Prevalence of daily fruit and vegetable intake by socio-economic characteristics, women's empowerment, and climate zone: an ecological study in Latin American cities.

Abstract

This cross-sectional ecological study described fruit and vegetable (F&V) intake variability across 144 cities in 8 Latin American countries and by city-level contextual variables. Data sources came from health surveys and census data (Argentina, Brazil, Chile, Colombia, El Salvador, Guatemala, Mexico, and Peru). Self-reported frequency of F&V intake was harmonised across surveys. Daily F&V intake was considered as consumption 7 d of the week. Using a mixed-effects model, we estimated age and sex-standardised city prevalences of daily F&V intake. Through Kruskal-Wallis tests, we compared city F&V daily intake prevalence by tertiles of city variables related to women's empowerment, socio-economics, and climate zones. The median prevalence for daily F&V intake was 55.7% across all cities (22.1% to 85.4%). Compared to the least favourable tertile of city conditions, F&V daily intake prevalence was higher for cities within the most favourable tertile of per capita GDP (median = 65.7% vs. 53.0%), labour force participation (median = 68.7% vs. 49.4%), women achievement-labour force score (median = 63.9% vs. 45.7%), and gender inequality index (median = 58.6% vs. 48.6%). Also, prevalences were higher for temperate climate zones than arid climate zones (median = 65.9% vs. 50.6%). No patterns were found by city level of educational attainment, city size, or population density. This study provides evidence that the prevalence of daily F&V intake varies across Latin American cities and may be favoured by higher socio-economic development, women's empowerment, and temperate weather. Interventions to improve F&V intake in Latin America should consider the behaviour disparities related to underlying local social, economic, and climate zone characteristics.