Cited by 597Nutritional Studies and DietNutrition, Health and Food BehaviorNutrition, Health, and Society Studies

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Global Variability in Fruit and Vegetable Consumption

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Hall, Justin N., Moore, Spencer, Harper, Sam B., Lynch, John W.·2009·American Journal of Preventive Medicine

DOI 10.1016/j.amepre.2009.01.029

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Abstract

Background Low fruit and vegetable consumption is an important risk factor for chronic diseases, but for many (mainly developing) countries, no prevalence data have ever been published. This study presents data on the prevalence of low fruit and vegetable intake for 52 countries and for various sociodemographic groups and settings across these countries.Methods Data from 196,373 adult participants from 52 countries taking part in the World Health Survey (2002-2003) were analyzed in the summer of 2008. Low fruit and vegetable consumption was defined according to the WHO guidelines of a minimum of five servings of fruits and/or vegetables daily.Results Low fruit and vegetable consumption prevalence ranged from 36.6% (Ghana) to 99.2% (Pakistan) for men and from 38.0% (Ghana) to 99.3% (Pakistan) for women. Significant differences in the likelihood of low fruit and vegetable intake between men and women were found in 15 countries. The prevalence of low fruit and vegetable consumption tended to increase with age and decrease with income. Although urbanicity was not associated overall with low fruit and vegetable consumption, urban and rural differences were significant for 11 countries.Conclusions Overall, 77.6% of men and 78.4% of women from the 52 mainly low- and middle-income countries consumed less than the minimum recommended five daily servings of fruits and vegetables. Baseline global information on low fruit and vegetable consumption obtained in this study can help policymakers worldwide establish interventions for addressing the global chronic disease epidemic.

