{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:02:27Z","timestamp":1789448547457,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:00:00Z","timestamp":1789171200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015829","name":"Polish Ministry of Health","doi-asserted-by":"crossref","award":["POWR.05.01.00-00-0035\/17"],"award-info":[{"award-number":["POWR.05.01.00-00-0035\/17"]}],"id":[{"id":"10.13039\/501100015829","id-type":"DOI","asserted-by":"crossref"}]},{"award":["POWR.05.01.00-00-0035\/17"],"award-info":[{"award-number":["POWR.05.01.00-00-0035\/17"]}],"id":[{"id":"https:\/\/ror.org\/02ksnyp08","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Fruit and vegetable, fish, and sugar-sweetened beverage (SSB) intake are important modifiable determinants of cardiovascular risk, yet data on these dietary behaviours among middle-aged adults in Poland remain limited. This study assessed their prevalence and sociodemographic correlates. Methods: We conducted a cross-sectional study of 4935 adults aged 40\u201365 years (mean age 54.2 \u00b1 7.0 years; 59.4% women) participating in the \u201cBet on Prophylaxis\u2014Program for the Prevention of Cerebral Vascular Diseases, in the Masovian, Podlaskie and Warmian-Masurian Voivodeships\u201d. Dietary habits and physical activity (PA) were assessed using a structured questionnaire. Multivariable logistic regression identified independent correlates of each dietary behaviour, including sex \u00d7 education interactions. Results: Daily fruit and vegetable consumption was reported by 67.7% of participants, fish consumption \u22651\u20132 times\/week by 64.1%, and frequent SSB consumption by 14.0%. Daily fruit and vegetable intake was independently associated with female sex (OR = 1.92), higher education (OR = 2.24), older age, and PA (all p &lt; 0.001). Women reported healthier fruit and vegetable and SSB habits than men, while fish intake did not differ by sex. Neither body mass index (BMI) nor waist-to-hip ratio (WHR) was independently associated with any dietary behaviour after full adjustment, although WHR showed a weak unadjusted association with poorer fruit and vegetable and SSB habits. A global test of the sex \u00d7 education interaction was significant for fish consumption (Wald \u03c72 = 15.2, df = 3, p = 0.002), but not for fruit and vegetable (p = 0.622) or SSB consumption (p = 0.083). Conclusions: Dietary behaviours differed by sex and education, with central adiposity showing a weaker, non-independent association compared with the unadjusted analysis. The association between education and diet differed by sex for fish consumption, being evident mainly among men; a similar pattern for SSB consumption did not reach statistical significance.<\/jats:p>","DOI":"10.3390\/nu18182990","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T09:34:01Z","timestamp":1789378441000},"page":"2990","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fruit and Vegetable, Fish, and Sugar-Sweetened Beverage Consumption Among Adults Aged 40\u201365 Years: A Cross-Sectional Study of Dietary Patterns and Sociodemographic Correlates in North-Eastern Poland"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4114-1195","authenticated-orcid":false,"given":"Dominika","family":"Jakubowicz-Lachowska","sequence":"first","affiliation":[{"name":"Department of Neurology, Medical University of Bialystok, 15-267 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Bazylewicz","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Bialystok, 15-267 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateusz","family":"Wierci\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Bialystok, 15-267 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateusz","family":"Bargielski","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Bialystok, 15-267 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia","family":"Szy\u0142ak","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Bialystok, 15-267 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Kapica-Topczewska","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Bialystok, 15-267 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9624-6299","authenticated-orcid":false,"given":"Anna","family":"Miro\u0144czuk","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Bialystok, 15-267 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Snarska","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Medical University of Bialystok, 15-089 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Chor\u0105\u017cy","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Bialystok, 15-267 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Ku\u0142akowska","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Bialystok, 15-267 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Kochanowicz","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Bialystok, 15-267 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Stea, T.H., Nordheim, O., Bere, E., Stornes, P., and Eikemo, T.A. (2020). Fruit and vegetable consumption in Europe according to gender, educational attainment and regional affiliation\u2014A cross-sectional study in 21 European countries. