Low fruit and vegetable consumption is one of the leading contributors to the global burden of non-communicable disease and death (Lim et al. 2013). A 2003 FAO/WHO joint report defines adequate fruit and vegetable consumption as an individual daily intake of 400 grams of fruit and vegetables (or the equivalent of 5 servings). This household level indicator is a measure of diet quality and can be used to understand diet patterns in households and can be aggregated to see patterns between regions.
Method of Construction
Household Consumption and Expenditure Survey (HCES) data can be used to construct this indicator by summing the total weight (in grams) of fruits and vegetables consumed by the household as reported by the respondent. This total can then be divided by the number of household members, and then divided by the number of days within the survey recall period. The resulting value is the number of grams of fruits and vegetables consumed per capita per day for the household. If this number is at or above 400 grams/capita/day, the household is classified as having adequate fruit and vegetable consumption.
This indicator is one of several indicators included in the ADePT-FSM (Food Security Module) software package, which is a free standalone software developed by the FAO and the World Bank that allows users to easily derive food security indicators from household survey data. The software download and corresponding documentation can be found on the FAO website, here. Please also see the Moltedo et al. 2014 book published by the World Bank, which provides detailed instructions for analyzing food security using household survey data.
This household level indicator can be used to identify inadequacy of fruit and vegetable consumption between population sub-groups, including those based on household income, gender of household head, and those in different geographic areas. It can be used in studies to identify the potential socioeconomic and cultural determinants of inadequate fruit and vegetable consumption that can advise local or national strategies to encourage consumption and improve dietary practices (Jaime et al 2003).
Strengths and Weaknesses
This household level indicator reflects an important aspect of dietary quality and can serve as a proxy for the quality of individual diets within the households. Other indicators of adequacy of fruit and vegetable consumption may use the consumption of five servings per day as the definition of adequacy, rather than 400 grams (Hall et al. 2009), but the concept of serving may differ by country. These indicators may be subject to bias due to the considerable variability of definitions of fruits, vegetables, and portion sizes between countries (Agudo 2004), though the data from HCES could be classified by the researcher into standardized categories of fruits and vegetables. A benefit of using grams instead of serving sizes is that it can improve comparability across countries. One drawback of this indicator, along with other household level indicators, is that it assumes that individuals within the household consume food equal to their proportionate need, which may not always occur. In addition, this indicator uses data collected from one individual within the household who is reporting everyone’s consumption, which may not be accurate, especially considering food that may have been consumed away from home. Because this is a household level indicator, it can be used to compare diet quality across households, but not among individuals within the same household.
HCES data can be used to calculate this indicator and are (generally) publicaly available. The International Household Survey Network (IHSN) is an online repository for household surveys (IHSN). For details on the consumption module in HCES see Smith et al. (2014).
There are no links to validation studies to show for this indicator.