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Background
Conventional or Organic? Motives and Trends in Polish Vegetable Consumption
Mazur-Włodarczyk, K., & Gruszecka‐Kosowska, A. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19084667 · Cited by 7
“The low consumption of fruit and vegetables increases with age and decreases with income [25] and depends on the gender—women consume more vegetables than men [18].”
Background
Changes in cardiovascular disease burden associated with psychopathology in Australian adults 2004–2008
Atlantis, E. E., & Sullivan, T. (2012) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2012.02.006 · Cited by 8
“In addition, global variability in psychopathology [12] and other well-established lifestyle risk factors such as smoking [13], inadequate fruit and vegetable consumption [14], and physical inactivity [15] could undoubtedly confound CVD trends across populations.”
Background
Early life factors among the many influences of child fruit and vegetable consumption
Chaffee, B. W. (2014) · Jornal de Pediatria · doi:10.1016/j.jped.2014.06.001 · Cited by 7
Fatty Acid and Cholestrol Content of Manchego Type Cheese Prepared with Incorporated Avocado Oil
Algarra, M., Sánchez, C., da Silva, J. C. G. E., & Jiménez-Jiménez, J. (2011) · International Journal of Food Properties · doi:10.1080/10942912.2010.503358 · Cited by 7
Anthocyanins in Health and Disease Prevention
Nunez, M., & Magnuson, B. A. (2013) · CRC Press eBooks · doi:10.1201/b15554-2 · Cited by 7
Effectiveness of healthy eating interventions among children: A quantitative systematic review
Shorey, S., & Chan, V. (2020) · Journal of Advanced Nursing · doi:10.1111/jan.14606 · Cited by 7
The relationship between children’s and mothers’ vegetable liking in Chile, China and the United States
Estay, K., Pan, S., Zhong, F., & Guinard, J. (2020) · Food Quality and Preference · doi:10.1016/j.foodqual.2020.104000 · Cited by 7
Current perspectives and challenges in the estimation of fruit juice consumption across the lifecycle in Europe
Walton, J., & Kehoe, L. (2024) · Nutrition Research Reviews · doi:10.1017/s095442242400009x · Cited by 6
Twelve Month Efficacy of Computer-Tailored Communication in Boosting Fruit and Vegetable Consumption Among Adults Aged Forty and over: A Three-Level Meta-Analysis and Systematic Review of Randomized Controlled Trials
Misir, A., Viechtbauer, W., de Vries, H., & Mesters, I. (2023) · Advances in Nutrition · doi:10.1016/j.advnut.2023.100150 · Cited by 7
“Unfortunately, consumption of F & V in many regions of the world is still low [9].”
Background
Changes in Traditional Agriculture Ecosystem in Rawain Valley of Uttarakhand State in India
Kala, C. P. (2014) · Applied ecology and environmental sciences/Applied ecology and environmental science · doi:10.12691/aees-2-4-1 · Cited by 6
“In low and middle income countries, the situation is more alarming as about 77% of men and 78% of women consume less than the minimum recommended daily servings of fruits and vegetables [3].”
Background
U.S. Fruit and Vegetable Affordability on the Thrifty Food Plan Depends on Purchasing Power and Safety Net Supports
Young, S. K., & Stewart, H. G. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19052772 · Cited by 6
Post-migration food habits of New Zealand South Asian migrants: Implications for health promotion practice
Parackal, S. M. (2023) · Journal of Migration and Health · doi:10.1016/j.jmh.2023.100182 · Cited by 6
Dietary Practices Among Type 2 Diabetes Patients Visiting a Non-communicable Disease (NCD) Clinic in a District of Western India: A Cross-Sectional Study
Patel, B., Unadkat, S. V., Patel, H. D., & Rathod, M. (2024) · Cureus · doi:10.7759/cureus.52604 · Cited by 7
Glycemic Response of Type 2 Diabetics to Raisins
Wilson, T. E., Anderson, J. A., Andersen, K. F., Heimerman, R. A., Larson, M. M., Freeman, M., & Baker, S. E. (2012) · Food and Nutrition Sciences · doi:10.4236/fns.2012.38153 · Cited by 6
“However, the recent World Health Survey demonstrated that upwards of 78% of the population in the 52 countries studied were found to have not reached the desired five fruit and vegetable servings/day [4].”
Background
Diabetes mellitus: fatores associados entre usuários da Estratégia Saúde da Família
Marinho, N. B. P., de Vasconcelos, H. C. A., Alencar, A. M. P. G., de Almeida, P. C., & Damasceno, M. M. C. (2012) · Acta Paulista de Enfermagem · doi:10.1590/s0103-21002012005000018 · Cited by 6
“Variables such as age (22,27,28), income (26) and education (22,26,27) were positively associated with consumption of fruits and vegetables.”
Background
Spot‐testing urine pH , a novel dietary biomarker? A randomised cross‐over trial
Parmenter, B. H., Slater, G., & Frassetto, L. A. (2016) · Nutrition & Dietetics · doi:10.1111/1747-0080.12325 · Cited by 6
PHYTOCHEMICAL SCREENING OF SELECTED INDIGENOUS EDIBLE PLANTS FROM THE TOWNS OF ISABELA, PHILIPPINES
Ruma, O. C. (2016) · Cited by 6
Nethouses protect cucumber plants from insect pests and increase yields in eastern Africa
Nordey, T., Delétré, E., Mlowe, N., & Martin, T. (2020) · The Journal of Horticultural Science and Biotechnology · doi:10.1080/14620316.2020.1735948 · Cited by 6
Promoting Fruit and Vegetable Intake in Parents: A Cluster Randomised Controlled Trial
