Improving fruit and vegetable consumption will require a holistic approach

“Eat more fruit and vegetables.”

This is a common refrain, spoken by everyone from doctors to health policymakers to parents, and with good reason: These foods are rich in a broad range of vitamins, minerals, antioxidants, and dietary fiber that are essential for good health. Yet globally, fruit and vegetable consumption is far below what is recommended by the World Health Organization, and poor diets remain a primary cause of malnutrition, and the leading cause of disease, worldwide. Improving diets, including increasing fruit and vegetable intake specifically, could save one in five lives annually.

Knowing this, the question becomes, why aren’t people eating more fruit and vegetables and healthier diets in general? The answers to this question are complex and vary across people and settings but boil down to the need to overcome issues related to availability, accessibility, affordability, and desirability.

In low- and middle-income countries, the extent and nature of this nutrition challenge is poorly understood, due, in part, to insufficient dietary data. Improving fruit and vegetable consumption requires evidence-based approaches that address issues throughout the value chain—from production to transportation and processing, to food environments, to consumption.

In a new research initiative developed in close partnership between CGIAR, the World Vegetable Center, and other partners, researchers will work with innovation, implementation, and scaling partners to address low fruit and vegetable consumption in low- and middle-income countries. They will take an innovative, holistic end-to-end approach that begins with consumers, to better understand their dietary patterns and the barriers to increased fruit and vegetable consumption they face at several levels, including:

• Availability: Insufficient year-round availability of diverse fruits and vegetables, which means high costs and hard-to-find sources.
• Accessibility: All too often, consumers are not close enough to safe sources of fruit and vegetables for consumption to be convenient and in some cases, even possible on a regular basis.
• Affordability: Low income coupled with inadequate year-round supply of safe and diverse fruits and vegetables make healthy diets unaffordable for more than 3 billion people worldwide, with fruit and vegetables being among the least affordable.
• Desirability: Absent (or in addition to) other issues, intake of these essential foods is still too low, requiring a closer look at context and population-specific considerations preventing people from making healthy diet choices and identifying and testing innovative programs and policies to support healthy diets.

These are complex challenges, to be sure, but they are not insurmountable.

As CGIAR, the world’s largest global agricultural innovation network, embarks on implementing an ambitious new strategy to transform food, land, and water systems in a climate crisis, it will bring more than 50 years of scientific innovation, successful implementation, and deeply collaborative partnerships to address low fruit and vegetable consumption across low- and middle-income countries worldwide. This new Initiative, called Fruit and Vegetables for Sustainable, Healthy Diets (FRESH), considers obstacles and opportunities throughout the food system. On the production side the focus will be on vegetables. In the first phase, the Initiative will focus on four countries: Benin and Tanzania in Africa, and Sri Lanka and the Philippines in Asia, with an eye toward sharing learning and experiences with other countries worldwide. In particular, the work will focus on:

• Understanding and influencing consumer behavior: Filling critical gaps in dietary data and barriers to healthy diets, and specifically fruit and vegetable intake, is necessary to identify context-specific opportunities and constraints to increasing intake and improving diet quality. With this understanding, appropriate interventions to shift dietary behavior can be co-designed with implementation partners and tested and successful approaches scaled.
• Addressing issues of biodiversity, seed systems, and genetic innovation: For consumers to have assured access to sufficient and year-round supplies of vegetables, farmers need access to quality seeds from a diverse range of vegetables, particularly traditional vegetables.
• Ensuring safe and sustainable production systems: To ensure food system transformation both provides healthy diets and is sustainable in a changing climate, options and strategies for sustainable diversification and intensification, along with technologies and practices must be identified and made available, particularly to smallholder farmers.
• Considering postharvest issues and ensuring inclusive markets: Reducing postharvest losses, addressing food safety, and empowering women and youth are vital to the success of building fruit and vegetable value chains in low- and middle-income countries. Identifying problems and entry points for interventions is an important first step, to be followed by designing and testing interventions and developing training materials and strategies in close collaboration with partners and stakeholders to ensure they are demand-led and respond to local needs.
• Developing food environments that are conducive to health and nutrition: The food environment, where the consumer encounters the food they eat, plays a central role in nutrition. Country-specific evidence to understand accessibility and affordability barriers to fruit and vegetable consumption, is needed to develop interventions and innovations to improve the food environment for consumers, particularly those from marginalized groups and most at risk for poor-quality diets and malnutrition in all its forms.
• Strengthening the enabling environment: Policymakers need evidence and data to design policies, build capacity, and strengthen the enabling environment so fruit and vegetable consumption can grow. In collaboration with stakeholders and partners, existing evidence must be reviewed, gaps identified, and new research generated from end-to-end to facilitate informed action.

Informed by a rich history of research on nutrition and food systems for healthy diets and research to support policies and programs, and in close collaboration with a dedicated group of partners, this effort from CGIAR can turn “eat more fruit and vegetables” from a colloquial suggestion into a concrete reality for millions worldwide.

Deanna Olney is a Senior Research Fellow with IFPRI's Poverty, Health, and Nutrition Division; Ravi Gopal Singh is a Cropping Systems Agronomist with the International Maize and Wheat Improvement Center (CIMMYT); Pepijn Schreinemachers is Lead Scientist at the World Vegetable Center; Janet Hodur is a Senior Communications Specialist with CGIAR.

To learn more about the initiative, visit the FRESH webpage.

This post also appears on the CGIAR website.