What underlies inadequate and unequal fruit and vegetable consumption in India? An exploratory analysis.
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ABSTRACT:
SUBMITTER: Choudhury S
PROVIDER: S-EPMC7063694 | biostudies-literature | 2020 Mar
REPOSITORIES: biostudies-literature
Publications
What underlies inadequate and unequal fruit and vegetable consumption in India? An exploratory analysis.
Choudhury Samira S Shankar Bhavani B Aleksandrowicz Lukasz L Tak Mehroosh M Green Rosemary R Harris Francesca F Scheelbeek Pauline P Dangour Alan A
Global food security 20200301
Adequate consumption of fruit and vegetables is key to improved diet-related health in India. We analyse fruit and vegetable consumption in the Indian population using National Sample Survey data. A series of regressions is estimated to characterise the distribution of household fruit and vegetable consumption and explore key socio-economic and food system drivers of consumption. Household income and price are important correlates, but consumption is also higher where households are headed by fe ...[more]
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Project description:Background: Prevalence of F&V consumption in Namibia is not known. In this study we aimed to address this gap by using nationally representative data with the objectives of measuring the prevalence of adequate F&V consumption among adult men and women and their socio demographic determinants. Methods: This study is based on data from Namibia Demographic and Health Survey (NDHS2013). Sample population were 14 185 men and women aged between 15 and 49 years.Amount of fruit and vegetable consumption was measured by self-reported frequencies and was defined as adequate (at least 5 servings/day) according to World Health Organization (WHO)guidelines. Results: Overall, only 4.3% (3.8-4.9%) of the men and women reported consuming at least 5 servings of F&V a day, with the percentage being slightly higher among women (4.8%,95% CI=3.7-6.2) compared with men (4.2%, 95% CI=3.6-4.8). In the multivariable analysis,education level and household wealth status appeared to be the only factors associated with adequate F&V intake. Men and women who had primary level education had higher odds of eating at least 5 servings of F&V a day compared with those who had no education. Regarding wealth status, men and women from non-poor households had respectively 2.13 times(OR=2.13, 95% CI=1.01-4.48) and 2.2 times (OR=2.19, 95% CI=1.56-3.38) higher odds of eating at least 5 servings of F&V a day. Conclusion: Only a small proportion of the men and women consumed adequate amount of F&V on daily basis. Having primary level education and non-poor household wealth status were positively associated with adequate amount of F&V intake.
| S-EPMC6249495 | biostudies-other
Project description:Fruit and vegetable (FV) based intervention studies can be effective in increasing short term FV consumption. However, the longer term efficacy of such interventions is still unclear. The aim of the current study was to examine the maintenance of change in FV consumption 18-months after cessation of a FV intervention and to examine the effect of participating in a FV intervention on barriers to FV consumption.A follow-up of a randomised controlled FV trial in 83 older adults (habitually consuming ?2 portions/day) was conducted. At baseline, participants were assigned to continue consuming ?2 portions FV/day or consume ?5 portions FV/day for 16-weeks. We assessed FV intake and barriers to FV consumption at baseline, end of intervention and 18-months post-intervention.At 18-months, mean FV intakes in both groups were greater than baseline. The 5 portions/day group continued to show greater increases in FV consumption at 18-months than the 2 portions/day group (p?<?0.01). At 18-months, both groups reported greater liking (p?<?0.01) and ease in consuming FV (p?=?0.001) while difficulties with consuming FV decreased (p?<?0.001). The 2 portions/day group reported greater awareness of FV recommendations at 18-months (p?<?0.001).Participating in a FV intervention can lead to longer-term positive changes in FV consumption regardless of original group allocation.Clinical Trials.gov NCT00858728 .
| S-EPMC4683738 | biostudies-literature
Project description:Fruits and vegetables are an essential part of the human diet, but many people do not consume the recommended serves to prevent cardiovascular disease and cancer. In this research, we evaluate the cost-effectiveness of interventions to promote fruit and vegetable consumption to determine which interventions are good value for money, and by how much current strategies can reduce the population disease burden.In a review of published literature, we identified 23 interventions for promoting fruit and vegetable intake in the healthy adult population that have sufficient evidence for cost-effectiveness analysis. For each intervention, we model the health impacts in disability-adjusted life years (DALYs), the costs of intervention and the potential cost-savings from averting disease treatment, to determine cost-effectiveness of each intervention over the lifetime of the population, from an Australian health sector perspective. Interventions that rely on dietary counselling, telephone contact, worksite promotion or other methods to encourage change in dietary behaviour are not highly effective or cost-effective. Only five out of 23 interventions are less than an A$50,000 per disability-adjusted life year cost-effectiveness threshold, and even the most effective intervention can avert only 5% of the disease burden attributed to insufficient fruit and vegetable intake.We recommend more investment in evaluating interventions that address the whole population, such as changing policies influencing price or availability of fruits and vegetables, to see if these approaches can provide more effective and cost-effective incentives for improving fruit and vegetable intake.
