Fruit and vegetable consumption across population segments: evidence from a national household survey

BACKGROUND

The 2002 World Health Report documented that low fruit and vegetable intake are among the top ten risk factors contributing to attributable mortality and up to three million lives could be saved each year by adequate consumption of F&V across the globe, leading an examination of behavioral preferences of the individual and family social, environmental, and behavioral factors that constitute perceived barriers to fruit and vegetable consumption.

OBJECTIVE

The study examines factors affecting the choice of eating fruits and vegetables by household members and calculates eating frequency probabilities of different population-origin associated with personal attributes and behavior.

METHOD

Turkish Health Survey (THS) 2019 data from the Turkish Statistical Institute (TSI) national representative household panel is applied. Estimating a random-effect bivariate probit model of fruit and vegetable choice, we calculated marginal probabilities of choosing fruits and vegetables, the joint probability of choosing both, and conditional probabilities between choosing to eat either, detecting consumption synergy.

RESULTS

The role of uncontrolled variables in choosing to eat fruits and vegetable (F&V) differs between the decision of an average family and the decision of individual family members. The attitude is positive for an average family and contrasts with the negative attitude among some family members. Most individual and family attributes inversely affect fruit and vegetable choice across different groups, while a positive relationship exists between the likelihood of fruit and vegetable choice and attributes such as age, marital status, education, weight, having health insurance, income, and time and forms of physical activity.

CONCLUSION AND RECOMMENDATION

Instead of a general policy for the implementation of a healthy and balanced nutrition program to improve fruit and vegetable eating frequency, it appears more effective to adopt programs with distinct characteristics that segregate society into different cohorts. We suggest appropriate policies and offer suitable approaches to reach targeted groups.

Association between Adequate Fruit and Vegetable Intake and CVDs-Associated Risk Factors among the Malaysian Adults: Findings from a Nationally Representative Cross-Sectional Study

This study aimed to investigate the relationship between adequate fruit and vegetable intake, and cardiovascular diseases (CVDs)-associated risk factors (i.e., diabetes, hypertension and hypercholesterolemia) among Malaysian adults without history of chronic diseases. We analyzed the data from 11,172 Malaysian adults (i.e., 5554 male and 5618 female), who participated in the population-based National Health and Morbidity Survey 2015. Multiple logistic regression was employed to determine the relationship between adequate daily intake of fruit and vegetables (i.e., ≥5 servings per day) and undiagnosed diabetes, undiagnosed hypertension, and undiagnosed hypercholesterolemia, after adjustment for sociodemographic characteristics and lifestyle risk factors. The mean age (±SE) of these participants was 40.79 (±0.17) years old. Our data demonstrated an adequate daily intake of fruit and vegetables was inversely associated with undiagnosed hypercholesterolemia (adjusted OR: 0.71; 95% CI: 0.51–0.98). Further analyses demonstrated an inverse association between the adequate daily intake of vegetables alone and undiagnosed hypertension (adjusted OR: 0.71; 95% CI: 0.51–0.98). The findings from this study suggest the need for a holistic public health approach to reinforce public awareness about diet-related diseases, which will eventually aid in the prevention of CVDs among Malaysian adults in the long run.

Potentially Toxic Metals in the High-Biomass Non-Hyperaccumulating Plant Amaranthus viridis: Human Health Risks and Phytoremediation Potentials

Human health risk and phytoremediation of potentially toxic metals (PTMs) in the edible vegetables have been widely discussed recently. This study aimed to determine the concentrations of four PTMs, namely Cd, Fe, Ni, and Zn) in Amaranthus viridis (leaves, stems, and roots) collected from 11 sampling sites in Peninsular Malaysia and to assess their human health risk (HHR). In general, the metal levels followed the order: roots > stems > leaves. The metal concentrations (µg/g) in the leaves of A. viridis ranged from 0.45 to 2.18 dry weight (dw) (0.05−0.26 wet weight (ww)), 74.8 to 535 dw (8.97−64.2 ww), 2.02 to 7.45 dw (0.24−0.89 ww), and 65.2 to 521 dw (7.83−62.6 ww), for Cd, Fe, Ni, and Zn, respectively. The positive relationships between the metals, the plant parts, and the geochemical factions of their habitat topsoils indicated the potential of A. viridis as a good biomonitor of Cd, Fe, and Ni pollution. With most of the values of the bioconcentration factor (BCF) > 1.0 and the transfer factor (TF) > 1.0, A. viridis was a very promising phytoextraction agent of Ni and Zn. Additionally, with most of the values of BCF > 1.0 and TF < 1.0, A. viridis was a very promising phytostabiliser of Cd and Fe. With respect to HHR, the target hazard quotients (THQ) for Cd, Fe, Pb, and Zn in the leaves of A. viridis were all below 1.00, indicating there were no non-carcinogenic risks of the four metals to consumers, including children and adults. Nevertheless, routine monitoring of PTMs in Amaranthus farms is much needed.

Dietary practices, food purchasing, and perceptions about healthy food availability and affordability: a cross-sectional study of low-income Malaysian adults

Background

Malaysia has the highest rate of overweight and obesity among Asian countries. Obesity is increasing particularly among low-income populations. This study aimed to assess dietary practices among low-income adults in urban communities, including gender and ethnic variation, to inform the development of locally tailored, evidence-based interventions for health promotion.

