Review of policies to increase fruit and vegetable consumption and physical activity in 49 low- and middle-income countries

Fruit and vegetable consumption may protect against sarcopenia but there are no studies on this topic from low- and middle-income countries (LMICs). Thus, we assessed this association among older adults from six LMICs. Community-based cross-sectional data of the Study on Global Aging and Adult Health were analyzed. Sarcopenia was defined as the presence of low skeletal muscle mass based on indirect population formula, and either slow gait or low handgrip strength. Quintiles of vegetable and fruit consumption were created based on the number of servings consumed on a typical day. Multivariable logistic regression analysis was conducted. The sample consisted of 14,585 individuals aged ≥65 years (mean (SD) age 72.6 (11.4) years; 55% females). Adjusted analyses showed that overall, compared to the lowest quintile (Q1), the highest quintile (Q5) of fruit consumption was associated with a 40% lower odds for sarcopenia (OR = 0.60; 95% CI = 0.42−0.84) but this association was largely driven by the strong association among females (e.g., Q5 vs. Q1 OR = 0.42; 95% CI = 0.24−0.73), with no significant associations found among males. Vegetable consumption was not significantly associated with sarcopenia. Future studies of longitudinal design may shed light on whether increasing fruit consumption among older females in LMICs may reduce risk for sarcopenia.

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Consumption of Fruits and Vegetables Among Individuals 15 Years and Older in 28 Low- and Middle-Income Countries

Journal of Nutrition ◽

10.1093/jn/nxz040 ◽

2019 ◽

Vol 149 (7) ◽

pp. 1252-1259 ◽

Cited By ~ 5

Author(s):

Sarah M Frank ◽

Jacqui Webster ◽

Briar McKenzie ◽

Pascal Geldsetzer ◽

Jennifer Manne-Goehler ◽

...

Keyword(s):

Fruits And Vegetables ◽

Vegetable Consumption ◽

Food Prices ◽

Fruit And Vegetable Consumption ◽

Noncommunicable Diseases ◽

Fruit And Vegetable ◽

Middle Income ◽

Individual Level ◽

Middle Income Countries ◽

Low And Middle Income

ABSTRACT Background The WHO recommends 400 g/d of fruits and vegetables (the equivalent of ∼5 servings/d) for the prevention of noncommunicable diseases (NCDs). However, there is limited evidence regarding individual-level correlates of meeting these recommendations in low- and middle-income countries (LMICs). In order to target policies and interventions aimed at improving intake, global monitoring of fruit and vegetable consumption by socio-demographic subpopulations is required. Objectives The aims of this study were to 1) assess the proportion of individuals meeting the WHO recommendation and 2) evaluate socio-demographic predictors (age, sex, and educational attainment) of meeting the WHO recommendation. Methods Data were collected from 193,606 individuals aged ≥15 y in 28 LMICs between 2005 and 2016. The prevalence of meeting the WHO recommendation took into account the complex survey designs, and countries were weighted according to their World Bank population estimates in 2015. Poisson regression was used to estimate associations with socio-demographic characteristics. Results The proportion (95% CI) of individuals aged ≥15 y who met the WHO recommendation was 18.0% (16.6–19.4%). Mean intake of fruits was 1.15 (1.10–1.20) servings per day and for vegetables, 2.46 (2.40–2.51) servings/d. The proportion of individuals meeting the recommendation increased with increasing country gross domestic product (GDP) class (P < 0.0001) and with decreasing country FAO food price index (FPI; indicating greater stability of food prices; P < 0.0001). At the individual level, those with secondary education or greater were more likely to achieve the recommendation compared with individuals with no formal education: risk ratio (95% CI), 1.61 (1.24–2.09). Conclusions Over 80% of individuals aged ≥15 y living in these 28 LMICs consumed lower amounts of fruits and vegetables than recommended by the WHO. Policies to promote fruit and vegetable consumption in LMICs are urgently needed to address the observed inequities in intake and prevent NCDs.

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Increasing Fruit and Vegetable Consumption among Schoolchildren: Efforts in Middle-Income Countries

Food and Nutrition Bulletin ◽

10.1177/156482651303400109 ◽

2013 ◽

Vol 34 (1) ◽

pp. 75-94 ◽

Cited By ~ 8

Author(s):

Ramani Wijesinha-Bettoni ◽

Aya Orito ◽

Marianne Löwik ◽

Catherine McLean ◽

Ellen Muehlhoff

Keyword(s):

Vegetable Consumption ◽

Fruit And Vegetable Consumption ◽

Fruit And Vegetable ◽

Middle Income ◽

Middle Income Countries

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Meeting fruit and vegetable consumption and physical activity recommendations among adolescents intending to lose weight

Preventive Medicine Reports ◽

10.1016/j.pmedr.2018.10.021 ◽

2019 ◽

Vol 13 ◽

pp. 11-15 ◽

Cited By ~ 2

Author(s):

Lisa Kakinami ◽

Stephanie A. Houle-Johnson ◽

Zewditu Demissie ◽

Sylvia Santosa ◽

Janet E. Fulton

Keyword(s):

Physical Activity ◽

Vegetable Consumption ◽

Fruit And Vegetable Consumption ◽

Fruit And Vegetable ◽

Physical Activity Recommendations ◽

Activity Recommendations

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Rams Have Heart, a Mobile App Tracking Activity and Fruit and Vegetable Consumption to Support the Cardiovascular Health of College Students: Development and Usability Study (Preprint)

10.2196/preprints.15156 ◽

2019 ◽

Author(s):

Michelle C Krzyzanowski ◽

Paul N Kizakevich ◽

Vanessa Duren-Winfield ◽

Randall Eckhoff ◽

Joel Hampton ◽

...

