Fruit and vegetable consumption in rural adults population in INDEPTH HDSS sites in Asia

Background: Low fruit and vegetable consumption is among the top 10 risk factors contributing to mortality worldwide. WHO/FAO recommends intake of a minimum of 400 grams ( or five servings) of fruits and vegetables per day for the prevention of chronic diseases such as heart diseases, cancer, diabetes, and obesity. Objective: This paper examines the fruit and vegetable consumption patterns and the prevalence of inadequate fruit and vegetable consumption ( less than five servings a day) among the adult population in rural surveillance sites in five Asian countries. Data and methods: The analysis is based on data from a 2005 cross-site study on non-communicable disease risk factors which was conducted in nine Asian INDEPTH Health and Demographic Surveillance System ( HDSS) sites. Standardised protocols and methods following the WHO STEPwise approach to risk factor surveillance were used. The total sample was 18,429 adults aged 25-64 years. Multivariate logistic regression analysis was performed to assess the association between socio-demographic factors and inadequate fruit and vegetable consumption. Results: Inadequate fruit and vegetable consumption was common in all study sites. The proportions of inadequate fruit and vegetable consumption ranged from 63.5% in men and 57.5% in women in Chililab HDSS in Vietnam to the whole population in Vadu HDSS in India, and WATCH HDSS in Bangladesh. Multivariate logistic regression analysis in six sites, excluding WATCH and Vadu HDSS, showed that being in oldest age group and having low education were significantly related to inadequate fruit and vegetable consumption, although the pattern was not consistent through all six HDSS. Conclusions: Since such a large proportion of adults in Asia consume an inadequate amount of fruits and vegetables, despite of the abundant availability, education and behaviour change programmes are needed to promote fruit and vegetable consumption. Accurate and useful information about the health benefits of abundant fruit and vegetable consumption should be widely disseminated.