Vegetable and Fruit Consumption Among Adolescents in the Gulf Cooperation Council Countries: A Pooled Analysis of National School Surveys.

Background/

Objectives

Insufficient vegetable and fruit (VF) consumption during adolescence increases the risk of diet-related non-communicable diseases, yet no pooled, survey-weighted analysis of VF intake exists for the Gulf Cooperation Council (GCC) countries. This study estimated the prevalence and correlates of VF consumption among adolescents in the GCC countries.

Methods

Cross-sectional data from the most recent Global School-based Student Health Survey (GSHS) in five GCC countries-Bahrain (2016), Kuwait (2015), Oman (2015), Qatar (2011), and the United Arab Emirates (UAE; 2016)-were pooled (n = 21,528 school-going adolescents aged 12-18 years); GSHS data were not available for Saudi Arabia. The primary outcome was consuming VF five or more times per day. Because the GSHS items record the frequency of eating occasions and not portion size, this is a frequency-based proxy for the World Health Organization (WHO) recommendation of at least 400 g per day. Survey-weighted prevalence estimates with 95% confidence intervals (CIs) and adjusted prevalence ratios (aPRs) from Poisson regression models were computed, overall and by sex.

Results

The weighted prevalence of consuming VF on five or more occasions per day ranged from 15.5% (95% CI: 13.2-18.1) in Kuwait to 25.2% (95% CI: 22.6-28.0) in Qatar and was higher among boys than girls in all five countries. The outcome was less prevalent at older ages (aPR = 0.66, 95% CI: 0.56-0.79 for 16-18 years vs. ≤12 years), among adolescents reporting low parental support (aPR = 0.85, 95% CI: 0.76-0.95), and among those who were not physically active daily (aPR = 0.68, 95% CI: 0.62-0.74) and was more prevalent among boys (aPR = 1.18, 95% CI: 1.08-1.29).

Conclusions

Fewer than one in four adolescents in the GCC countries consumed VF on five or more occasions per day. Multicomponent school-based and family-engaging interventions are needed, particularly for girls and older adolescents.