| more than 0% | (63) | (84) | (131) | (62) | |
SD: Standard Deviation.
Discussion
Our results indicated that the proportion of people with severely insufficient frequency of vegetable intake was smaller among vegetable cultivators than non-cultivators, regardless of whether they were farmers or non-farmers. Within non-cultivators, the proportion of people with severely insufficient frequency of vegetable intake was smaller among those who rarely, sometimes, and often received vegetable than those who never received any. In addition, almost all cultivators answered they were growing the vegetable for home consumption whether they were farmers or non-farmers. Moreover, 84% of farmers and 62% of non-farmers cultivated the vegetables for giving to neighbors. Previous studies also showed a positive relationship between vegetable intake and vegetable cultivation3,4,5,6,7,8,9,10,11,12, 14) or received vegetables13, 14). The results of this study, therefore, confirm these previous findings. In addition, we newly found a negative relationship between vegetable cultivation and the proportion of people with severely insufficient vegetable intake. Furthermore, we found a negative relationship between receiving vegetables that might be derived from vegetable cultivation and the proportion of people with severely insufficient vegetable intake among non-cultivators. Taking into account the proportion of vegetable cultivators growing the vegetables for giving to neighbors, it was suggested that vegetable cultivation is negatively related not only to the proportion of severely insufficient vegetable intake frequency of the vegetable cultivators, but also to that of neighboring residents through receiving vegetables.
This was cross-sectional study; therefore, it was not possible to determine the causal relationship only by the results of this study. However, it was suggested that the proportion of severely insufficient vegetable intake frequency decreases with vegetable cultivation based on previous studies4, 6, 8, 23). In one of these studies6), a positive causal relationship between vegetable cultivation and vegetable intake was suggested in the pre-post design study. In addition, the other studies discussed the following: improvement of the accessibility of vegetables and fruits due to the existence of the community garden4), improvement in the availability of vegetables due to having a vegetable garden23), and using vegetables naturally for daily meals as a result of participation in community gardens8). Conversely, when the vegetable cultivation decreases, the proportion of people with severely insufficient vegetable intake may increase. Less convenient access to vegetables grown by themselves or received from neighbors may be associated with a greater tendency toward severely inadequate vegetable intake. This conjecture has a policy implication: so as not to increase the proportion of people with severely insufficient vegetable intake in a particular area, we should promote and sustain the cultivation of vegetables in that area. Agricultural populations in Japan are decreasing24). It may be necessary to increase the number of farmers and to maintain the cultivation of vegetables in rural areas. This can include the establishment of community gardens in urban areas and securing an environment where vegetables can be cultivated and shared with those who cannot cultivate them at home. Some reports have found a positive relationship between the utilization of community gardens and vegetable intake4, 5, 8,9,10). An attempt has also been made to give products grown in a community garden set up in an urban outpatient clinic not only to those who visited the community garden but also to other patients who visited the clinic25). This study indicated that 18% of patients received products from the community garden25). In this way, by practicing planned cultivation of vegetables and giving harvested vegetables to neighboring residents, is a promising way to increase the vegetable intake of neighboring residents as well as those who participate in community gardens.
The study does have several limitations. First, response bias and sampling bias are both possibilities, since the response rate was only 25.9% and the nature of the sampling was non-random. Second, it is not known whether the number of vegetable intake times per day reported by respondents reflects their actual vegetable intake because criterion-related validity has not been verified. Although we estimated the severely insufficient vegetable intake from the percentage of responses, there was little evidence that these people indeed had severely insufficient vegetable intake. It is necessary to measure the vegetable intake using an accurate method and to identify the relationship that was suggested in this study. Third, since we did not include psychological factors that affect vegetable intake (primarily, whether one likes to eat vegetables) in this study, their influence cannot be ruled out. Fourth, we did not research a direct relationship that non-cultivators received vegetables from vegetable cultivators. In rural areas of Japan, it is being seen that people received many vegetables from neighboring farmers and to share them with friends and colleagues. Henceforth, it is necessary to examine in detail the influence of vegetable acquisition directly and indirectly from vegetable cultivators. Finally, as mentioned previously, this was a cross-sectional study, and longitudinal studies would be needed to reveal causal relationships.
Conclusion
This study found a negative association of the proportion of severely insufficient vegetable intake frequency with vegetable cultivation. Among those who do not cultivate vegetables, frequency of receiving vegetables from neighbors was negatively related with the proportion of severely insufficient vegetable intake frequency. In addition, almost all cultivators were growing the vegetable for home consumption, and majority of cultivators cultivated the vegetables for giving to neighbors, whether they were farmers or non-farmers. Over all, it was suggested that vegetable cultivation is negatively related not only to the proportion of severely insufficient vegetable intake frequency of the vegetable cultivators, but also that of neighboring residents through receiving vegetables.
Conflict of Interest
The authors have no conflict of interest to report.
Acknowledgments
We would like to thank the participants in this study. This study was funded by the Nakatani Suzuyo Memorial Fund for Nutrition and Dietetics.
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