Methods

This cross-sectional study was conducted from August to December 2020. Stratified sampling was employed to recruit 2983 low-income adults from households in the bottom 40% of the economic spectrum (B40) at six public, low-cost housing flats in the Federal Territory of Kuala Lumpur, Malaysia. Face-to-face interviews were conducted using a structured questionnaire to understand dietary practices, perceptions of healthy food availability and affordability, and factors affecting food purchasing decisions.

Results

A staggering 89.5% of B40 adults were found to not consume adequate daily amounts of fruits and vegetables. In addition, 68.1% reported consuming sugar-sweetened beverages at least once per week, including commercially packed ready-to-drink beverages, sugar-added self-prepared drinks, and premixed drinks. Intake was statistically significantly higher among men (71.7%), Malays (70.3%), and Indians (69.9%). Bread and other commercially baked goods were the most common processed foods, and 52.9% of respondents consumed it at least once per week. Majorities reported that healthy foods were moderately available and priced. The top three reported factors affecting food purchase choices were price (79.4%), availability (75%), and taste (73%).

Conclusions

Adults in low-cost housing communities have unhealthy dietary patterns with low intake of fruits and vegetables and high intake of ultra-processed foods and calorie-dense local foods, with variations across gender and ethnicity. The study highlighted the need for educating low-income families on diet-disease relationships and possibilities for inexpensive, healthy eating that rely on minimally processed fresh foods. Policymakers engaging the food industry are advised to consider how to increase the affordability and availability of healthy foods in low-income communities in urban areas.

Bioaccumulation of zinc in edible tropical vegetables in Peninsular Malaysia and its human health risk assessment based on various ethnicities in Malaysia

Along with the growing utilization of zinc (Zn) and Zn-containing nanoparticles in various industries, Zn ecotoxicological evaluation on human food supply is necessary even though Zn is generally considered safe and rarely concentrated ecotoxicologically. This study aimed to investigate the bioaccumulation of Zn in 18 species of vegetables (seven leafy, nine fruity vegetables and one species each of tuber and legume) collected from two farming sites in the west coast of Peninsular Malaysia. A human health risk assessment (HHRA) was also conducted. In addition to HHRA based on the general population, HHRA based on each major ethnic group of the Malaysian society was also determined considering that the food consumption pattern would definitely be varied across ethnicities and age groups (children and adults). The study results showed that Zn concentrations were significantly higher (p < 0.05) in leafy vegetables than in other types of vegetables. However, the target hazard quotient (THQ) values were all found to be < 1.0. Therefore, based on the Malaysian ethnicities and age groups with their respective vegetable consumption patterns, the results indicated insignificant noncarcinogenic human health risk of Zn via oral consumption of vegetables by the Malaysian population. As a metric of measurement of HHRA, a comparison of THQ values could yield previously unreported insights into HHRA differences among the compared populations. A comparison of THQ values among the consumer groups indicated higher HHR for Chinese Malaysians and children due to their higher vegetable consumption and lower body weight, respectively. A comparison the Zn intakes of all the consumer groups with the recommended nutrient intakes indicated that the oral consumption of the vegetable species collected in this study would not result in Zn-related hazards and would not be able to fulfil the Zn dietary need of the individual consumer.

The Prevalence and Social Determinants of Fruit and Vegetable Consumption and Its Associations With Noncommunicable Diseases Risk Factors Among Adults in Laos

The study aimed to assess the prevalence and correlates of fruit and vegetable (FAV) consumption and its associations with noncommunicable diseases risk factors among adults in Laos. In a national cross-sectional survey in 2013, 2527 individuals (18-64 years old) responded to a questionnaire, and anthropometric and blood pressure measurements, and biochemistry tests were conducted. On average, participants had 0.99 servings of fruits a day and 1.33 servings of vegetables a day, a combined total of 2.32 servings of FAVs per day. Almost 1 in 5 respondents (18.9%) had 2 or more servings of fruit a day, 8.7% had 3 or more servings of vegetables a day, and 94.7% had less than 5 servings of FAV a day. In adjusted logistic analysis, being a Lao-Tai increased the odds of consuming 2 or more servings of fruits daily. Past month binge drinking decreased the odds of having 3 or more servings of vegetables daily. Higher education and urban residence decreased the odds of inadequate (<5 servings) FAV consumption. In adjusted linear regression analysis, increased FAV consumption was associated with higher body mass index scores. A high prevalence of inadequate FAV consumption was found. Interventions targeting identified modifiable risk factors, including lower education, general obesity, and binge drinking, may potentially increase FAV consumption in Laos.

SOCIO-DEMOGRAPHIC FACTORS ASSOCIATED WITH DIETARY BEHAVIOUR AMONG YOUNG GHANAIANS AGED 15–34 YEARS

This study used data from the 2008 Ghana Demographic and Health Survey to investigate the association between selected socio-demographic factors and dietary behaviour as measured by fruit and vegetable consumption among a sample of 6139 young people aged 15–34 years in Ghana. Overall, fruit and vegetable consumption was low in young people, but females were likely to consume more fruit and vegetables than their male counterparts. Respondents from the Mande ethnic group, those who resided in rural areas and those living in the Brong/Ahafo, Ashanti and the Eastern regions consumed more fruit and vegetables than those from other regions. Females who were Catholic/Anglican, Methodist/Presbyterian and Pentecostal/Charismatic were more likely than those of other religions to consume fruit and vegetables, while Muslim males generally consumed more fruit and vegetables. The findings point to the need for interventions to educate young people in Ghana about the health benefits of eating fruit and vegetables.