Fruit and Vegetable Intake and Non-Communicable Diseases among Adults Aged ≥50 Years in Low- and Middle-Income Countries

Objectives: The relationship between consuming ≥2 servings of fruits and ≥3 servings of vegetables a day, which has been identified as optimal for health (i.e., adequate fruit/vegetable consumption), and non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) is largely unknown. Therefore, using data from six LMICs, we investigated the independent association between inadequate fruit/vegetable consumption and 12 NCDs, and estimated the prevalence of inadequate fruit/vegetable consumption among people with NCDs. Design and Setting: Cross-sectional, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Participants: Data on 34129 individuals aged ≥50 years were analyzed [mean (SD) age 62.4 (16.0); maximum age 114 years; 52.1% females]. Measurements: Information on the number of servings of fruits and vegetables consumed on a typical day was self-reported. Twelve NCDs were assessed. Multivariable logistic regression analysis was conducted. Results: Overall, 67.2% had inadequate fruit/vegetable consumption. Inadequate fruit/vegetable consumption was independently associated with significantly higher odds for chronic lung disease (OR=1.25), diabetes (OR=1.45), hearing problems (OR=1.75), and visual impairment (OR=2.50). The prevalence of inadequate fruit/vegetable consumption was particularly high among people with visual impairment (92.5%), depression (90.5%), asthma (79.8%), and hearing problems (78.4%). Conclusion: Promotion of fruit and vegetable consumption (≥2 servings of fruits and ≥3 servings of vegetables a day) in LMICs may lead to prevention of some NCDs (e.g., diabetes, chronic lung disease). Furthermore, people with certain NCDs (e.g., visual impairment, depression) had particularly high prevalence of inadequate fruit/vegetable consumption, and it is thus important to target this population to increase fruit/vegetable consumption.