Non-attitudinal and non-knowledge based factors constrain households from translating good nutritional knowledge and attitude to achieve the WHO recommended minimum intake level for fruits and vegetables in a developing country setting: evidence from Gulu district, Uganda

Lomira, Benjamin Kenyi Bendere; Nassanga, Prossy; Okello, Daniel Micheal; Ongeng, Duncan

doi:10.1186/s40795-021-00469-5

Cited by 3 publications

(20 citation statements)

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“…In four studies the highest intake or purchase of fruit, vegetables or combined FV was observed among men (28,35,40,48). No differences between men and women, neither for fruit, nor for vegetable consumption or purchase was observed in ten studies (29,32,42,50,53,55,57,60,62,73).…”

Section: Gender/biological Sex DI Erencesmentioning

confidence: 85%

“…One study among adults in Mauritius examined the frequency and also the timing of fruit consumption between age groups and found significant differences between younger and older adults and whether fruit was consumed after lunch or after dinner (74). In seven studies, no association was found between age and fruit; between age and vegetable; or age and combined FV consumption or purchase (28,29,32,42,50,57,62).…”

Section: Agementioning

confidence: 99%

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Factors affecting fruit and vegetable consumption and purchase behavior of adults in sub-Saharan Africa: A rapid review

et al. 2023

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In order to achieve the Sustainable Development Goals, considerable dietary shifts, including an increase in the consumption of fruit and vegetables (FV) will be required. However, worldwide consumption of FV is far below international recommendations, including in many low- and middle-income countries (LMICs), particularly in Africa. Understanding what, where, when, and how people choose to eat requires an understanding of how individuals are influenced by factors in their social, physical, and macro-level environments. In order to develop effective interventions to increase fruit and vegetable consumption, the factors influencing consumer behavior need to be better understood. We conducted a rapid review to assess and synthesize data on individual, social, physical, and macro-level factors that enable or constrain fruit and vegetable consumption and purchase among adults living in sub-Saharan Africa. Our conceptual framework is based on a socio-ecological model which has been adapted to settings in LMICs and Africa. We systematically searched four electronic databases including Scopus, Medline (PubMed), PsycInfo, and African Index Medicus, and screened Google Scholar for gray literature. We included a total of 52 studies and narratively summarized the existing evidence for each identified factor across the different levels. We found that most studies assessed demographic factors at the individual level including household or family income, socio-economic status and education. Furthermore we identified a variety of important factors that influence FV consumption, in the social, physical, and macro environment. These include women's empowerment and gender inequalities, the influence of neighborhood and retail food environment such as distance to market and price of FV as well as the importance of natural landscapes including forest areas for FV consumption. This review identified the need to develop and improve indicators both for exposure and outcome variables but also to diversify research approaches.

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Section: Gender/biological Sex DI Erencesmentioning

confidence: 85%

Section: Agementioning

confidence: 99%

Factors affecting fruit and vegetable consumption and purchase behavior of adults in sub-Saharan Africa: A rapid review

et al. 2023

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“…Various studies have used simple score count to ascertain nutritional knowledge and attitude (Dissen et al, 2011;Halloran et al, 2018;Hill et al, 2020;Lomira et al, 2021). However, in this study, indices were constructed and adopted to encompass a set of knowledge and attitude variables.…”

Section: Discussionmentioning

confidence: 99%

“…In a study to assess the relationship between nutrition knowledge and optimal mealtime behaviors, Halloran et al (2018) also attributed similar factors, as indicated above, for a non-association, despite high levels of nutritional knowledge. Also, the negative or no association between FV consumption and knowledge and attitude measures has been attributed to non-knowledge and attitudinal factors such as production constraints, limited markets and postharvest methods, health issues, and policy constraints (Lomira et al, 2021). Nonetheless, in a former study in Kenya, an integrated nutritional knowledge and attitudinal approach that is participatory and considers people's social and cultural dimensions was found to be suitable to inform good dietary behavior (Waswa et al, 2015).…”

Section: Knowledge and Attitude Towards Fruit And Vegetable Processin...mentioning

confidence: 99%

“…Several studies from the US (Dissen et al, 2011;Halloran et al, 2018), Australia (Hill et al, 2020) and Uganda (Lomira et al, 2021) have shown positive associations between nutritional knowledge and/or attitudes and FV consumption and, in general, quality diet intake. In this study, it was expected that the knowledge and attitude indices would positively be associated with the FV consumption as measured in g/week.…”

Section: Knowledge and Attitude Towards Fruit And Vegetable Processin...mentioning

confidence: 99%

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Fruit and vegetable processing and consumption: Knowledge, attitude, and practices among rural women in East Africa

