Low fruit and vegetable intake and its associated factors in Ethiopia: A community based cross sectional NCD steps survey

Background: Non-communicable diseases (NCDs), including cardiovascular diseases, diabetes mellitus, cancers and chronic respiratory diseases, have remained the major burden and threat of the world with quite alarming rise in the developing nations. Eating a diet high in fruits and vegetables is associated with a decreased risk of many chronic diseases. Methods: Community-based cross-sectional survey based on the World Health Organization (WHO) NCD Stepwise approach was done. The survey was conducted in the 9 regions and two city administrations (Addis Ababa and Dire Dawa) in Ethiopia. The target population for this survey included all men and women age 15-69 years old who consider Ethiopia to be their primary place of residence. A single population-proportion formula was used to determine the sample size: design effect coefficient of 1.5, Z-score of1.96, proportion of 35.2%and marginal error of 0.04. A total of 513 EAs were covered nationwide. Thus, 10,260 study participants were included in the study. A mix of sampling approach namely stratified, three-stage cluster sampling, simple random sampling and Kish method were employed to select the study settings and the study participants. Descriptive weighted analysis was done along with complex sample analysis, and bivariate and multivariate analysis was conducted for fruit and/or vegetable intake. Result: The prevalence of fruit and/or vegetable consumption in Ethiopia was found to be (1.5%). More female than male ate fruit and vegetable in Ethiopia. When adjusted for included demographic and residence confounders (age, sex, location, income, education), those in rural area of residence ate ≥5 servings of fruits and vegetable [OR and (95% CI) [2.77 (1.60, 4.80)] than their counterparts. Conclusion and recommendation: Fruits and/or vegetables intake was generally extremely low. As the general level of risk factors rises, more people are put at risk. Preventive interventions to address these behaviours are implemented at individual, group, and community levels and include education, access to fruits and vegetables should therefore aim at reducing risk throughout the population.