Insufficient Fruit and Vegetable Intake in a Low- and Middle-Income Setting: A Population-Based Survey in Semi-Urban Tanzania.

Beverly Msambichaka, Ikenna C Eze, Ramadhan Abdul, Salim Abdulla, Paul Klatser, Marcel Tanner, Ramaiya Kaushik, Eveline Geubbels, Nicole Probst-Hensch
Author Information
  1. Beverly Msambichaka: Ifakara Health Institute Dar es Salaam, Kiko Avenue, P.O. Box 78373, Dar es Salaam, Tanzania. msambichakabeverly@gmail.com.
  2. Ikenna C Eze: Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland. ikenna.eze@swisstph.ch. ORCID
  3. Ramadhan Abdul: Ifakara Health Institute Dar es Salaam, Kiko Avenue, P.O. Box 78373, Dar es Salaam, Tanzania. rabdul@ihi.or.tz.
  4. Salim Abdulla: Ifakara Health Institute Dar es Salaam, Kiko Avenue, P.O. Box 78373, Dar es Salaam, Tanzania. sabdulla@ihi.or.tz.
  5. Paul Klatser: Athena Institute, Vrije Universiteit/Free University, 1081 HV Amsterdam, The Netherlands. paulklatser@gmail.com.
  6. Marcel Tanner: Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland. marcel.tanner@swisstph.ch.
  7. Ramaiya Kaushik: Shree Hindu Mandal Hospital, Chusi St, P.O. Box 581, Dar es Salaam, Tanzania. ceo@hindumandal.org.
  8. Eveline Geubbels: Ifakara Health Institute Dar es Salaam, Kiko Avenue, P.O. Box 78373, Dar es Salaam, Tanzania. egeubbels@ihi.or.tz.
  9. Nicole Probst-Hensch: Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland. nicole.probst@swisstph.ch.

Abstract

A daily intake of 5 portions of fruit and vegetables (FV) is recommended for protection against non-communicable diseases (NCDs). Inadequate FV intake is a global problem but resource-poor countries like Tanzania are most deprived and constitute settings where little is known for informing public health interventions. This study aimed to describe the prevalence of inadequate FV intake, frequency of FV intake, portions of FV intake and their associations with socio-demographic/lifestyle factors in South-Eastern Tanzania. Data on FV dietary indicators, socio-demographic factors, smoking, alcohol and healthcare use were collected from 7953 participants (≥15 years) of the population-based MZIMA open community cohort (2012-2013). Multivariable logistic regression was used to examine associations between FV intake outcomes and their socio-demographic/lifestyle determinants. Most (82%) of the participants did not meet the recommended daily FV intake While only a fraction consumed fruits daily (15.5%), almost half consumed vegetables daily (44.2%). However, the median (IQR) number of vegetable portions consumed was lower (2(1)/person/day) than that for fruits (2(2)/person/day) People with higher education were more likely to consume fruits daily. Independent correlates of inadequate FV intake included young age, being male, low education, low-income occupations, low alcohol, high tobacco and low healthcare use. Public health interventions should target the socio-economically deprived and culturally-rooted preferences while prioritizing promotion of vegetable for most immediate gain in overall FV intake.