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| S-EPMC6908839 | biostudies-literature
Project description:OBJECTIVE:Public health decision makers not only consider health benefits but also economic implications when articulating and issuing lifestyle recommendations. Whereas various estimates exist for the economic burden of physical inactivity, excess body weight and smoking, estimates of the economic burden associated with our diet are rare. In the present study, we estimated the economic burden attributable to the inadequate consumption of vegetables and fruit in Canada. DESIGN:We accessed the Canadian Community Health Survey to assess the inadequacy in the consumption of vegetables and fruit and published meta-analyses to assemble risk estimates for chronic diseases. Based on these inadequacy and risk estimates, we calculated the population-attributable fraction and avoidable direct and indirect costs to society. Direct costs include those for hospital care, physician services and drugs in 2015. RESULTS:About 80 % of women and 89 % of men consume inadequate amounts of vegetables and fruit. We estimated this to result in an economic burden of $CAN 3·3 billion per year, of which 30·5 % is direct health-care costs and 69·5 % is indirect costs due to productivity losses. A modest 1 percentage point annual reduction in the prevalence of inadequate vegetables and fruit consumption over the next 20 years would avoid approximately $CAN 10·8 billion, and an increase of one serving of vegetables and fruit per day would avoid approximately $CAN 9·2 billion. CONCLUSIONS:Further investments in the promotion of vegetables and fruit will prevent chronic disease and substantially reduce direct and indirect health-care costs.
| S-EPMC5426323 | biostudies-literature
Project description:BackgroundCancer survivors, especially those who are older, experience increased comorbidity and risk for secondary cancers. A varied dietary pattern rich in vegetables and fruits (V&F) is recommended to improve health. However, V&F intake can differ by rural vs urban status.ObjectiveOur objective was to assess the differences in V&F consumption among older cancer survivors residing in urban- and rural-designated areas, and to explore whether differences exist according to sex, race, and cancer type.DesignThis was a cross-sectional secondary analysis.Participants/settingScreening data from the Harvest for Health trial were obtained from October 2016 to November 2019 on 731 Medicare-eligible cancer survivors across Alabama.Main outcome measuresV&F consumption was measured by 2 items from the National Cancer Institute's dietary screener Eating at America's Table. Rural and urban residence was coded at the ZIP-code level using the US Department of Agriculture's Rural-Urban Commuting Area coding schema using 5 different classifications (A through E). Sex, race, and cancer type were dichotomized as male or female, non-Hispanic White or non-Hispanic Black, and gastrointestinal or other cancers, respectively.Statistical analysesKruskal-Wallis rank sum and post-hoc tests were performed to detect differences in V&F consumption (α < .05).ResultsThe study sample was largely female (66.2%) and non-Hispanic White (78.1%); mean age was 70 years and reported average V&F intake was 1.47 cups/d. V&F consumption of cancer survivors living in isolated, small, rural towns was roughly one-half that consumed by survivors living elsewhere; thus, statistically significant rural-urban differences were found in models that accounted specifically for this subgroup, that is, Rural-Urban Commuting Area categorizations A and E. V&F consumption also was significantly lower in non-Hispanic Black (1.32 ± 0.98 cups/d) than non-Hispanic White survivors (1.51 ± 1.10 cups/d) (P = .0456); however, no statistically significant differences were detected by sex and cancer type.ConclusionsAnalyses that address the variability within rural-designated areas are important in future studies. Moreover, a greater understanding is needed of factors that adversely affect V&F consumption of those most vulnerable, that is, older, non-Hispanic Black cancer survivors, as well as those living in isolated, small, rural towns to best target future interventions.Trial registrationClinicalTrials.gov: NCT02985411.
