Factors associated with frequency of fruit and vegetable consumption among selected sub-Saharan African populations: evidence from the Cardiovascular H3Africa Innovation Resource Project
Authors: Okekunle Akinkunmi Paul , Asowata Osahon Jeffery , Akpa Onoja Matthew , Fakunle Adekunle Gregory , Chikowore Tinashe , Mohamed Shukri F , Obiako Reginald , Komolafe Morenikeji , Osaigbovo Godwin O , Ogbole Godwin , Arulogun Oyedunni , Sarfo Fred Stephen , Wahab Kolawole , Owolabi Lukman , Akinyemi Joshua , Akpalu Albert , Uvere Ezinne , Akinyemi Rufus , Jenkins Carolyn , Arnett Donna K , Lackland Daniel , Ovbiagele Bruce , Ramsay Michèle , Owolabi Mayowa ,   SIREN, AWI-Gen and the H3Africa Consortium, Owolabi Mayowa , Akpa Onoja , Ogbole Godwin , Akinyemi Joshua , Arulogun Oyedunni , Agunloye Atinuke M , Adeoye Abiodun , Fakunle Adekunle , Okekunle Akinkunmi Paul , Uvere Ezinne O , Oladimeji Adebayo , Diala Samuel , Yaria Joseph , Efidi Richard , Asowata Osahon J , Olowoyo Paul , Adebayo Philip , Ogunjimi Luqman , Tito-Ilori Moyinoluwalogo M , Melikam Ezinne S , Adeegbe Oluwayemisi , Ogah Okechukwu S , Coker Motunrayo M , Adebajo Olayinka , Olalere Abimbola , Olalusi Dotun , Makanjuola Akintomiwa , Macaulay Funmi O , Ovbiagele Bruce , Tagge Raelle , Sarfo Fred S , Singh Arti , Owusu Dorcas , Adusei Nathaniel , Appiah Lambert , Akpalu Josephine , Adamu Sheila , Ampofo Michael , Appiah Lambert , Mensah Yaw , Akpalu Albert , Calys-Tagoe Benedict , Laryea Ruth Y , Agyekum Francis , Wahab Kolawole , Sanya Emmanuel O , Ogunmodede James A , Oyinloye Olalekan I , Kolo Philip M , Bello Abiodun H , Obiako Reginald , Ibinaiye Philip , Olayemi Balogun , Abubakar Sani A , Sule Abdullateef G , Oguike Wisdom , Shidali Vincent , Komolafe Morenikeji , Olowookere Samuel , Fawale Bimbo , Adeniyi Sunday , Sunmonu Taofik , Owolabi Lukman , Abunimye Esther , Isah Suleiman Y , Dambatta Hamisu A , Jenkins Carolyn , Lackland Daniel T , Osaigbovo Godwin O , Imoh Lucius , Abdul Salaam , Amusa Ganiyu , Uwanuruochi Kelechukwu , Chukwuonye Innocent I , Onyeonoro Ugochukwu , Ohagwu Kenneth A , Akinyemi Rufus , Adeleye Osimhiarherhuo , Akinwande Kazeem S , Ogunronbi Mayowa , Adeniyi Wasiu , Adesina Julius , Odunlami Olufemi A , Akisanya Cynthia , Adeniji Olaleye , Tiwari Hemant K , Srinivasasainagendra Vinodh , Tollman Stephen , Wade Alisha , Kabudula Chodziwadziwa , Ohene-Kwofie Daniel , Gómez-Olivé F Xavier , Wafawanaka Floidy , Kahn Kathleen , Gondwe Mwawi , Twine Rhian , Wagner Ryan , Kyobutungi Catherine , Khayeka-Wandabwa Christopher , Asiki Gershim , Kisiangani Isaac , Mohamed Shukri , Alberts Marianne , Choma Solomon , Mashinya Felistas , Mashaba Given , Tinto Halidou , Sorgho Herman , Boua Palwendé Romuald , Oduro Abraham R , Agongo Godfred , Debpuur Cornelius , Nonterah Engelbert , Norris Shane A , Micklesfield Lisa , Baloyi Vukosi , Ramsay Michèle , Choudhury Ananyo , Mthembu Busisiwe , Soo Cassandra , Sengupta Dhriti , Tambo Ernest , Ceballos Francisco Camiña , Mukomana Freedom , Tluway Furahini , Wandera Henry , Soodyall Himla , Brandenburg Jean-Tristan , Smyth Natalie , Crowther Nigel , Oduaran Ovokeraye , Hazelhurst Scott , Ali Stuart , Mathema Theo , Chikowore Tinashe , Swiel Yaniv , Lombard Zané , Sankoh Osman , Tindana Pauline 
Published: January 2024

Abstract

Background
Frequent fruit and vegetable consumption is considered a promising dietary behaviour that protects health. However, most existing studies about the factors associated with this phenomenon among Africans are based on single-country reports, apart from one meta-regression combining smaller studies. This study harmonized large datasets and assessed factors associated with the frequency of fruit and vegetable consumption in this population.

Methods
Individual-level data on sociodemographics, lifestyle and diet from 20 443 participants across five African countries (Burkina Faso, Ghana, Kenya, South Africa and Nigeria), from the Stroke Investigative Research and Educational Network (SIREN) and Africa Wits-INDEPTH partnership for Genomic Research (AWI-Gen) studies, were harmonized. Total frequency of fruit and vegetable consumption (in portions/week) was classified as ‘low’ (≤6), ‘moderate’ (7–14) and ‘high’ (≥15). Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of factors associated with the total frequency of fruit and vegetable consumption (using ‘low’ consumption as the reference) were estimated using multinomial regression models.

Results
Mean age of participants was 54.3 ± 11.8 years, 10 641 (52.1%) were female, and the median (interquartile range) frequency of total fruit and vegetable consumption was 10.0 (4.0, 21.0) portions/week. Participants with a family history of cardiovascular disease [moderate (aOR, 0.92; 95% CI, 0.85, 1.00) and high (aOR, 0.85; 95% CI, 0.78, 0.92)], current smokers [moderate (aOR, 0.83; 95% CI, 0.74, 0.94) and high (aOR, 0.78; 95% CI, 0.69, 0.88)], current alcohol users [moderate (aOR, 0.92; 95% CI, 0.85, 1.00) and high (aOR, 0.82; 95% CI, 0.76, 0.89)] and physically inactive participants [moderate (aOR, 0.85; 95% CI, 0.75, 0.96) and high (aOR, 0.80; 95% CI, 0.70, 0.90)] were less likely to consume fruits and vegetables frequently.

Conclusion
Africans with lifestyle risk factors for cardiovascular disease were less likely to consume fruit and vegetables frequently.