Keywords

References

  1. J Nutr. 2009 Mar;139(3):568-75 [PMID: 19158224]
  2. BMC Public Health. 2012 Oct 28;12:912 [PMID: 23102008]
  3. Public Health Nutr. 2011 Apr;14(4):694-701 [PMID: 20576194]
  4. Am J Clin Nutr. 2005 Oct;82(4):806-12 [PMID: 16210710]
  5. Appetite. 2012 Aug;59(1):155-60 [PMID: 22524998]
  6. Int J Behav Nutr Phys Act. 2006 Aug 11;3:22 [PMID: 16904006]
  7. Public Health Nutr. 2004 Feb;7(1A):245-50 [PMID: 14972063]
  8. BMC Health Serv Res. 2017 Mar 31;17 (1):243 [PMID: 28359277]
  9. Int J Epidemiol. 2015 Jun;44(3):848-61 [PMID: 25979725]
  10. Nutrients. 2017 Jul 31;9(8):null [PMID: 28758956]
  11. Glob Health Action. 2014 May 15;7:23439 [PMID: 24848655]
  12. Adv Nutr. 2013 May 01;4(3):384S-92S [PMID: 23674808]
  13. J Am Coll Nutr. 2011 Oct;30(5):285-94 [PMID: 22081614]
  14. J Hum Hypertens. 2007 Sep;21(9):717-28 [PMID: 17443205]
  15. Int J Cardiol. 2017 Mar 1;230:127-135 [PMID: 28024910]
  16. BMJ. 2014 Jul 29;349:g4490 [PMID: 25073782]
  17. J Am Diet Assoc. 2008 Aug;108(8):1315-22 [PMID: 18656571]
  18. Br J Nutr. 2012 Feb;107(3):428-35 [PMID: 21762541]
  19. Int J Behav Nutr Phys Act. 2010 Feb 02;7:12 [PMID: 20181070]
  20. Circulation. 1999 Jan 5-12;99(1):178-82 [PMID: 9884399]
  21. Glob Health Action. 2012 Nov 29;5:1-8 [PMID: 23195518]
  22. Am J Prev Med. 2009 May;36(5):402-409.e5 [PMID: 19362694]
  23. Psychol Rep. 2004 Jun;94(3 Pt 1):976-82 [PMID: 15217058]
  24. Int J Public Health. 2010 Dec;55(6):669-78 [PMID: 20872040]
  25. Br J Nutr. 2006 Oct;96(4):620-35 [PMID: 17010219]
  26. J Am Diet Assoc. 2009 Mar;109 (3):474-8 [PMID: 19248865]
  27. BMC Public Health. 2014 Nov 27;14:1231 [PMID: 25429981]
  28. Prev Med. 1998 Jul-Aug;27(4):536-44 [PMID: 9672947]
  29. Am J Clin Nutr. 2002 May;75(5):809-17 [PMID: 11976153]
  30. Eur J Nutr. 2012 Sep;51(6):637-63 [PMID: 22684631]
  31. Am J Clin Nutr. 2014 Dec;100(6):1520-31 [PMID: 25411287]
  32. Biochem J. 2007 Jan 1;401(1):1-11 [PMID: 17150040]
  33. Adv Nutr. 2012 Jul 01;3(4):506-16 [PMID: 22797986]
  34. Paediatr Perinat Epidemiol. 2012 Jul;26 Suppl 1:205-22 [PMID: 22742612]
  35. Nutr J. 2010 Jan 13;9:2 [PMID: 20070890]
  36. Lancet Glob Health. 2016 Oct;4(10 ):e695-703 [PMID: 27567348]
  37. Nutr Metab Cardiovasc Dis. 2015 Mar;25(3):253-66 [PMID: 25456155]
  38. Am J Prev Med. 2008 Jun;34(6):535-543 [PMID: 18471592]

MeSH Term

Adolescent
Adult
Developing Countries
Diet Surveys
Diet, Healthy
Female
Fruit
Humans
Income
Male
Middle Aged
Nutritional Status
Nutritive Value
Poverty
Recommended Dietary Allowances
Tanzania
Urban Health
Vegetables
Young Adult

Word Cloud

Created with Highcharts 10.0.0FVintakedailyTanzaniaportionsvegetableshealthcareuseconsumedfruits2educationlowfruitrecommendeddeprivedhealthinterventionsinadequateassociationssocio-demographic/lifestylefactorsalcoholparticipantsvegetable/person/day5protectionnon-communicablediseasesNCDsInadequateglobalproblemresource-poorcountrieslikeconstitutesettingslittleknowninformingpublicstudyaimeddescribeprevalencefrequencySouth-EasternDatadietaryindicatorssocio-demographicsmokingcollected7953≥15yearspopulation-basedMZIMAopencommunitycohort2012-2013Multivariablelogisticregressionusedexamineoutcomesdeterminants82%meetfraction155%almosthalf442%HowevermedianIQRnumberlower1PeoplehigherlikelyconsumeIndependentcorrelatesincludedyoungagemalelow-incomeoccupationshightobaccoPublictargetsocio-economicallyculturally-rootedpreferencesprioritizingpromotionimmediategainoverallInsufficientFruitVegetableIntakeLow-Middle-IncomeSetting:Population-BasedSurveySemi-UrbanIfakaraoccupation

Similar Articles

Cited By