Mensah, Daniel, Nunes, Ana R., Bockarie, Tahir, Lillywhite, Robert and Oyebode, Oyinlola (2020) Meat, fruit and vegetable consumption in sub-Saharan Africa : a systematic review and meta-regression analysis. Nutrition Reviews . (In Press)

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Abstract

Context: The dietary choices people make affect personal health and have consequences for the environment, both of which have serious implications for the 2030 Sustainable Development Agenda. In global reviews, the literature on meat, fruit, and vegetable consumption in sub-Saharan Africa (SSA) is limited.

Objective: This systematic review set out to quantify meat, fruit, and vegetable consumption in sub-Saharan African populations and to answer the question: How much meat, fruit and/or vegetables are being consumed daily by which individuals in SSA over the years?

Data Sources: Following the PRISMA guidelines, the authors systematically searched MEDLINE, EMBASE, ASSIA CINAHL, Web of Science, POPLINE and Google Scholar to identify 47 (out of 5922 search results) studies reporting meat, fruit and/or vegetable consumption in sub-Saharan African populations.

Data Extraction: Three independent investigators extracted data on year of data collection, study country, study population and geographical context, and population intake of meat, fruit and/or vegetables.
Data Analysis: Using STATA SE version 15, random effects meta-regression analyses were used to test the effect of year of data collection and method of data collection on population meat, fruit, and vegetable consumption. The analyses also tested any association between age, sex, urban/rural residence or a country’s economic development, and population intake of meat, fruits and/or vegetables. The review was started in 2017 and completed in 2019.

Results: Richer SSA countries were likely to consume more meat (ß =36.76, p=0.04) and vegetables (ß =43.49, p=0.00) than poorer countries. Vegetable intake has increased dramatically over the last three decades from ≈10g to ≈110g (ß=4.43, p=0.00). Vegetable (ß=-25.48, p=0.00) consumption was higher in rural than urban residents. Although the trend of meat consumption has gone up (≈25g to ≈75g), the trend is non-significant (ß=0.63, N.S.). Daily average per capita meat consumption was 98g, above 70g recommendation, while fruit and vegetable intake (268g) remain below WHO’s recommendation (400g).

Conclusions: Given the low intake of plant-based foods it is likely that SSA populations may be deficient in high quality protein and micronutrients as suggested by the EAT-lancet commission. There is the need for promoting both the adequate supply and demand of plant-based protein and micronutrients including fruit, vegetables, nuts, seeds and legumes in SSA countries. While dietary changes in SSA may offer large absolute benefits, consideration of the magnitude of dietary change, particularly increasing or reducing meat consumption, will need to occur in a way that ensures that policy and interventions support the reduction of under-nutrition and micronutrient deficiencies without worsening NCD prevalence and environmental impacts. There is also the need for preventive action that ensures that SSA populations do not increase their meat consumption as disposable incomes increase and countries’ economic development rise as seen in most countries undergoing economic transformation.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Science > Life Sciences (2010- ) Faculty of Medicine > Warwick Medical School
Journal or Publication Title:	Nutrition Reviews
Publisher:	Oxford University Press
ISSN:	0029-6643
Official Date:	2020
Dates:	Date Event 2020 Available 28 February 2020 Accepted
Date of first compliant deposit:	16 March 2020
Status:	Peer Reviewed
Publication Status:	In Press
Publisher Statement:	This is a pre-copyedited, author-produced version of an article accepted for publication in Nutrition Reviews following peer review. The version of record [insert complete citation information here] is available online at: xxxxxxx [insert URL and DOI of the article on the OUP website].
Access rights to Published version:	Restricted or Subscription Access
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