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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Risk factor profile for non-communicable diseases: findings of a STEPS survey from urban settlement of Bangalore
Abdussattar, & Itrat, M. (2018) · International Journal of Community Medicine and Public Health · doi:10.18203/2394-6040.ijcmph20185249 · Cited by 3
Improving Nutritional Status of Rural Household through Nutrition Garden in Golaghat and Sivasagar Districts of Assam
Borthakur, M., Begum, T., Neog, M., & Borthakur, S. (2021) · International Journal of Current Microbiology and Applied Sciences · doi:10.20546/ijcmas.2021.1001.301 · Cited by 2
“Due to inadequate consumption of vegetables, deficiency of micro-nutrients especially of iron, vitamin A and iodine are prevalent in the developing world (Hall et al., 2009; Kanungsukkasem et al., 2009; Leenders et al., 2013; NCCDPHP, 2013).”
Background
Associations between dietary intake of B vitamins and cardiovascular risk factors in elderly men: A cross‐sectional study
Mozaffari, H., Askari, M., Bellissimo, N., & Azadbakht, L. (2021) · International Journal of Clinical Practice · doi:10.1111/ijcp.14691 · Cited by 2
Is Fruit and Vegetable Intake Associated with Body Composition Among Pakistani Adolescents?
Safdar, N. F., Murad, A. M., Jawed, N., & Inam, S. (2022) · Nutrition and Dietary Supplements · doi:10.2147/nds.s340798 · Cited by 5
Exploring the association between agricultural production systems and household diets in Viet Nam
Bandyopadhyay, A., Azzarri, C., Haile, B., Chungmann, K., Alvarez, C., Moltedo, A., Sattar, A., Bell, W. F. L., & Rogers, B. L. (2022) · Food Security · doi:10.1007/s12571-022-01276-x · Cited by 2
“8% for men and women, respectively (Hall et al., 2009).”
Worldwide associations of fruit and vegetable supply with blood pressure from 1975 to 2015: an ecological study
Griep, L. M. O., Bentham, J., & Mahadevan, P. (2023) · BMJ Nutrition Prevention & Health · doi:10.1136/bmjnph-2022-000455 · Cited by 2
Fruit and vegetable consumption among young school children in Pokhara, Kaski: A cross-sectional study
Shrestha, N., Banstola, S., & Sharma, B. (2023) · Journal of Gandaki Medical College-Nepal · doi:10.3126/jgmcn.v16i1.53645 · Cited by 2
Pattern of lifestyle behaviors and associated risk of being bullied at schools: A latent class analysis of 25,379 adolescents in Jiangsu Province of China
Huang, F., Wang, Y., Yang, J., Zhang, F., Wang, X., Yao, X., Yang, W., Zhou, Y., Fan, L., & Du, W. (2023) · Research in Nursing & Health · doi:10.1002/nur.22331 · Cited by 2
The quality of Indian diets: A comparison of two indices to predict risk of dietary inadequacies linked to non-communicable diseases
Mediratta, S., & Mathur, P. (2023) · World Nutrition · doi:10.26596/wn.202314336-47 · Cited by 2
Dietary fibre: insights and opportunities
McBurney, M. I. (2010) · Wageningen Academic Publishers eBooks · doi:10.3920/978-90-8686-692-2_012 · Cited by 2
Expenditure on Fresh Vegetables, Fresh Fruits, and Peanut Products in Urban Ghana: Does Location Matter?Preprint
Meng, T., Florkowski, W. J., Sarpong, D. B., Chinnan, M. S., & Resurreccion, A. V. A. (2014) · RePEc: Research Papers in Economics · doi:10.22004/ag.econ.162427 · Cited by 2
“Studies are remarkablely consistent in supporting fresh vegetables, fresh fruits, and peanut product consumption are influenced by socio-demographic factors (Ruel et al., 2005; Hall et al. 2009; Jolly et al., 2008).”
