A couple of weeks ago, the findings of a study by the Food and Agriculture Organization of the United Nations (FAO) revealing the decline of fruit and vegetable consumption in Ghana hit the news headlines. These findings though undesirable, are actually a reflection of what is happening globally - fruit and vegetable intakes are persistently low worldwide.

According to the World Health Organisation, an estimated 5.2 million deaths worldwide were attributable to inadequate fruit and vegetable consumption in 2013.  The WHO/FAO recommends a minimum of 400g (5 portions) of fruit and vegetables per for the prevention of chronic diseases such as heart disease, cancer, diabetes and obesity, as well as for the prevention and alleviation of several micronutrient deficiencies, especially in less developed countries. This 400g excludes potatoes and other tubers like cassava and yam which are classified as starchy vegetables in other contexts.

For Ghana, a number of the key findings of the FAO study highlighted by the Daily Graphic are worth pondering over.

Findings of the Ghana-based study

Firstly, the study found that daily fruit consumption was 1.5 portions per day whilst daily vegetable consumption stood at 2.3 portions per day. When compared to WHO’s recommendation of a minimum total of 5 portions of fruit and vegetables per day, we have improvements to make. We need further research to identify and understand the specific reasons for the low consumption of fruits and vegetables especially amongst different population groups in Ghana. In a study conducted among university students in Ghana, cost and satiety were the significant factors found to hinder students’ fruit intake.

In this study by FAO also, the reasons given for low consumption included high cost of fruit and vegetables, satiety and concerns about food safety. Economic factors including cost have been identified by other studies in determining fruit and vegetable consumption patterns in sub-Saharan Africa^.  Therefore, promotion campaigns alone are unlikely to result in addressing the low intake of fruit and vegetables. Each individual factor associated with low consumption of fruit and vegetables must be taken on its own merit and addressed thoroughly by relevant stakeholders.

Another interesting finding of the FAO study was that in Ghana, that, the consumption rate of fruit and vegetables among men was 37% whilst that of women stood at 30%.  This differs from findings from numerous studies around the world demonstrating a pattern of lower fruit and vegetable intake in men compared to women.  Given the large role women play as decision-makers in family food choices and dietary intakes in Ghana, it is important to further investigate the reasons underlying this unusual finding.

 Finally, the top 3 fruits that many Ghanaians preferred to consume were mango, watermelon and orange. This is a positive finding in the sense that, when it comes to eating fruits and vegetables, it is important to focus on eating a wide variety in order to optimise intake of micronutrients and bioactive compounds. Indeed, dietitians and nutrition educators emphasise eating fruits and vegetables within the full range of colours of the rainbow. With these 3 fruits, we can count at least 3 rainbow colours – yellow for mangoes, red for watermelon and orange/yellow for oranges which is a good starting point. Any campaigns to promote fruit and vegetable intake must clearly outline the different local varieties of fruit and vegetables available during specific seasons and within different geographical areas in the country. Emphasis must also be placed on the importance of the different nutrients found in the different coloured fruits and vegetables as well as a focus on practical and acceptable strategies for including each type in our dietary intakes.

The reality

A number of studies have reported significant improvements in fruit and vegetable consumption when a multi-faceted approach is taken including interventions such as, promoting school and backyard gardens, interventions to reduce the cost of fruit and vegetables, processing to increase shelf-life, nutrition education and behaviour change programmes based on local knowledge.

The reality is that, individuals will not ordinarily increase their fruit and vegetables intakes to recommended levels for health without knowledge of the health benefits, adequate incomes and ready availability of safe and wide variety of fruits and vegetables.

Continued efforts to monitor, identify and address the multiple factors linked to the persistent problem of low consumption of fruits and vegetables goes a long way in addressing this problem and improving the health of the nation.