Agricultural abundance, dietary shortfall: national determinants of daily fruit and vegetable intake in Türkiye National Nutrition and Health Survey.

Abstract

Background: Türkiye is one of the world's leading producers of fruits and vegetables (F&V). Yet, findings from the Türkiye Nutrition and Health Surveys (TNHS-2010 and TNHS-2017) reveal a 24.3% decline in consumption over this period. This discrepancy between agricultural capacity and dietary intake highlights the need to better understand factors associated with consumption. This disconnect between agricultural abundance and dietary intake underscores the need to understand the factors influencing F&V consumption at the population level.

Methods: This cross-sectional secondary analysis used data from the nationally representative TNHS-2017. The analytic sample included 12,406 individuals aged ≥ 15 years who completed the Food Frequency Questionnaire. Anthropometric measurements were obtained by trained dietitians in Family Health Centers across all 81 provinces of the country; pregnant and lactating women were excluded. F&V intake was categorized as daily versus non-daily, and freshly squeezed fruit juice as never, occasional, or daily. Binary logistic regressions were used to identify factors associated with daily F&V intake, and multinomial logistic regression was used to examine factors associated with juice consumption.

Results: Daily F&V intake was observed in 38.6% of participants. Higher odds of daily intake were seen among women (aOR 1.58, 95% CI 1.44-1.73), older adults, individuals with greater physical activity, and dietary supplement users, whereas higher food insecurity was inversely associated with daily intake (aOR per unit 0.90, 95% CI 0.86-0.93). Regional disparities were pronounced, with higher odds in the Mediterranean and Middle East Anatolia and lower odds in several inland and northeastern regions relative to the Aegean. BMI and body roundness index were not independently associated with intake after adjustment. For freshly squeezed fruit juice, occasional consumption was more likely among higher-educated groups and supplement users and less likely among smokers and food-insecure individuals. Daily juice consumption was rare.

Conclusions: In Türkiye, daily F&V intake was associated with sociodemographic, regional, behavioral, and food security factors rather than body size indicators. These findings provide nationally relevant evidence to support strategies aimed at improving fruit and vegetable consumption, particularly by addressing affordability, regional disparities, and food insecurity, while clarifying the limited role of juice.