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February 20-21, 2017 Berlin, Germany

International Congress on

Nutrition & Health

Volume 7 Issue 1 (Suppl)

J Nutr Food Sci

ISSN:2155-9600 JNFS, an open access journal

Nutrition & Health 2017

February 20-21, 2017 Berlin, Germany

J Nutr Food Sci 2017, 7:1 (Suppl)

The availability, affordability and consumption of fruits and vegetables in 18 countries across income

levels: Findings from the prospective urban rural epidemiology (PURE) study

Victoria Miller

McMaster University, Canada

everal international guidelines recommend the consumption of two servings of fruits and three servings of vegetables per day, but

their intake is thought to be low worldwide. We aimed to determine the extent to which such low intake is related to availability

and affordability. We assessed fruit and vegetable consumption using data from country-specific, validated semi-quantitative food

frequency questionnaires in the prospective urban rural epidemiology (PURE) study, which enrolled participants from communities

in 18 countries between Jan 1 2003 and Dec 31 2013. We documented household income data from participants in these communities;

we also recorded the diversity and non-sale prices of fruits and vegetables from grocery stores and market places between Jan 1

2009 and Dec 31 2013. We determined the cost of fruits and vegetables relative to income per household member. Linear random

effects models, adjusting for the clustering of households within communities, were used to assess mean fruit and vegetable intake

by their relative cost. Of 143,305 participants who reported plausible energy intake in the food frequency questionnaire, mean fruit

and vegetable intake was 3.76 servings (95% CI 3.66-3.86) per day. Mean daily consumption was 2.14 servings (1.93-2.36) in low-

income countries (LICs), 3.17 servings (2.99-3.35) in lower-middle-income countries (LMICs), 4.31 servings (4.09-4.53) in upper-

middle-income countries (UMICs), and 5.42 servings (5.13-5.71) in high-income countries (HICs). In 130,402 participants who had

household income data available, the cost of two servings of fruits and three servings of vegetables per day per individual accounted

for 51.97% (95% CI 46.06-57.88) of household income in LICs, 18.10% (14.53-21.68) in LMICs, 15.87% (11.51-20.23) in UMICs and

1.85% (-3.90 to 7.59) in HICs (P

trend

=0.0001). In all regions, a higher percentage of income to meet the guidelines was required in rural

areas than in urban areas (p<0.0001 for each pairwise comparison). Fruit and vegetable consumption among individuals decreased

as the relative cost increased (P

trend

=0.00040). The consumption of fruit and vegetables is low worldwide, particularly in LICs, and

this is associated with low affordability. Policies worldwide should enhance the availability and affordability of fruits and vegetables.