Barriers to consumption of fruits and vegetables and strategies to overcome them in low- and middle-income countries: a narrative review

Kaur, Sukhdeep

doi:10.1017/s0954422422000166

Cited by 9 publications

(7 citation statements)

References 213 publications

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“…Our study results indicate global action is needed to improve vegetable and fruit consumption among young children. Multidimensional strategies that address personal and external barriers to vegetable and fruit consumption for infants and young children are likely to be most effective [ 41 , 42 ]. Interventions targeting the wider food system/agricultural production can work in tandem with school gardens, improved home gardens, cash transfers, nutrition education, and behavior change for families and communities [ 41 , 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…Multidimensional strategies that address personal and external barriers to vegetable and fruit consumption for infants and young children are likely to be most effective [ 41 , 42 ]. Interventions targeting the wider food system/agricultural production can work in tandem with school gardens, improved home gardens, cash transfers, nutrition education, and behavior change for families and communities [ 41 , 43 , 44 ]. As most research on effective strategies is from high income-settings, two areas for future research include generating evidence from LMICs on effective interventions and translating strategies from other contexts to improve vegetable and fruit consumption among young children.…”

Section: Discussionmentioning

confidence: 99%

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Estimates and trends of zero vegetable or fruit consumption among children aged 6–23 months in 64 countries

Allen

Assaf

Namasté

et al. 2023

PLOS Glob Public Health

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Children require a diverse diet, that includes vegetables and fruits, to support growth and development and prevent non-communicable diseases. The WHO-UNICEF established a new infant and young child feeding (IYCF) indicator: zero vegetable or fruit (ZVF) consumption among children aged 6–23 months. We estimated the prevalence, trends, and factors associated with ZVF consumption using nationally representative, cross-sectional data on child health and nutrition in low-and-middle-income countries. We examined 125 Demographic and Health Surveys in 64 countries conducted between 2006–2020 with data on whether a child ate vegetables or fruits the previous day. Prevalence of ZVF consumption was calculated by country, region, and globally. Country trends were estimated and tested for statistical significance (p<0.05). Logistic regression analysis was used to examine the relationship between ZVF and child, mother, household, and survey cluster characteristics by world region and globally. Using a pooled estimate of the most recent survey available in each country, we estimate the global prevalence of ZVF consumption as 45.7%, with the highest prevalence in West and Central Africa (56.1%) and the lowest in Latin America and the Caribbean (34.5%). Recent trends in ZVF consumption varied by country (16 decreasing, eight increasing, 14 no change). Country trends in ZVF consumption represented diverse patterns of food consumption over time and may be affected by the timing of surveys. Children from wealthier households and children of mothers who are employed, more educated, and have access to media were less likely to consume ZVF. We find the prevalence of children aged 6–23 months who do not consume any vegetables or fruits is high and is associated with wealth and characteristics of the mother. Areas for future research include generating evidence from low-and-middle-income countries on effective interventions and translating strategies from other contexts to improve vegetable and fruit consumption among young children.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Estimates and trends of zero vegetable or fruit consumption among children aged 6–23 months in 64 countries

Allen

Assaf

Namasté

et al. 2023

PLOS Glob Public Health

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“…In Spain, the mean vegetable intake in 2010 for adults ≥20 years of age was between 150 and 174.9 g/d, clearly below recommendations [21]. Socio-demographic and cultural factors, environmental conditions, and worldwide tendencies have been identified as barriers to the consumption of fruits and vegetables [40]. Between the worldwide and environmental tendencies, increasing urbanization may be related to the low consumption of vegetables.…”

Section: Discussionmentioning

confidence: 99%

Determinants of Consumption of Vegetables among the Spanish Population: A Cross-Sectional Study

Lucha-López,

Hidalgo-García,

Lucha-López

et al. 2023

Foods

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The consumption of vegetables is one of the fundamentals of a healthy diet. The purposes of the present study were to describe the frequency of consumption of vegetables in the general Spanish population and to explore the relations between the consumption of vegetables and sex, age, cohabitation circumstances, educational level, and body mass index (BMI). Methods: An analytical cross-sectional study was accomplished based on data from the European Health Survey in Spain (2020). Results: A total of 20,745 (52.1% women) subjects with a median age of 54 years old were included. Only 2.8% of them ate vegetables at least three times a day. The adjusted generalized linear model showed that being a woman increased the odds of consuming vegetables at least three times a day by 1.666 times (p < 0.001). Not cohabiting as a couple decreased the odds by 0.783 (p < 0.001). Having studied at a university increased the odds by 1.812 times (p < 0.001) and possessing a certificate of higher education by 1.408 (p = 0.030). Being overweight decreased the odds by 0.924 (p = 0.006). For every additional year of age, the odds of consuming vegetables at least three times a day increased by 1.3% (p < 0.001). Conclusions: The vast majority of the general Spanish population did not consume an optimal amount of vegetables. Women, people with higher levels of education, and older individuals reported having a more frequent intake of vegetables. Not cohabiting as a couple and being overweight were related to a less frequent intake of vegetables.

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“…without addressing the broader cultural-ecological components of how food is produced, distributed, acquired, and consumed [81]. Snacking outside the home may be perceived as an empowering, rebellious, progressive step particularly for girls whose preferences cannot be expressed within the home due to the need to prioritise and defer to men and boys.…”

Section: Plos Onementioning

confidence: 99%

Eating for honour: A cultural-ecological analysis of food behaviours among adolescent girls in the southern plains of Nepal

Morrison,

Basnet,

Sharma

2023

PLoS ONE

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Access to adequate and nutritious food is important for the current and future health of adolescent girls. Interventions often focus on the individual as responsible for their own health ignoring the complex structural issues that underlie optimal nutrition. In South Asia gender inequalities have been noted as an important determinant of poor nutrition among women and their young children, but analysis of adolescent girls’ diets and what influences these are rarely undertaken. Therefore, we sought to analyse the factors affecting what and where girls’ eat and what affects their behaviour in the plains of Nepal, using a cultural-ecological approach. We analysed a secondary qualitative dataset of focus group discussions with adolescent girls aged 12–19 years old, young mothers, mothers-in-law, and older female key informants. Eating was heavily influenced by patriarchal norms. Boys had preferential access to food, money, and freedom of movement to appreciate their future role in providing for the family. Food was an investment, and boys were perceived to have more nutritional need than girls. Girls were not perceived to be a good return on investment of food, and eating practices sought to prepare them for life as a subservient daughter-in-law and wife. Obedience and sacrifice were valued in girls, and they were expected to eat less and do more housework than boys. Girls’ eating and behaviour was constrained to maintain self and family honour. Interventions should acknowledge cultural influences on eating and engage multiple actors in addressing harmful gender norms which limit eating and prevent girls from reaching their potential.

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Barriers to consumption of fruits and vegetables and strategies to overcome them in low- and middle-income countries: a narrative review

Cited by 9 publications

References 213 publications

Estimates and trends of zero vegetable or fruit consumption among children aged 6–23 months in 64 countries

Estimates and trends of zero vegetable or fruit consumption among children aged 6–23 months in 64 countries

Determinants of Consumption of Vegetables among the Spanish Population: A Cross-Sectional Study

Eating for honour: A cultural-ecological analysis of food behaviours among adolescent girls in the southern plains of Nepal

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