Sun, Y., Fung, S. S. W., Man, P. K. W., Wan, A., Stewart, S. M., Lam, T. H., & Ho, S. Y. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18105206 · Cited by 7
“However, the minimum intake of five daily servings of FV recommended by the World Health Organization is not met in most parts of the world [7].”
Background
Perspectives on Fruit and Vegetable Consumption and Government Dietary Guidelines: Content Analysis of Comments on News Websites
Hornsby, B., & Ensaff, H. (2021) · Journal of Medical Internet Research · doi:10.2196/19917 · Cited by 6
“Low FV consumption is also an international issue [15], including among children [16-18].”
Household Food and Nutrient Intake of Semai Aborigines of Peninsular Malaysia
Dhanapal, A. C. T. A., Subapriya, M. S., & Aung, H. P. (2018) · Indian Journal of Science and Technology · doi:10.17485/ijst/2018/v11i4/109848 · Cited by 6
Exposure to (Poly)phenol Metabolites after a Fruit and Vegetable Supplement Intake: A Double-Blind, Cross-Over, Randomized Trial
Romain, C., Bresciani, L., Muralidharan, J., Mena, P. R., Chung, L. H., Alcaráz, P. E., Rio, D. D., & Cases, J. (2022) · Nutrients · doi:10.3390/nu14224913 · Cited by 5
Burden and inequalities of chronic kidney disease attributable to diet globally, regionally and temporally, 1990–2021
Wei, N., Yang, M., Zheng, P., & Xu, J. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1592389 · Cited by 5
Effects of changes in the economic environment on diet- and physical activity related behaviours and corollary outcomes: a large-scale scoping review.
Shemilt, I., Hollands, G. J., Marteau, T. M., Jebb, S. A., Kelly, M. P., Nakamura, R., Suhrcke, M., & Ogilvie, D. (2013) · Cited by 5
Modifying Students’ Intentions to Eat Sustainably
McDonough, T., Plourde, H., & Hendrickson-Nelson, M. (2014) · The International Journal of Sustainability Education · doi:10.18848/2325-1212/cgp/v09i02/55300 · Cited by 6
THE FALLACY OF ORGANIC AND CONVENTIONAL FRUIT AND VEGETABLE PRICES IN THE METROPOLITAN REGION OF CAMPINAS, SÃO PAULO, BRAZIL
Watanabe, M. A., de Abreu, L. S., & Luiz, A. J. B. (2020) · Journal of Asian Rural Studies · doi:10.20956/jars.v4i1.2147 · Cited by 5
A Macroeconomic Review of the Factors Influencing Fruit Consumption in Romania—The Road towards Sustainability
Popescu, G., Istudor, N., Zaharia, A., Diaconeasa, M. C., Panait, I., & Cucu, M. C. (2021) · Sustainability · doi:10.3390/su132212793 · Cited by 5
ASSESSMENT OF THE FOOD PATTERNS OF IMMIGRANT ECUADORIAN POPULATION IN SOUTHERN SPAIN BASED ON A 24-H FOOD RECALL SURVEY.
Mosquera, J. A. N., Llaguno, S. N. S., Pérez‐Rodríguez, F., & Rojas, R. M. (2015) · PubMed · doi:10.3305/nh.2015.32.2.8244 · Cited by 5
“In addition, specific classification factors were considered for statistical study such as: sex (man and woman), age groups (14-19, 2029, 39-39, 40-49, 50-59, 60-69), professional occupation (restaurants and services, administrative, farmers, construction workers) and city (Cordoba and Seville).”
Background
Cardiovascular risk profile of mothers of a Portuguese birth cohort: A survey 4years after delivery
Alves, E., Henriques, A., Correia, S., Santos, A. C., Azevedo, A., & Barros, H. (2013) · Preventive Medicine · doi:10.1016/j.ypmed.2013.06.029 · Cited by 5
“The World Health Survey (2002–2003), described a prevalence of fruit and vegetable consumption very similar to the one described, for Spanish women aged N17 years (Hall et al., 2009).”
Background
Increasing fruit and vegetable intake: where are we at and how do we reach recommendations?
Vandevijvere, S., & Knai, C. (2015) · Public Health Nutrition · doi:10.1017/s1368980015002803 · Cited by 5
“countries consumed less than the minimum recommended five daily servings of F&V((1)).”
Background
Fruit and Vegetable, Sugar-Sweetened Beverage Consumption among Kindergartners in Accra Metropolitan Area, Ghana: A Cross-Sectional Study
Lopes, P. H. (2018) · European Journal of Preventive Medicine · doi:10.11648/j.ejpm.20180604.13 · Cited by 5
Chemical, microbial and antioxidant activity of Cola lepidota K. Schum fruits
Oranusi, S. U., Onibokun, A. E., Afolabi, O., Okpalajiaku, C., Seweje, A., Olopade, B. K., & Obafemi, Y. D. (2020) · Czech Journal of Food Sciences · doi:10.17221/360/2018-cjfs · Cited by 5
“This may account for the high prevalence of malnutrition, particularly micronutrient deficiencies, and the increasing prevalence of diet related non-communicable diseases in low- and middle-income countries (Hall et al. 2009).”
Background
Alimental Food Consumption Among Urban Households: An Empirical Study of Ghana
Meng, T., Florkowski, W. J., Sarpong, D. B., Chinnan, M. S., & Resurreccion, A. V. A. (2018) · RePEc: Research Papers in Economics · doi:10.22004/ag.econ.355561 · Cited by 5
Determination of minerals by ICP-AES in indigenous vegetables from Southwest Nigeria
Babalola, S. O., & Akinwande, B. A. (2014) · Nutrition & Food Science · doi:10.1108/nfs-10-2013-0124 · Cited by 5
NUTRIENT COMPOSITION, ANTIOXIDANT POTENTIAL AND SENSORY EVALUATION OF DEVELOPED MIXED CONCENTRATED JUICE
Malek, N. A. H. C., Haron, H., & Yahya, H. M. (2019) · Jurnal Teknologi · doi:10.11113/jt.v81.12615 · Cited by 5
“The intake of fruits and vegetables among the global population is lower than the recommended intake which is a minimum five servings of fruits and/or vegetables daily [2, 3].”
Background

