CGIAR Initiative: Fruit and Vegetables for Sustainable Healthy Diets <p class="ql-align-justify">Poor diets are a primary cause of malnutrition and the leading cause of disease worldwide&nbsp;1–3&nbsp;Improving diets, including increasing fruit and vegetable (F&amp;V) intake, could save one in five lives annually1. Micronutrients are essential for health; those obtained from F&amp;Vs have a lower environmental footprint than from other foods4&nbsp;making F&amp;Vs essential to&nbsp;<strong>healthy&nbsp;and&nbsp;sustainable</strong>&nbsp;<strong>diets</strong>.&nbsp;Dietary&nbsp;trends, combined with population growth and climate change5, are impeding delivery of the Sustainable Development Goals (SDGs), in particular, the&nbsp;SDG2 goal to end hunger, achieve food security and improve nutrition.&nbsp;</p><p class="ql-align-justify">&nbsp;</p><p class="ql-align-justify">Globally, F&amp;V intake is far below recommended levels4. However,&nbsp;the extent and nature of the problem&nbsp;is poorly understood due to insufficient dietary data,&nbsp;especially in LMICs.&nbsp;Increasing F&amp;V intake&nbsp;will require starting with consumers, understanding dietary patterns and addressing&nbsp;<strong>desirability, accessibility,</strong>&nbsp;<strong>affordability,&nbsp;</strong>and&nbsp;<strong>availability&nbsp;</strong>barriers<strong>&nbsp;</strong>through cost-effective solutions using an end-to-end approach.&nbsp;</p><p class="ql-align-justify">&nbsp;</p><p class="ql-align-justify">Even when F&amp;V are accessible and affordable, intake is too low6&nbsp;highlighting the role of&nbsp;<strong>desirability&nbsp;</strong>in F&amp;V intake. Context- and population-specific, cost-effective multi-channel behavioral and experiential approaches7&nbsp;and policy changes are needed to improve F&amp;V desirability. Cost-effectiveness may be optimized by targeting programs and policies towards those whose preferences are most malleable (e.g.,&nbsp;young children8&nbsp;and adolescents9&nbsp;and/or influential (e.g.,&nbsp;women10).&nbsp;&nbsp;</p><p class="ql-align-justify">&nbsp;</p><p class="ql-align-justify">Improving&nbsp;<strong>accessibility</strong>&nbsp;necessitates bringing consumers and the foods they desire closer together. This can be accomplished in several ways such as increasing home production of F&amp;Vs11,12&nbsp;altering the physical food environment, and digitization.&nbsp;</p><p class="ql-align-justify">&nbsp;&nbsp;</p><p class="ql-align-justify">More than 3 billion people cannot afford a healthy diet13. Often, F&amp;V are among the least affordable foods2.&nbsp;On the demand side,&nbsp;<strong>affordability&nbsp;</strong>of F&amp;Vs<strong>&nbsp;</strong>can be increased with social assistance programs (SAPs) (e.g.,&nbsp;school-feeding programs or cash-based transfers), or through providing fair wages for workers.&nbsp;On the supply side, increasing&nbsp;<strong>availability&nbsp;</strong>is essential to reducing cost of F&amp;Vs and accommodating increased intake.&nbsp;The gap between F&amp;V supply and demand is projected to remain large globally, especially in sub-Saharan Africa (SSA)14. To provide enough vegetables for healthy diets production likely needs to increase by 75% by 20504&nbsp;in addition to reducing postharvest losses, estimated at 30-50%. To attain this, systemwide improvements are needed such as improving farmer access to- and use of- quality seed of resilient&nbsp;cultivars, irrigation, safe pest management technologies and appropriate post-harvest handling (e.g.,&nbsp;cold chains, digitization, and shorter supply chains). Lastly, institutional or socio-economic constraints on marginalized groups (such as unequal pay or zero-hours contracts) should be removed so F&amp;V sector jobs are safe and profitable.&nbsp;&nbsp;</p><p class="ql-align-justify">&nbsp;</p><p class="ql-align-justify">Poor diets&nbsp;are causing an&nbsp;overwhelming loss of DALYs and lives.&nbsp;Solutions for improving diet quality, in part by increasing F&amp;V intake, are urgently needed. Climate change15&nbsp;is&nbsp;negatively affecting&nbsp;F&amp;V production5&nbsp;and innovations will need to address these issues. Women and youth are central to sustainable&nbsp;changes in the F&amp;V sector. Women are often involved in vegetable production16&nbsp;and tend to decide what food is prepared and how.&nbsp;Youth&nbsp;also have an important role to play in the evolution of&nbsp;the F&amp;V sector.&nbsp;17&nbsp;Additionally, influencing&nbsp;their&nbsp;diet practices can have short- and long-term benefits.&nbsp;Thus, FRESH innovations along the continuum from consumption to production will&nbsp;also&nbsp;be designed to empower women and youth, and other&nbsp;marginalized groups. Solutions to the intractable problem of low F&amp;V intake will clearly need to be multifaceted and interconnected requiring the proposed end-to-end approach.&nbsp;</p><p><br></p>