Low intake of commonly available fruits and vegetables in socio-economically disadvantaged communities of South Africa: influence of affordability and sugary drinks intake

Background: Consumption of fruits and vegetables reduces the risk of obesity, diabetes, cancer, cardiovascular
mortality and all-cause mortality. The study assessed the pattern of intake and the factors that influence daily intake
of commonly available fruits and vegetables in economically disadvantaged South African communities.
Methods: This is a cross-sectional study nested on an ongoing longitudinal study in South Africa. Two communities (a
rural and urban) of low socio-economic status were purposely selected from two of the nine provinces. A sample of
535 participants aged 30–75 years was randomly selected from the longitudinal cohort of 1220; 411 (78%) women.
Data were collected using validated food frequency and structured interviewer-administered questionnaires.
Descriptive and multivariate regression analysis were undertaken.
Results: A higher proportion of participants in the urban township compared to their rural community
counterparts had purchased fruits (93% vs. 51%) and vegetables (62% vs. 56%) either daily or weekly. Only
37.8% of the participants consumed at least two portions of commonly available fruits and vegetables daily,
with no differences in the two communities. Daily/weekly purchase of sugar sweetened beverages (SSBs) was
associated with daily intake of fruits and vegetables (p = 0.014). Controlling for age and gender, analysis
showed that those who spent R1000 (USD71.4) and more on groceries monthly compared to those who
spent less, and those who travelled with a personal vehicle to purchase groceries (compared to those who
took public transport) were respectively 1.6 times (AOR, 95% CI: 1.05–2.44; p = 0.030) and 2.1 times (AOR, 95%
CI: 1.06–4.09; p = 0.003) more likely to consume at least two or more portions of fruits and vegetables daily.
Those who purchased SSBs daily or weekly were less likely (AOR, 95% CI: 0.54, 0.36–0.81, p = 0.007) to consume two or
more portions of fruits and vegetables daily. The average household monthly income was very low (only
2.6% of households earned R5000 (US$357.1); and education level, attitude towards fruits and vegetables and owning
a refrigerator had no significant association with fruits and vegetable daily intake.
Conclusion: These findings indicate that affordability and frequency of purchase of sugary drinks can influence daily
intake of fruits and vegetables in resource-limited communities.
Keywords: Fruit and vegetables, Daily, Intake, Affordability, South Africa, Community