Keyword(s):

Physical Activity ◽

Query Language ◽

Vegetable Intake ◽

Vegetable Consumption ◽

User Participation ◽

Mobile App ◽

Fruit And Vegetable Consumption ◽

Fruit And Vegetable Intake ◽

Black College ◽

Fruit And Vegetable

BACKGROUND With the increasing use of mobile devices to access the internet and as the main computing system of apps, there is a growing market for mobile health apps to provide self-care advice. Their effectiveness with regard to diet and fitness tracking, for example, needs to be examined. The majority of American adults fail to meet daily recommendations for healthy behavior. Testing user engagement with an app in a controlled environment can provide insight into what is effective and not effective in an app focused on improving diet and exercise. OBJECTIVE We developed Rams Have Heart, a mobile app, to support a cardiovascular disease (CVD) intervention course. The app tracks healthy behaviors, including fruit and vegetable consumption and physical activity, throughout the day. This paper aimed to present its functionality and evaluated adherence among the African American college student population. METHODS We developed the app using the Personal Health Informatics and Intervention Toolkit, a software framework. Rams Have Heart integrates self-reported health screening with health education, diary tracking, and user feedback modules to acquire data and assess progress. The parent study, conducted at a historically black college and university-designated institution in southeastern United States, consisted of a semester-long intervention administered as an academic course in the fall, for 3 consecutive years. Changes were made after the cohort 1 pilot study, so results only include cohorts 2 and 3, comprising a total of 115 students (n=55 intervention participants and n=54 control participants) aged from 17 to 24 years. Data collected over the study period were transferred using the secure Hypertext Transfer Protocol Secure protocol and stored in a secure Structured Query Language server database accessible only to authorized persons. SAS software was used to analyze the overall app usage and the specific results collected. RESULTS Of the 55 students in the intervention group, 27 (49%) students in cohort 2 and 25 (45%) in cohort 3 used the Rams Have Heart app at least once. Over the course of the fall semester, app participation dropped off gradually until exam week when most students no longer participated. The average fruit and vegetable intake increased slightly, and activity levels decreased over the study period. CONCLUSIONS Rams Have Heart was developed to allow daily tracking of fruit and vegetable intake and physical activity to support a CVD risk intervention for a student demographic susceptible to obesity, heart disease, and type 2 diabetes. We conducted an analysis of app usage, function, and user results. Although a mobile app provides privacy and flexibility for user participation in a research study, Rams Have Heart did not improve compliance or user outcomes. Health-oriented research studies relying on apps in support of user goals need further evaluation.

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The UK Coronavirus Job Retention Scheme and changes in diet, physical activity and sleep during the COVID-19 pandemic: Evidence from eight longitudinal studies

10.1101/2021.06.08.21258531 ◽

2021 ◽

Author(s):

Bozena Wielgoszewska ◽

Jane Maddock ◽

Michael J Green ◽

Giorgio Di Gessa ◽

Sam Parsons ◽

...

Keyword(s):

Physical Activity ◽

Longitudinal Studies ◽

Social Protection ◽

Vegetable Consumption ◽

Recovery Period ◽

Health Behaviours ◽

Fruit And Vegetable Consumption ◽

Job Retention ◽

Fruit And Vegetable ◽

The Uk

Background: In March 2020 the UK implemented the Coronavirus Job Retention Scheme (furlough) to minimize job losses. Our aim was to investigate associations between furlough and diet, physical activity, and sleep during the early stages of the pandemic. Methods: We analysed data from 25,092 participants aged 16 to 66 years from eight UK longitudinal studies. Changes in employment (including being furloughed) were defined by comparing employment status pre- and during the first lockdown. Health behaviours included fruit and vegetable consumption, physical activity, and sleeping patterns. Study-specific estimates obtained using modified Poisson regression, adjusting for socio-demographic characteristics and pre-pandemic health and health behaviours, were statistically pooled. Associations were also stratified by sex, age, and education. Findings: Across studies, between 8 and 25% of participants were furloughed. Compared to those who remained working, furloughed workers were slightly less likely to be physically inactive (RRR:0.85, [0.75-0.97], I2=58.7%) and did not differ in diet and sleep behaviours. In stratified analyses, furlough was associated with low fruit and vegetable consumption among males (RRR=1.11; 95%CI: 1.01-1.22; I2: 0%) but not females (RRR=0.84; 95%CI: 0.68-1.04; I2: 65%). Considering change in behaviour, furloughed workers were more likely than those who remained working to report increased fruit and vegetable consumption, exercise, and hours of sleep. Interpretation: Those furloughed exhibited broadly similar levels of health behaviours with those who remained in employment during the initial stages of the pandemic. Social protection policies in the post-pandemic recovery period and during future economic crises may help protect population health. Funding: Medical Research Council.

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