Low fruit and vegetable consumption in Mozambique: results from a WHO STEPwise approach to chronic disease risk factor surveillance

Abstract

Monitoring food consumption and its determinants over time is essential for defining and implementing health promotion strategies, but surveillance is scarce in Africa. The present study aimed to describe fruit and vegetable consumption in Mozambique according to sociodemographic characteristics and place of residence (urban/rural). A national representative sample (n 3323) of subjects aged 25-64 years was evaluated in 2005 following the WHO Stepwise Approach to Chronic Disease Risk Factor Surveillance, which included an assessment of usual fruit and vegetable consumption (frequency and quantity). Crude prevalence and age-, education-and family income-adjusted prevalence ratios (PR) with 95 % CI were computed. Less than 5 % of the subjects reported an intake of five or more daily servings of fruits/vegetables. Both fruits and vegetables were more often consumed by women and in rural settings. In urban areas, the prevalence of fruit intake ($ 2 servings/d) increased with education ($ 6 years v. ,1 year: women, adjusted PR ¼ 3·11, 95 % CI 1·27, 7·58; men, adjusted PR ¼ 3·63, 95 % CI 1·22, 10·81), but not with income. Conversely, vegetable consumption ($2 servings/d) was less frequent in more educated urban men ($6 years v. , 1 year: adjusted PR ¼ 0·30, 95 % CI 0·10, 0·94) and more affluent rural women ($ $801 US dollars (USD) v. $0-64: adjusted PR ¼ 0·32, 95 % CI 0·13, 0·81). The very low intake of these foods in this setting supports the need for fruit and vegetable promotion programmes that target the whole population, despite the different socio-demographic determinants of fruit and vegetable intake.Key words: Fruits: Vegetables: Africa: Mozambique Global data on consumption show that more than threequarters of the population consume less than the minimum recommendation of five daily servings of fruits and vegetables (1) . Insufficient intake of these food items is estimated to be responsible for approximately 14 % of gastrointestinal cancer, 11 % of IHD, 9 % of stroke deaths and approximately 2·9 % of overall mortality worldwide (2) . In Africa, the mortality attributable to low fruit and vegetable consumption is much smaller (0·4 % of all deaths) (3)

Fruit and vegetable intake and associated factors in older adults in South Africa

“…These rates seem to be similar to a previous survey among the adult population in South Africa (4) and in a study among older adults in Northern Ireland (10), but the prevalence rate of insufficient FV intake was lower in this study than among elderly populations in several Asian countries (5), Mozambique (7), and Iran (8) and it was higher than in Canada (9). Unlike other studies (11–16), the prevalence of low FV intake was higher (although not significantly) among female than male older adults in this study.…”

“…Previous studies among the adult population in South Africa in 2003 found that 72.2% of men and 66.7% of women had low FV consumption (5) and in a local study, 7% of the villagers and none of the semi-urban dwellers reported the recommended five or more FV servings per day (6). In a more recent study among adults (25–64 years) in Mozambique, less than 5% of the subjects reported an intake of five or more daily servings of FVs (7). In Iran, a middle-income country, low mean number of FV servings per day (1.76) among persons aged 60 and above were reported (8), while in some high-income countries, lower rates of FV intake was found among older adults, for example, 47% in Canada (9) and a mean consumption of 4.0 and 4.1 portions of FVs per weekday and per weekend day, respectively, in Northern Ireland (10).…”

“…Various factors have been identified to be associated with low prevalence of FV intake, including 1) Sociodemographics: older age (4, 11), male gender (11–16), lower education (5, 9, 12, 17–19), lower income (4, 9, 14, 18, 20), urban or rural residence (7, 21), and White population group or race (13); 2) Lack of social cohesion or social capital (8, 12, 22), and being single, widowed, or divorced (11, 13, 17, 20); 3) Chronic and other illness conditions: diabetes (23), hypertension (24), overweight or obese (11, 22), or not overweight (25), depressive symptoms (26); 4) Poor subjective health status (22); 5) Lifestyle factors: smokers (17, 19, 27), low physical activity (11, 19), drinking alcohol (11), and not drinking alcohol (19); and 6) Knowledge and psychosocial determinants (8, 28). …”

Multiple cardiovascular risk factors in Kenya: evidence from a health and demographic surveillance system using the WHO STEPwise approach to chronic disease risk factor surveillance

“…Inadequate consumption, however, is most commonly seen in many countries in SSA,22 and our findings are no exception. Approximately one out of every seven adults reported daily fruit or vegetable consumption while most people reported consuming fruits or vegetables 2–3 days per week.…”

Physical activity patterns in Mozambique: Urban/rural differences during epidemiological transition

“…The present community-based cross-sectional study evaluated a representative sample of the Mozambican adults aged 25 to 64 years, between September and November 2005, as previously described in detail (Padrão et al, 2011(Padrão et al, , 2012. Briefly, the survey followed a complex sampling design with clustering at a geographical unit level and at the household level, as well as stratification by province.…”