Abstract

Low fruit and vegetable consumption (FVC) remains a global health challenge. Fostering subsistence agriculture through the production and home-grown consumption (HGC) of fruits and vegetables are seen as potential strategies for improving overall FVC, in particular, for developing countries like India. In addition, educational strategies targeting FVC health literacy are also used. Little evidence has documented a connection between these two strategies. We examine the single and combined influence of HGC and health literacy with regard to benefits from fruits and vegetable consumption. Data were collected from 427 rural households in the state of Odisha, India. Three outcomes were examined: FVC, as well as fruit and vegetables separately. Linear and Poisson regression were used to examine the association among home-grown consumption (HGC), FVC health literacy, and the FVC outcomes. Findings show that HGC, but not FVC health literacy, was directly associated with FVC (β = 0.65, SE = 0.10, p = 0.008) and vegetable consumption (β = 0.57, SE = 0.11, p = 0.02). However, both HGC (β = 0.58, SE = 0.05, p < 0.01) and FVC health literacy (β = −0.07, SE = 0.02, p = 0.001) were associated with fruit consumption. In addition, HGC effect is concentrated among participants who reported low FVC health literacy, especially on overall FVC and vegetables alone. Results are discussed in relation to the beneficial role played by HGC in those particularly vulnerable households who perceived little FVC health literacy. Our results provide insights on novel improved FVC consumption across all population segments. Future research should explore the complex interplay between agricultural policies and educational programs in the design of interventions promoting fruit and vegetable production and consumption.

Highlights

  • Fruits and vegetables (FVs) are important components of a healthy diet, and when consumed in sufficient levels, it can reduce the risk of chronic diseases, such as diabetes and obesity, cardiovascular diseases, and certain types of cancer [1,2,3,4,5]

  • When comparing between the low- and high-health literacy groups, there were no differences for overall fruit and vegetable consumption (FVC) and vegetable consumption (VC) alone, but the high-health literacy group had significantly lower fruit consumption (FC) compared with the lower one

  • The study found that people with a high level of home-grown fruits and vegetables consumption (HgFVC) would associate with more FVC (β = 0.65, SE = 0.10, p = 0.008), but the household health literacy was not associated with FVC (β = 0.12, SE = 0.07, p = 0.21) after adjusting for control variables

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Summary

Introduction

Fruits and vegetables (FVs) are important components of a healthy diet, and when consumed in sufficient levels, it can reduce the risk of chronic diseases, such as diabetes and obesity, cardiovascular diseases, and certain types of cancer [1,2,3,4,5]. The Food and Agriculture Organization of the United Nations/World Health Organization (FAO/WHO) recommends a daily individual intake of at least 400 g of FVs a day, which is the equivalent of five servings of 80 g each [6]. In spite of robust evidence for the benefits associated with normative fruit and vegetable consumption (FVC), the majority of people consistently consume less than the daily recommended FV intakes [6,7,8,9]. Among people living in low- and middle-income countries (LMICs), 78% consume less than the daily recommended FVC [7, 8]. Agricultural produce from homesteads cannot only be sold to earn income for food expenses and can be used for people’s own household consumption [19, 21, 22]

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