Adherence
In low-income countries, the cost of meeting the recommended daily intake of five servings of fruits and vegetables consumes a disproportionate share of household income (median 51.97%), rendering the guideline unaffordable for the majority of the population.
If you live in a low-income region, the standard advice to eat five servings of produce daily may be economically impossible. Focus on the most affordable nutrient-dense options available in your local market (often vegetables over fruits in these regions) and prioritize consistency over perfection. Policy-level changes to improve affordability are necessary to make these guidelines achievable.
In 130 402 participants who had household income data available, the cost of two servings of fruits and three servings of vegetables per day per individual accounted for 51·97% (95% CI 46·06–57·88) of household income in LICs... In all regions, a higher percentage of income to meet the guidelines was required in rural areas than in urban areas... Fruit and vegetable consumption among individuals decreased as the relative cost increased
Why this rating
Large-scale observational study (PURE) across 18 countries with robust statistical modeling, though cross-sectional design limits causal inference.
Source
Availability, affordability, and consumption of fruits and vegetables in 18 countries across income levels: findings from the Prospective Urban Rural Epidemiology (PURE) study
Victoria Miller et al. · The Lancet Global Health · 2016
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