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In low-income countries, including India, only 27% of the population could have more than one serving of fruits per day. Photo: Reuters
In low-income countries, including India, only 27% of the population could have more than one serving of fruits per day. Photo: Reuters

Most people cannot afford fruits and vegetables: ‘Lancet’ study

Except people in high-income countries, most of the world cannot afford the fruits and vegetables they need, according to research in 'Lancet'

New Delhi: Three in four Indians are yet to taste the fruits of economic growth—or indeed, its veggies.

Recent research published in the British medical journal Lancet calculates fruit and vegetable intake among people of different countries, on the basis of gross national income per person.

The research finds that the average global intake of fruits and vegetables is less than required levels—defined as at least two servings of fruits and three servings of vegetables per person per day. And affordability is a crucial factor behind the deficient intake.

In low-income countries, including India, only 27% of the population could have more than one serving of fruits per day.

The study is based on responses received from 157,000 adults aged 35-70 years in 18 countries and five continents between 1 January 2003 and 31 December 2013. The researchers considered 143,000 respondents as the rest did not report “plausible energy intake" in the range of 500-5,000 kilo calories per day.

The selected countries were taken from four groups: low income (Bangladesh, India, Pakistan, Zimbabwe); low-middle income (China, Colombia, Iran, Occupied Palestinian Territory); upper-middle income (Argentina, Brazil, Chile, Malaysia, Poland, Turkey, South Africa) and high-income (Canada, Sweden, United Arab Emirates).

Data collected by the researchers shows that the lower the average income of a country, the lower the average consumption of fruits and vegetables. For the entire cohort, and bottom three income-group countries, consumption levels are lower than the required number of servings.

Both price levels and prices as a proportion of overall income levels are to blame for the lower consumption levels in poorer countries. In purchasing power parity terms, vegetables are cheapest in low-income countries while fruits are the most expensive. However, the real difference lies in the cost of one serving of fruit or vegetable as a share of income per household. These values for low-income countries are in multiples of 19 and 50 for vegetables and fruits in comparison with their respective levels in high-income countries.

How difficult would it be to bridge this gap? It would be a gigantic task in low-income countries, as more than half of the households’ income would have to be spent to achieve these consumption levels. The requirement drops to less than 2% for high-income countries. The income requirements are higher in rural areas than urban areas.

The study’s findings help us contextualize an earlier Plainfacts article which showed that increase in fruit and vegetable consumption in India (a low-income country) has been much less than the increase in China (a low-middle income country). This is despite the fact that India’s horticultural production has almost tripled since 1991-92.

The paper quotes an earlier Lancet study which showed that the lack of enough fruits and vegetables in the diet was responsible for 1.7 million deaths globally. It also says that increasing their availability and affordability is crucial to improving quality of diet of most people in low-income and low-middle income countries.

There has been big debate in India on the increasing gap between poverty estimates and average calorie intake levels. The majority view holds that declines in calorie intakes should not be taken as an indicator of worsening income levels. This consensus notwithstanding, concerns remain about the alarming level of malnutrition in the country. The glaring deficiency of fruits and vegetables in Indian diets is another pointer to the poor quality of diet of the average Indian.

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