Association between Fruit and Vegetables eating habits and practices in relation to the prevalence of diet related chronic non-communicable diseases in Zanzibar, Tanzania
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Obesity, diabetes, some cancers and hypertension are diet-related Non-
Communicable Diseases (NCDs). NCDs are the leading cause of deaths in
developed countries and account for approximately one-third of deaths in developing ones. According to the FAO/WHO joint report on fruit and vegetables for health (2004), low fruit and vegetables consumption is associated with NCDs. In developing countries, NCDs such as diabetes mellitus and hypertension are estimated to become the leading cause of morbidity and mortality by 2020. In Zanzibar, the incidence of diabetes has increased from 252 new cases in 2006 to 373 in 2008 and hypertension is the third most common cause of hospital admission and second cause of death after pneumonia (Jiddawi, 2008, TRGZ, 2010).
The two aims of this study were to identify and explore the association between fruit and vegetables eating habits and practices and the prevalence of diet related chronic non-communicable diseases in Zanzibar and to investigate how the quantitative data collection regarding fruit and vegetables consumption in the NCD survey was carried out.
The design of this study is: Contextual mixed methods research with triangulation of quantitative and qualitative data. The quantitative component of the study is a
secondary analysis of data on obesity, hypertension, diabetes and fruit and
vegetables consumption previously collected in the Zanzibar NCD survey. The
qualitative component includes ten household observations and several market
observations. Furthermore, a literature review was undertaken in order to further
understand the context of the study area.
The findings showed that the mean daily fruit intake was 0.9 (±SD 0.8) and mean
daily vegetable intake was 0.7 (±SD 0.6). These findings are below the minimum five portions of fruit and vegetables per day recommended by the World Health
Organisation. There were three times more obese women (19.4%) than men (6.4%),
38% of men and 33% of women were hypertensive and 2.2% of men and 2.8% of
women were diabetic. The prevalence of diabetes, hypertension and obesity was
higher in urban areas than rural ones. People from rural areas earned on average 4.5 times less than in urban ones and were more restrained in their choice of fruit and vegetables. The household observations suggested a relationship between
rural/urban setting, kitchen facilities, cooking practices and food diversity as well as
consumption of vegetables. Furthermore, fruits seemed to only be considered as a
snack and not used in food preparation. The findings also underlined the importance of adapting quantitative data collection tools for future research in order to better evaluate fruit and vegetables consumption and its association with diet-related NCDs.