BackgroundResult
Patterns and correlates of nutrition knowledge across five countries in the 2018 international food policy study
Bhawra, J., Kirkpatrick, S. I., Hall, M. G., Vanderlee, L., White, C. M., & Hammond, D. G. (2023) · doi:10.32920/24624900 · Cited by 2
Lifestyle patterns in the Peruvian population: analysis of tobacco, alcohol and fruit/vegetable consumption based on a nine-year national surveyPreprint
Vera-Ponce, V. J., Zuzunaga-Montoya, F. E., Vásquez-Romero, L. E. M., Loayza-Castro, J. A., Carrillo, C. I. G. D., & Chenet, S. M. (2024) · medRxiv · doi:10.1101/2024.05.26.24307960 · Cited by 2
“…52 primarily low and middle-income countries found between 77.6% to 78.4% of men and women consumed less than the recommended five daily portions of fruits and vegetables, demonstrating while this work is dated, the current situation likely differs little from what was occurring at that time (23) .”
BackgroundInfluential
Patterns and determinants of eating healthy in KenyaPreprint
Wambiya, E. O. A., Kisia, L., Osindo, J., Kisiangani, I., Kipruto, S., Ilboudo, P., Donfouet, H. P. P., & Mohamed, S. F. (2021) · Research Square · doi:10.21203/rs.3.rs-829020/v1 · Cited by 2
Social embeddedness and innovation behavior of innovation platform actors
Turyahikayo, W., Matsiko, F. B., Miiro, R. F., Okiror, J. J., & Obaa, B. B. (2021) · International Journal of Agricultural Extension · doi:10.33687/ijae.009.01.3546 · Cited by 1
Development of traditional gardening to improve household food and Nutrition security: A Review
Chandravanshi, D., Khaparde, M., Sahu, E., Singh, I., Sinha, A. K., & Verma, S. (2024) · International Journal of Research in Agronomy · doi:10.33545/2618060x.2024.v7.i6a.783 · Cited by 1
A case for breeding heat-tolerant broccoli
Cabrera, M., & Messina, C. D. (2025) · npj Sustainable Agriculture · doi:10.1038/s44264-025-00096-8 · Cited by 2
Knowledge of Health Benefits of Fruits, Vegetables, and Antioxidants, Propensity to Sustainability and Adherence to the Mediterranean Diet: An Interrelated Evaluation
Calella, P., Siervo, M., Pelullo, C. P., Liguori, F., Valerio, G., Liguori, G., & Gallè, F. (2026) · Nutrients · doi:10.3390/nu18101490 · Cited by 1
“However, despite these benefits, global consumption levels of fruits and vegetables are often below the recommended amounts, particularly in low-and middle-income countries [9].”
Barriers to fruit and vegetable consumption among migrant workers in Bangkok: a mixed-methods study
Suvanbenjakule, P., Schreinemachers, P., & Goh, E. V. (2026) · BMC Nutrition · doi:10.1186/s40795-026-01442-w · Cited by 1
“In developing countries, an estimated 78% of adults consume fewer than five portions or 400 g of fruits and vegetables daily [3, 4], the minimum amount recommended by the World Health Organization [5].”
Estimation of fruit and vegetable consumption in a cohort of Ghanaian women and evaluation of knowledge, attitudes and practice
Moss, J., & Mushtaq, S. (2013) · Proceedings of The Nutrition Society · doi:10.1017/s0029665113003315 · Cited by 1
Prevalence of Hypertension and Associated Risk Factors in Adults from a Semi Urban District in Ghana: A Population Based Survey
Opare, J. K. L. (2014) · International Journal of TROPICAL DISEASE & Health · doi:10.9734/ijtdh/2014/7844 · Cited by 1
Global Trends in the Promotion of Fruit and Vegetable Consumption for Better Nutrition and Health
Yang, R.-Y., Lee, M., Wahlqvist, M. L., & Holmer, R. (2015) · Cited by 1
Are the Dietary Guidelines for Meat, Fat, Fruit and Vegetable Consumption Appropriate for Environmental Sustainability? A Review of the Literature
Reynolds, C. J., Buckley, J. D., Weinstein, P., & Boland, J. W. (2016) · Apple Academic Press eBooks · doi:10.1201/b20562-20 · Cited by 1
Food and Diseases in Zanzibar
Keller, A. (2012) · Les Cahiers d Afrique de lEst · doi:10.4000/eastafrica.502 · Cited by 1
Vegetables
Capurso, A., Crepaldi, G., & Capurso, C. A. (2018) · Practical issues in geriatrics · doi:10.1007/978-3-319-78084-9_9 · Cited by 1
Carotenoids-Effective Radical Scavengers for Healthy and Beautiful Skin
Elpelt, A., Lohan, S. B., Darvin, M. E., Lademann, J., & Meinke, M. C. (2019) · Health Education and Public Health · doi:10.31488/heph.129 · Cited by 1
Avaliação do consumo de frutas em pacientes com diabetes mellitus tipo 2
de Barros, A. O., Sarmento, R. A., Antonio, J. P., de Almeida, J. C., & Nicoletto, B. B. (2022) · Clinical & Biomedical Research · doi:10.22491/2357-9730.113807 · Cited by 1
Nutritional Intake Differences in Combinations of Carbohydrate-Rich Foods in Pirapó, Republic of Paraguay
Caballero, Y., Matakawa, K., Ushiwata, A., Akatsuka, T., & Sudo, N. (2023) · Nutrients · doi:10.3390/nu15051299 · Cited by 1
“Nevertheless, vegetable consumption was still low compared with the WHO’s recommendation of five servings of fruits and vegetables on a daily basis, although only a few countries achieve that recommendation [15].”