Authors: Hall, J. N., Moore, S., Harper, S. B., & Lynch, J. W.
Affiliations: Queen's University (CA)
McGill University (CA)
University of South Australia (AU)
Corresponding author: Moore, Spencer
ORCID: Hall, Justin N.
Moore, Spencer
Harper, Sam B.
Lynch, John W.
Venue: American Journal of Preventive Medicine
Publisher: Elsevier BV
Published: 2009-05
Volume: 36
Issue: 5
Pages: 402-409.e5
ISSN: 0749-3797 (ISSN-L)
DOI: 10.1016/j.amepre.2009.01.029
OpenAlex: W2060303123
Cited by: 597
References: 41
Citations by year: 2026: 15 · 2025: 21 · 2024: 27 · 2023: 42 · 2022: 41 · 2021: 52 · 2020: 47 · 2019: 35 · 2018: 48 · 2017: 48 · 2016: 39 · 2015: 43 · 2014: 53 · 2013: 27 · 2012: 28
FWCI: 19.74
Type: journal article
Language: en
Open access: green
research.wur.nl
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: American Journal of Preventive Medicine (publishedVersion)
PubMed (publishedVersion)
Socio-Environmental Systems Modeling (acceptedVersion)
Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Explore Bristol Research (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Funders: U.S. Public Health Service (263-MQ-611198)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Life Sciences › Agricultural and Biological Sciences › Food Science › Nutrition, Health, and Society Studies
Keywords: fruit and vegetable intake, prevalence, sociodemographic differences, sex differences, age differences, income, urban-rural differences, low- and middle-income countries, chronic disease prevention, dietary guidelines, World Health Survey
MeSH terms: Adolescent, Adult, Aged, Cross-Sectional Studies, Diet, Female, Fruit, Humans, Male, Middle Aged, Vegetables, Global Health, Prevalence, Nutrition Policy

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