Consumption of Fruits and Vegetables Among Individuals 15 Years and Older in 28 Low- and Middle-Income Countries.


Journal

The Journal of nutrition
ISSN: 1541-6100
Titre abrégé: J Nutr
Pays: United States
ID NLM: 0404243

Informations de publication

Date de publication:
01 07 2019
Historique:
received: 21 11 2018
revised: 21 12 2018
accepted: 21 02 2019
pubmed: 4 6 2019
medline: 9 4 2020
entrez: 2 6 2019
Statut: ppublish

Résumé

The WHO recommends 400 g/d of fruits and vegetables (the equivalent of ∼5 servings/d) for the prevention of noncommunicable diseases (NCDs). However, there is limited evidence regarding individual-level correlates of meeting these recommendations in low- and middle-income countries (LMICs). In order to target policies and interventions aimed at improving intake, global monitoring of fruit and vegetable consumption by socio-demographic subpopulations is required. The aims of this study were to 1) assess the proportion of individuals meeting the WHO recommendation and 2) evaluate socio-demographic predictors (age, sex, and educational attainment) of meeting the WHO recommendation. Data were collected from 193,606 individuals aged ≥15 y in 28 LMICs between 2005 and 2016. The prevalence of meeting the WHO recommendation took into account the complex survey designs, and countries were weighted according to their World Bank population estimates in 2015. Poisson regression was used to estimate associations with socio-demographic characteristics. The proportion (95% CI) of individuals aged ≥15 y who met the WHO recommendation was 18.0% (16.6-19.4%). Mean intake of fruits was 1.15 (1.10-1.20) servings per day and for vegetables, 2.46 (2.40-2.51) servings/d. The proportion of individuals meeting the recommendation increased with increasing country gross domestic product (GDP) class (P < 0.0001) and with decreasing country FAO food price index (FPI; indicating greater stability of food prices; P < 0.0001). At the individual level, those with secondary education or greater were more likely to achieve the recommendation compared with individuals with no formal education: risk ratio (95% CI), 1.61 (1.24-2.09). Over 80% of individuals aged ≥15 y living in these 28 LMICs consumed lower amounts of fruits and vegetables than recommended by the WHO. Policies to promote fruit and vegetable consumption in LMICs are urgently needed to address the observed inequities in intake and prevent NCDs.

Sections du résumé

BACKGROUND
The WHO recommends 400 g/d of fruits and vegetables (the equivalent of ∼5 servings/d) for the prevention of noncommunicable diseases (NCDs). However, there is limited evidence regarding individual-level correlates of meeting these recommendations in low- and middle-income countries (LMICs). In order to target policies and interventions aimed at improving intake, global monitoring of fruit and vegetable consumption by socio-demographic subpopulations is required.
OBJECTIVES
The aims of this study were to 1) assess the proportion of individuals meeting the WHO recommendation and 2) evaluate socio-demographic predictors (age, sex, and educational attainment) of meeting the WHO recommendation.
METHODS
Data were collected from 193,606 individuals aged ≥15 y in 28 LMICs between 2005 and 2016. The prevalence of meeting the WHO recommendation took into account the complex survey designs, and countries were weighted according to their World Bank population estimates in 2015. Poisson regression was used to estimate associations with socio-demographic characteristics.
RESULTS
The proportion (95% CI) of individuals aged ≥15 y who met the WHO recommendation was 18.0% (16.6-19.4%). Mean intake of fruits was 1.15 (1.10-1.20) servings per day and for vegetables, 2.46 (2.40-2.51) servings/d. The proportion of individuals meeting the recommendation increased with increasing country gross domestic product (GDP) class (P < 0.0001) and with decreasing country FAO food price index (FPI; indicating greater stability of food prices; P < 0.0001). At the individual level, those with secondary education or greater were more likely to achieve the recommendation compared with individuals with no formal education: risk ratio (95% CI), 1.61 (1.24-2.09).
CONCLUSIONS
Over 80% of individuals aged ≥15 y living in these 28 LMICs consumed lower amounts of fruits and vegetables than recommended by the WHO. Policies to promote fruit and vegetable consumption in LMICs are urgently needed to address the observed inequities in intake and prevent NCDs.

Identifiants

pubmed: 31152660
pii: S0022-3166(22)16658-7
doi: 10.1093/jn/nxz040
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1252-1259

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © American Society for Nutrition 2019.

Auteurs

Sarah M Frank (SM)

Harvard Center for Population and Development Studies, Harvard University, Cambridge, MA.

Jacqui Webster (J)

The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.

Briar McKenzie (B)

The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.

Pascal Geldsetzer (P)

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA.

Jennifer Manne-Goehler (J)

Massachusetts General Hospital, Boston, MA.

Glennis Andall-Brereton (G)

Non-Communicable Diseases, Caribbean Public Health Agency, Port of Spain, Trinidad and Tobago.

Corine Houehanou (C)

Laboratory of Epidemiology of Chronic and Neurological Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Abomey-Calavi, Atlantique, Benin.

Dismand Houinato (D)

Laboratory of Epidemiology of Chronic and Neurological Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Abomey-Calavi, Atlantique, Benin.

Mongal Singh Gurung (MS)

Health Research and Epidemiology Unit, Ministry of Health, Thimphu, Bhutan.

Brice Wilfried Bicaba (BW)

Direction de la Protection de la Santé de la Population, Ouagadougou, Kadiogo, Burkina Faso.

Roy Wong McClure (RW)

Epidemiology Office and Surveillance, Caja Costarricense de Seguro Social, San Jose, Costa Rica.

Adil Supiyev (A)

National Laboratory Astana and University Medical Center, Nazarbayev University, Astana, Kazakhstan.

Zhaxybay Zhumadilov (Z)

National Laboratory Astana and University Medical Center, Nazarbayev University, Astana, Kazakhstan.

Andrew Stokes (A)

Center for Global Health and Development, Boston University School of Public Health, Boston, MA.

Demetre Labadarios (D)

Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, Western Cape, South Africa.

Abla Mehio Sibai (AM)

American University of Beirut, Beirut, Lebanon.

Bolormaa Norov (B)

National Center for Public Health, Ulaanbaatar, Mongolia.

Krishna K Aryal (KK)

DFID/NHSP3/MEOR, Abt Associates, Kathmandu, Nepal.

Khem Bahadur Karki (KB)

Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.

Gibson B Kagaruki (GB)

National Institute for Medical Research, Dar es Salaam, Tanzania.

Mary T Mayige (MT)

National Institute for Medical Research, Dar es Salaam, Tanzania.

Joao S Martins (JS)

Faculty of Medicine and Health Sciences, National University of East Timor, Rua Jacinto Candido, Dili, Timor-Leste.

Rifat Atun (R)

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA.

Till Bärnighausen (T)

Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany.

Sebastian Vollmer (S)

Department of Economics and Centre for Modern Indian Studies, University of Göttingen, Göttingen, Germany.

Lindsay M Jaacks (LM)

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA.

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