Background
Prevalence of intestinal parasites on fruits and vegetables sold in Biu Local Government Area of Borno State, Nigeria
Usman, A. M. (2023) · Dutse Journal of Pure and Applied Sciences · doi:10.4314/dujopas.v9i2a.14 · Cited by 1
“World health organization (WHO) recommends consumption of at least 400 g of vegetable or fruit per day to prevent some diseases (Punsawad et al., 2019).”
Background
Patterns, socioeconomic inequalities and determinants of healthy eating in Kenya: results from a national cross-sectional survey
Wambiya, E. O. A., Donfouet, H. P. P., Kipruto, S., Kisia, L., Osindo, J., Kisiangani, I., Oguta, J. O., Ilboudo, P. G., & Mohamed, S. F. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-090698 · Cited by 1
“This will benefit from updated representative surveys on food consumption to enable longitudinal tracking of changes in dietary patterns and outcomes over time.”
Investigation on the anti-T3SS activity of Myanmar vegetables and identification of arjunglucoside II as a T3SS inhibitor from Ludwigia adscendens
Bai, L., Zhang, D., Liu, Y., Yang, X., & Lu, C. (2025) · Journal of Future Foods · doi:10.1016/j.jfutfo.2024.05.011 · Cited by 1
Changes in essential goods consumption after Targeted Subsidies Reform in Minoodar district of Qazvin (2011)
Asefzadeh, S., Gholamalipoor, S., & Alijanzadeh, M. (2014) · The Journal of Qazvin University of Medical Sciences · Cited by 1
FRUIT AND VEGETABLE CONSUMPTION BEHAVIOUR: A QUALITATIVE STUDY OF MALAY ADULTS IN SUBANG JAYA, SELANGOR
Ismail, N., Karim, S. A., Karim, R., Adzahan, N. M., & Halim, N. A. (2013) · Cited by 1
Relações hipotéticas entre os determinantes sociais da saúde que influenciam na obesidade em idosos Hypothetical relationships between social determinants of health that influence on obesity in the elderly
Stival, M. M., de Lima, L. R., & Karnikowski, O. (2015) · Cited by 1
An Investigation of Fruits and Vegetables Intake Among Female Adolescents of the City of Isfahan
Yarmohammadi, P., & Yarmohammadi, P. (2017) · International Journal of School Health · doi:10.5812/intjsh.43743 · Cited by 1
“Furthermore, surveys by the world health organization (WHO) during years 2002 and 2003 revealed that more than 3⁄4 of the males and females in 52 nations with low and medium income levels consume 5 servings of fruits and vegetables in their daily diets, which is lower than minimum recommended values (27).”
Background
Plan pursuit in the context of daily fruit and vegetable consumption: The importance of cue detection and the execution of the planned behaviour for overall behaviour change
Domke, A., Keller, J., Knoll, N., Sniehotta, F. F., Heuse, S., & Wiedemann, A. U. (2022) · British Journal of Health Psychology · doi:10.1111/bjhp.12593 · Cited by 1
Determinants of obesity in the Latin America and Caribbean region
Koengkan, M., Fuinhas, J. A., Tavares, A. I., & Silva, N. M. B. G. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-99339-5.00001-7 · Cited by 1

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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