The Food Environments of Fruit and Vegetable Consumption in East and Southeast Asia: A Systematic Review

Abstract

Fruit and vegetable (FV) consumption benefits the health of populations. This can be especially the case in locations which have undergone significant changes in their food environments, such as East and Southeast Asian countries. This current systematic review is the first to study the food environments—facilitators, barriers, and moderators—associated with FV consumption in East and Southeast Asia. We consulted five electronic academic databases of English peer-reviewed papers published between 2010 and 2020 and found 31 studies. Results of these studies show that individuals strongly perceive FVs as being high-quality and safe, and having trust in their benefits. Food businesses with modernized systems have significantly fostered the consumption of FVs. A main barrier to FV consumption, however, is financial concerns, exacerbated by food businesses with FV unavailability and urbanization-induced FV price inflation and dietary patterns. Demographics and shopping patterns further hinder FV consumption. The fragmented and conditionalized findings of the 31 studies require standardized FV consumption measurements. Unlike the impact of FV consumption determinants and their interactions in Western countries, those in Asia, particularly countries other than China, have been substantially understudied. Therefore, as the research gaps in studies of food environments and FV consumption in East and Southeast Asia urgently demand scholarly attention, this paper proposes recommendations that favour the consumption of FVs.

Geographic Clustering of Fast-Food Restaurants Around Secondary Schools in Hong Kong

“…Our study serves to raise awareness among authorities about food environments around secondary schools in Hong Kong. In the US, the National School Lunch Program was implemented in 1946 to enhance students' nutritional intake by offering school meals which meet US Department of Agriculture standards: currently, these standards include increasing the number and variety of fruits, vegetables, and whole grains and reducing the intake of trans-fat content and calories (31). This school meal program reduced weight status among school lunch participants, especially among students eligible for subsidies (31).…”

“…In the US, the National School Lunch Program was implemented in 1946 to enhance students' nutritional intake by offering school meals which meet US Department of Agriculture standards: currently, these standards include increasing the number and variety of fruits, vegetables, and whole grains and reducing the intake of trans-fat content and calories (31). This school meal program reduced weight status among school lunch participants, especially among students eligible for subsidies (31). The Hong Kong government could consider formulating a school lunch program with high nutrition standards and subsidizing secondary school students to buy healthy school lunches.…”

“…The Hong Kong government could consider formulating a school lunch program with high nutrition standards and subsidizing secondary school students to buy healthy school lunches. Apart from incorporating incentives to encourage students to eat nutritious food for lunch, the government could also initiate policies to lower the appeal of fast food by restricting fast-food advertising in major media channels and holding frequent educational sessions on the consequences of fast-food intake ( 32 , 33 ).…”

Quantity and variety of fruit and vegetable intake in midlife and cognitive impairment in late life: a prospective cohort study

“…Moreover, it is unclear whether increasing the variety in fruits and vegetables, independent of the quantity of intake, could further prevent cognitive impairment. Finally, the types of fruits and vegetables consumed commonly in different populations may vary due to socio-cultural factors such as religion, traditional beliefs and food preferences, as well as socio-economic factors such as cost, availability and ease of accessibility, which are all factors that can influence the diversity in fruits and vegetables between Asian and Western populations (13) . Given that most of previous studies were done in Western countries, studies among understudied Asian populations are necessary.…”

Evaluation of the Health-Promoting Properties of Selected Fruits

“…According to Aune et al [ 1 ], between 5.6 and 7.8 million premature deaths occurring worldwide in 2013, were attributable to a low fruit, and vegetable intake (lower than 500 and 800 g/day), respectively. In this context, Cheung et al [ 2 ] pointed that most of these mortality risks, mainly those related to cardiovascular disease, chronic diseases, and cancer, could be reduced by regular and varied consumption of fruit and vegetables. These protective effects are largely attributed to secondary metabolites including polyphenols, glucosinolates, carotenoids, terpenoids, alkaloids, saponins, vitamins, among others, present in fruits and vegetables [ 3 ] exhibiting antioxidant, antiatherogenic, anti-inflammatory, antimicrobial, and cardioprotective effects [ 4 ].…”