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0232521"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"GBD 2017 Diet Collaborators (2019). Health effects of dietary risks in 195 countries, 1990\u20132017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet, 393, 1958\u20131972. Erratum in Lancet 2021, 397, 2466. https:\/\/doi.org\/10.1016\/S0140-6736(21)01342-8.","DOI":"10.1016\/S0140-6736(21)01342-8"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1093\/ije\/dyw319","article-title":"Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality\u2014A systematic review and dose-response meta-analysis of prospective studies","volume":"46","author":"Aune","year":"2017","journal-title":"Int. J. Epidemiol."},{"key":"ref_4","unstructured":"World Health Organization (2026, January 15). Healthy Diet. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/healthy-diet."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1016\/S0140-6736(20)30752-2","article-title":"Global burden of 87 risk factors in 204 countries and territories, 1990\u20132019: A systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"Murray","year":"2020","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Zweifler, G., Zimny-Zaj\u0105c, A., Babicki, M., K\u0142oda, K., Mazur, G., Jankowska-Pola\u0144ska, B., Mastalerz-Migas, A., and Agrawal, S. (2025). Socio-Demographic Disparities in Diet and Their Association with Physical and Mental Well-Being: Million-Participant Cross-Sectional Study in Poland. Nutrients, 17.","DOI":"10.3390\/nu17182924"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Drywie\u0144, M.E., Hamulka, J., and Jezewska-Zychowicz, M. (2021). Perceived Nutrition and Health Concerns: Do They Protect against Unhealthy Dietary Patterns in Polish Adults?. Nutrients, 13.","DOI":"10.3390\/nu13010170"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"969","DOI":"10.5603\/KP.a2016.0003","article-title":"Are dietary habits of the Polish population consistent with the recommendations for prevention of cardiovascular disease?\u2014WOBASZ II project","volume":"74","author":"Stepaniak","year":"2016","journal-title":"Kardiol. Pol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Sto\u015b, K., Rychlik, E., Wo\u017aniak, A., O\u0142tarzewski, M., Jankowski, M., Gujski, M., and Juszczyk, G. (2022). Prevalence and Sociodemographic Factors Associated with Overweight and Obesity among Adults in Poland: A 2019\/2020 Nationwide Cross-Sectional Survey. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19031502"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"\u017barnowski, A., Jankowski, M., and Gujski, M. (2022). Public Awareness of Diet-Related Diseases and Dietary Risk Factors: A 2022 Nationwide Cross-Sectional Survey among Adults in Poland. Nutrients, 14.","DOI":"10.3390\/nu14163285"},{"key":"ref_11","unstructured":"Eurostat (2026, January 21). How Much Fruit and Vegetables Do You Eat Daily?. Available online: https:\/\/ec.europa.eu\/eurostat\/web\/products-eurostat-news\/-\/ddn-20220104-1."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e00032424","DOI":"10.1590\/0102-311xen032424","article-title":"Fruit and vegetable consumption among Brazilian adults: Trends from 2008 to 2023","volume":"41","author":"Veiga","year":"2025","journal-title":"Cad. Saude Publica"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Vogt, T., and Gustafsson, P.E. (2022). Disparities in fruit and vegetable intake at the intersection of gender and education in northern Sweden: A cross-sectional study. BMC Nutr., 8.","DOI":"10.1186\/s40795-022-00641-5"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1111\/j.1467-789X.2011.00879.x","article-title":"Body mass index, waist circumference and waist-hip ratio: Which is the better discriminator of cardiovascular disease mortality risk? Evidence from an individual-participant meta-analysis of 82864 participants from nine cohort studies","volume":"12","author":"Czernichow","year":"2011","journal-title":"Obes. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Zhang, B., Xiong, K., Cai, J., and Ma, A. (2020). Fish Consumption and Coronary Heart Disease: A Meta-Analysis. Nutrients, 12.","DOI":"10.3390\/nu12082278"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1038\/s41430-018-0190-2","article-title":"Fish consumption and risk of stroke, coronary heart disease, and cardiovascular mortality in a Dutch population with low fish intake","volume":"72","author":"Hengeveld","year":"2018","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1016\/j.numecd.2017.08.004","article-title":"Fish intake is associated with lower cardiovascular risk in a Mediterranean population: Prospective results from the Moli-sani study","volume":"27","author":"Bonaccio","year":"2017","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1186\/1475-2891-11-101","article-title":"Diet and lifestyle factors associated with fish consumption in men and women: A study of whether gender differences can result in gender-specific confounding","volume":"11","author":"Wennberg","year":"2012","journal-title":"Nutr. J."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Sto\u015b, K., Wo\u017aniak, A., Rychlik, E., and O\u0142tarzewski, M. (2024). Fish Consumption Frequency in the Adult Population in Poland. Appl. Sci., 14.","DOI":"10.20944\/preprints202408.2159.v1"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1017\/S0007114520003773","article-title":"A systematic review of the determinants of seafood consumption","volume":"126","author":"Govzman","year":"2021","journal-title":"Br. J. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.nutos.2021.10.004","article-title":"Impact of diet on the management of cardiovascular risk factors","volume":"40","author":"Pauli","year":"2021","journal-title":"Clin. Nutr. Open Sci."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Adriouch, S., Lelong, H., Kesse-Guyot, E., Baudry, J., Lampur\u00e9, A., Galan, P., Hercberg, S., Touvier, M., and Fezeu, L.K. (2017). Compliance with Nutritional and Lifestyle Recommendations in 13,000 Patients with a Cardiometabolic Disease from the Nutrinet-Sant\u00e9 Study. Nutrients, 9.","DOI":"10.3390\/nu9060546"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"5957","DOI":"10.1038\/s41467-023-41269-8","article-title":"Sugar-sweetened beverage intakes among adults between 1990 and 2018 in 185 countries","volume":"14","author":"Micha","year":"2023","journal-title":"Nat. Commun."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Shin, S., Kim, S.A., Ha, J., and Lim, K. (2018). Sugar-Sweetened Beverage Consumption in Relation to Obesity and Metabolic Syndrome among Korean Adults: A Cross-Sectional Study from the 2012\u20132016 Korean National Health and Nutrition Examination Survey (KNHANES). Nutrients, 10.","DOI":"10.3390\/nu10101467"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1590\/1413-81232020254.12912018","article-title":"Consumption of sugar-sweetened beverages in patients with established atherosclerosis disease","volume":"25","author":"Ribas","year":"2020","journal-title":"Cien. Saude Colet."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"914","DOI":"10.3945\/ajcn.115.107243","article-title":"Sugar-sweetened beverage consumption and incident hypertension: A systematic review and meta-analysis of prospective cohorts","volume":"102","author":"Jayalath","year":"2015","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"100536","DOI":"10.1016\/j.puhip.2024.100536","article-title":"Temporal changes and educational disparities in the frequent consumption of sugar-sweetened beverages among Estonian adults during 2006\u20132022","volume":"8","author":"Reile","year":"2024","journal-title":"Public Health Pract."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Alosaimi, N., Sherar, L.B., Griffiths, P., and Pearson, N. (2023). Clustering of diet, physical activity and sedentary behaviour and related physical and mental health outcomes: A systematic review. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-16372-6"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e73114","DOI":"10.2196\/73114","article-title":"Clustering of Lifestyle Behaviors and Their Association With Risk of Metabolic Syndrome Among Adults in Taiwan: Nationwide Cross-Sectional Study","volume":"11","author":"Chang","year":"2025","journal-title":"JMIR Public Health Surveill."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/18\/2990\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:14:23Z","timestamp":1789445663000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/18\/2990"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,12]]},"references-count":29,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["nu18182990"],"URL":"https:\/\/doi.org\/10.3390\/nu18182990","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,12]]}}}