2023

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High post-harvest losses of fruits and vegetables (FVs) limit their supply and availability for year-round consumption. Hence, processing innovations at their production areas could help address this constraint, which requires the need to assess people's perceptions in these areas. Therefore, this study gauged the knowledge, attitude, and practices towards FV processing and consumption and its relationship with actual FV consumption. Surveys were conducted with women in six study sites – three fruit and three vegetable production areas – in Kenya, Tanzania, and Uganda. Quantitative 24-h dietary and 7-day FV recalls were collected across two seasons. Open and closed-ended questions were constructed to assess the women's knowledge, attitude, and practices towards FV processing and consumption. The fruit and vegetable sites included 584 and 732 women, respectively. Average fruit consumption was 4-135 g/day in the plenty season and 4-106 g/day in the lean season. Vegetable consumption was 112-146 g/day and 84-180 g/day in the plenty and lean season, respectively. There were significant consumption differences across seasons. Most women expressed high knowledge of FV processing and consumption benefits and showed a positive attitude towards FV processing and consumption. Yet, in practice, a small number of women process FVs largely due to limited processing know-how and equipment. The relationship between knowledge and attitude and FV consumption was negative or none. The high knowledge and positive attitude expressed, yet the limited processing know-how and equipment should be a basis for interventions to increase FV processing into nutritious products for better nutrition and to ensure their availability year-round.

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Status of household dietary diversity and associated factors among rural and urban households of Northern Uganda

2023

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Background In Northern Uganda, 21 and 52.4% of children under five are underweight and stunted, respectively while 32.9% of pregnant women are anemic. This demographic situation suggests among other issues, a lack of dietary diversity among households. Good nutrition practices that confer dietary quality such as dietary diversity are known to depend on nutrition knowledge and attitude and are shaped by sociodemographic and cultural factors. However, there is a paucity of empirical evidence to support this assertion for the variably malnourished population of Northern Uganda. Methods A cross-sectional nutrition survey was conducted among 364 household caregivers (182 from two locations in Northern Uganda; Gulu District (the rural) and Gulu City (the urban), selected through a multistage sampling approach. The aim was to determine the status of dietary diversity and its associated factors between rural and urban households of Northern Uganda. The household dietary diversity questionnaire and the food frequency questionnaire on a 7-day reference period were used to collect data on household dietary diversity whereas multiple choice questions and the five points Likert Scale were used to determine knowledge and attitude toward dietary diversity. Consumption of ≤ 5 food groups were regarded as low in dietary diversity, 6–8 food groups as medium and ≥ 9 as high dietary diversity score using the FAO 12 food groups. An Independent two-sample t-test was used to differentiate the status of dietary diversity between the urban and rural areas. The Pearson Chi-square Test was used to determine the status of knowledge and attitude while Poisson regression was used to predict dietary diversity based on caregivers’ nutritional knowledge and attitude and their associated factors. Results The 7-day dietary recall period revealed that dietary diversity was 22% higher in urban (Gulu City) than in the rural area (Gulu District) with rural and urban households achieving medium (score of 8.76 ± 1.37) and high (score of 9.57 ± 1.44) dietary diversity status, respectively. Diets in both locations were dominated by starchy cereals and tubers while animal-source foods and fruits and vegetables were the least consumed. A higher proportion (51.65%) of urban respondents had good nutrition knowledge toward dietary diversity compared to their rural counterparts (23.08%) and a significantly higher proportion (87.91%) of the former exhibited positive attitude towards dietary diversity than the rural counterparts (72.53%). Application of the Poisson regression shows that nutritional knowledge was a positive predictor of dietary diversity in the rural (β = 0.114; ρ = 0.000) than in the urban areas (β = -0.008; ρ = 0.551). Caregivers attitude had no significant effect across locations. In terms of associated factors, marital status is a positive predictor of dietary diversity in the urban (β = 1.700; ρ = 0.001) than the other location (β = -2.541; ρ = 0.008). Whereas education level of household caregiver and household food expenditure show negative effects across the two locations, the educational level of the household head is an outlier as it positively predicted dietary diversity in the rural (β = 0.003; ρ = 0.002) when compared to urban area (β = -0.002; ρ = -0.011). Conclusion Rural households in Northern Uganda have medium-level dietary diversity with urban households having high dietary diversity. Diets in both locations are dominated by starchy cereals and roots and tubers. The urban–rural food divide can be harmonized through nutrition education and outreach, specifically focusing on the FAO 12 food groups. Attitude toward consumption of fruits and vegetables which are seasonally abundant would improve dietary diversity and nutritional outcomes in the study area.

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Non-attitudinal and non-knowledge based factors constrain households from translating good nutritional knowledge and attitude to achieve the WHO recommended minimum intake level for fruits and vegetables in a developing country setting: evidence from Gulu district, Uganda

Cited by 3 publications

References 56 publications

Factors affecting fruit and vegetable consumption and purchase behavior of adults in sub-Saharan Africa: A rapid review

Factors affecting fruit and vegetable consumption and purchase behavior of adults in sub-Saharan Africa: A rapid review

Fruit and vegetable processing and consumption: Knowledge, attitude, and practices among rural women in East Africa

Status of household dietary diversity and associated factors among rural and urban households of Northern Uganda

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