Abstract
Physical inactivity and low consumption of fruits and vegetables (FV) during adolescence may persist through adulthood, putting adolescents at risk of developing chronic diseases. Although studies from high-income countries have reported differences in FV consumption and physical activity (PA) between adolescent boys and girls, few exist from low-and-middle-income countries (LMICs). In this study, we examined patterns of FV consumption and PA among adolescent boys and girls in LMICs. Country selection was based on availability of Global School-Based Student Health Survey (GSHS) data from 2004 to 2013. The total analytic sample was 164,771 adolescents from 49 LMICs. Descriptive statistics were generated to determine adolescents meeting the World Health Organization (WHO) recommendations for FV and PA. A Rao-Scott adjusted chi-square statistic was computed to assess gender differences. Less than 30% of adolescents across all countries met the WHO guidelines for FV consumption or PA. Morocco (29.5%) and India (29.5%) however had the highest percentage of adolescents meeting recommendations for FV and PA, respectively. Adolescent boys were more active than girls, and this difference was more notable in the Middle East and North African region. Adolescents achieving the WHO recommendations for daily consumption of FV and PA were consistently low in all countries.
Highlights
Non-communicable diseases (NCDs), such as cancer, diabetes, and cardiovascular disease, are the leading cause of death worldwide[1]
The study sample of low-and-middle-income countries (LMICs) included countries from the regions demarcated by the World Bank if they had (1) publicly available data on fruits and vegetables (FV) intake and physical activity (PA) behaviors), and (2) data available to allow the assessment of differences between adolescent boys and girls for these health behaviors
This study found that adolescent boys and girls living in LMICs commonly do not meet World Health Organization (WHO) recommendations for FV intake and physical activity
Summary
Non-communicable diseases (NCDs), such as cancer, diabetes, and cardiovascular disease, are the leading cause of death worldwide[1]. It is a public health priority to promote healthy lifestyles as well as monitor levels of behavioral risk factors in all age groups, including children and adolescents For this purpose, the WHO has established recommendations for adolescents for minimal levels of physical activity (PA) and dietary intake of fruits and vegetables (FV). The WHO recommends at least 60 minutes of moderate-to-vigorous physical activity each day[4], and a dietary intake of at least 400 grams of FV each day (roughly equivalent to five servings of FV/day)[5]. In a review of determinants of FV intake among children and adolescents, Rasmussen et al.[10] found that of the 49 studies reviewed, 27 studies found that girls had a higher consumption of fruits and vegetables compared to boys. The adolescence represents a critical period to encourage and create a conducive environment to be active, thereby minimizing the risk of NCDs, especially among girls
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