Consumption of fruits and vegetables among adolescents: a multi-national comparison of eleven countries in the Eastern Mediterranean Region

A regional cross-country profile of fruit and vegetable (F&V) consumption is lacking in the Eastern Mediterranean Region (EMR). This study examines the prevalence of and differences in consumption of F&V >= 5 times/d among adolescents in eleven EMR countries, and describes differences in the proportions of taking F&V >= 5 times/d by sex, age and BMI. The study included 26 328 school adolescents (13-15 years) with complete data on consumption of F&V, age, sex, weight and height taken from the Global School-based Student Health Survey conducted in the EMR between 2005 and 2009. Overall, only 19.4% of adolescents reported consuming F&V >= 5 times/d. The highest prevalence was reported in Djibouti (40.4%) and the lowest was reported in Pakistan (10.0 %). Statistically significant differences in prevalence were observed across countries (P < 0.05). With the exception of Oman, Libya and Djibouti, significantly more males than females ate F&V >= 5 times/d. The proportion of students consuming F&V >= 5 times/d also varied significantly in all countries based on BMI (P < 0.0001), with students within normal BMI having the highest frequency. A negative trend was observed between age and intake of F&V >= 5 times/d in most of the eleven EMR countries except Jordan, Djibouti and Morocco. The prevalence of adequate intake of F&V is low in the eleven EMR countries. There is a need for interventions to increase the prevalence of adolescents consuming F&V >= 5 times/d. Interventions should take into consideration the psychosocial, environmental and socio-environmental factors influencing F&V intake within countries.