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Stadlmayr B, Trübswasser U, McMullin S, Karanja A, Wurzinger M, Hundscheid L, Riefler P, Lemke S, Brouwer ID, Sommer I. Factors affecting fruit and vegetable consumption and purchase behavior of adults in sub-Saharan Africa: A rapid review. Front Nutr 2023; 10:1113013. [PMID: 37113298 PMCID: PMC10126510 DOI: 10.3389/fnut.2023.1113013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
In order to achieve the Sustainable Development Goals, considerable dietary shifts, including an increase in the consumption of fruit and vegetables (FV) will be required. However, worldwide consumption of FV is far below international recommendations, including in many low- and middle-income countries (LMICs), particularly in Africa. Understanding what, where, when, and how people choose to eat requires an understanding of how individuals are influenced by factors in their social, physical, and macro-level environments. In order to develop effective interventions to increase fruit and vegetable consumption, the factors influencing consumer behavior need to be better understood. We conducted a rapid review to assess and synthesize data on individual, social, physical, and macro-level factors that enable or constrain fruit and vegetable consumption and purchase among adults living in sub-Saharan Africa. Our conceptual framework is based on a socio-ecological model which has been adapted to settings in LMICs and Africa. We systematically searched four electronic databases including Scopus, Medline (PubMed), PsycInfo, and African Index Medicus, and screened Google Scholar for gray literature. We included a total of 52 studies and narratively summarized the existing evidence for each identified factor across the different levels. We found that most studies assessed demographic factors at the individual level including household or family income, socio-economic status and education. Furthermore we identified a variety of important factors that influence FV consumption, in the social, physical, and macro environment. These include women's empowerment and gender inequalities, the influence of neighborhood and retail food environment such as distance to market and price of FV as well as the importance of natural landscapes including forest areas for FV consumption. This review identified the need to develop and improve indicators both for exposure and outcome variables but also to diversify research approaches.
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Affiliation(s)
- Barbara Stadlmayr
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
- World Agroforestry (ICRAF), Nairobi, Kenya
| | - Ursula Trübswasser
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | | | | | - Maria Wurzinger
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Laura Hundscheid
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Petra Riefler
- Institute for Marketing and Innovation, Department of Economics and Social Science, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Stefanie Lemke
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
- Center for Agroecology, Water and Resilience, Coventry University, Coventry, United Kingdom
| | - Inge D. Brouwer
- Division of Human Nutrition and Health/CGIAR Initiative Sustainable Healthy Diets (SHiFT), Wageningen University, Wageningen, Netherlands
| | - Isolde Sommer
- Department for Evidence-Based Medicine and Evaluation, University for Continuing Education, Krems, Austria
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Developmental Programming in Animal Models: Critical Evidence of Current Environmental Negative Changes. Reprod Sci 2023; 30:442-463. [PMID: 35697921 PMCID: PMC9191883 DOI: 10.1007/s43032-022-00999-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022]
Abstract
The Developmental Origins of Health and Disease (DOHaD) approach answers questions surrounding the early events suffered by the mother during reproductive stages that can either partially or permanently influence the developmental programming of children, predisposing them to be either healthy or exhibit negative health outcomes in adulthood. Globally, vulnerable populations tend to present high obesity rates, including among school-age children and women of reproductive age. In addition, adults suffer from high rates of diabetes, hypertension, cardiovascular, and other metabolic diseases. The increase in metabolic outcomes has been associated with the combination of maternal womb conditions and adult lifestyle-related factors such as malnutrition and obesity, smoking habits, and alcoholism. However, to date, "new environmental changes" have recently been considered negative factors of development, such as maternal sedentary lifestyle, lack of maternal attachment during lactation, overcrowding, smog, overurbanization, industrialization, noise pollution, and psychosocial stress experienced during the current SARS-CoV-2 pandemic. Therefore, it is important to recognize how all these factors impact offspring development during pregnancy and lactation, a period in which the subject cannot protect itself from these mechanisms. This review aims to introduce the importance of studying DOHaD, discuss classical programming studies, and address the importance of studying new emerging programming mechanisms, known as actual lifestyle factors, during pregnancy and lactation.
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