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Project description:There is limited evidence in Japan regarding the psychosocial determinants of fruit/vegetable intake. We performed a cross-sectional study of people aged 18 years or older in four regions of Japan; 2308 (men: 1012, women: 1296) individuals who completed the questionnaires were included. We found that 24.8% of people were aware of the current recommendations for vegetables and 13.2% for fruit and that "ability to design meals" and "availability when eating outside of the home" were the most important factors related to self-efficacy and barriers to fruit and vegetable intake, respectively. People with high self-efficacy (OR: 3.16; 95% CI: 2.17, 4.60 for fruit; OR: 4.52; 95% CI: 3.08, 6.64 for vegetables) were more likely to consume more fruit and vegetables. People with high scores on attitude (OR: 1.54; 95% CI: 1.06, 2.24) and social support (OR: 1.59; 95% CI: 1.11, 2.27) were more likely to consume more fruit. People with high perceived barriers (OR: 0.69; 95% CI: 0.48, 0.98) were less likely to consume fruit. This study suggests a need to increase the general population's awareness of the fruit and vegetable intake recommendations; facilitating positive attitudes, self-efficacy, and social support for individuals and strengthening the ability of individuals to design meals with more vegetables and fruit might be useful intervention programs.
| S-EPMC4997472 | biostudies-literature
Project description:BackgroundThere is evidence of a clustering of healthy dietary patterns and physical activity among young people and also of unhealthy behaviours. The identification of influences on children's health behaviors, particularly clustered health behaviors, at the time at which they develop is imperative for the design of interventions. This study examines associations between parental modelling and support and children's physical activity (PA) and consumption of fruit and vegetables (FV), and combinations of these behaviours.MethodsIn 2002/3 parents of 775 Australian children aged 10-12 years reported how frequently their child ate a variety of fruits and vegetables in the last week. Children wore accelerometers for eight days during waking hours. Parental modelling and parental support (financial and transport) were self-reported. Binary logistic and multinomial logistic regression analyses examined the likelihood of achieving >/= 2 hours of PA per day (high PA) and of consuming >/= 5 portions of FV per day (high FV) and combinations of these behaviors (e.g. high PA/low FV), according to parental modelling and support.ResultsItems of parental modelling and support were differentially associated with child behaviours. For example, girls whose parents reported high PA modelling had higher odds of consuming >/= 5 portions of FV/day (OR = 1.95, 95% CI = 1.32-2.87, p < 0.001). Boys whose parents reported high financial support for snacks/fast foods had higher odds of having 'high PA/low FV' (OR = 2.0, 95% CI = 1.1-3.7).ConclusionParental modelling of and support for physical activity and fruit and vegetable consumption were differentially associated with these behaviours in children across behavioural domains and with combinations of these behaviours. Promoting parents' own healthy eating and physical activity behaviours as well encouraging parental modelling and support of these behaviours in their children may be important strategies to test in future research.
| S-EPMC2703614 | biostudies-literature
Project description:ObjectivesThe aim of this meta-analysis was to assess the quantitative associations between fruit and vegetable intake and cognitive disorders in older adults.DesignA meta-analysis.Setting and participantsWe used the PubMed, Web of Science and Scopus databases for a literature search to 12 April 2022. We preliminarily retrieved 11,759 studies, 16 of which met the inclusion criteria including six cross-sectional studies, nine cohort studies and one case-control study, incorporating 64,348 participants and 9,879 cases.MethodsUsing the three databases, we identified observational studies exploring the association. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random effects model.ResultsSixteen studies were included in the meta-analysis, and the results showed that increased fruit and vegetable consumption in older adults was associated with a decline in the prevalence of cognitive disorders (OR: 0.79, 95% CI: 0.76-0.83). Moreover, intake of fruits (OR: 0.83, 95% CI: 0.77-0.89) and vegetables (OR: 0.75, 95% CI: 0.70-0.80) alone were both associated with a lower prevalence of cognitive disorders. Subgroup analyses indicated that the intake of fruits and vegetables was associated with the prevalence of cognitive impairment (OR: 0.72, 95% CI: 0.76-0.80) and dementia (OR: 0.84, 95% CI: 0.78-0.91) but not Alzheimer's disease (OR: 0.88, 95% CI: 0.76-1.01).Conclusion and implicationsOur meta-analysis provides evidence that the intake of fruits and vegetables is inversely proportional and linearly associated with the prevalence of cognitive disorders in older adults. Future research is required to further investigate the preventive effects of the frequency, quantity, and duration of eating vegetables and fruits on cognitive disorders in older adults.
| S-EPMC9251442 | biostudies-literature