Would an increase in vegetable and fruit intake help to reduce the burden of nutrition-related disease in South Africa? An umbrella review of the evidence

Abstract

Evidence indicates that increased vegetable and fruit intake improves health. The intake of vegetables and fruit in South Africa is much lower than recommended. When considering the promotion of greater vegetable and fruit intake in South Africa, it is necessary to view the available evidence on the relationship between vegetable and fruit intake and disease risk reduction through a South African lens. This will help to determine whether or not interventions to optimise vegetable and fruit intake would contribute to reducing the burden of nutritionrelated disease in South Africa. The aim of this umbrella review was to compile the best available evidence from multiple reviews and scientific reports on the link  between vegetable and fruit intake and the nutrition-related burden-of-disease profile in South Africa. Vegetable and fruit intake has been associated with prevalent nutrition-related problems in South Africa, including vitamin A status and adiposity in children; and cancer, cardiovascular disease, type 2 diabetes and adiposity in adults. Reviewed evidence from systematic reviews and scientific reports has suggested that increasing vegetable and fruit intake in South Africa could potentially  contribute to reducing the burden of nutrition-related conditions in this country. Increasing vegetable and fruit intake in preschool children could improve their vitamin A nutriture. Enhancing vegetable and fruit intake in adults could contribute to reducing the risk of certain prevalent cancers (lung and gastrointestinal) and cardiovascular disease (coronary heart disease, ischaemic heart disease and cerebrovascular accidents). It should be kept in mind that the methodological quality of the included systematic reviews ranged from low to high (AMSTAR), and most reviews did not assess the scientific quality of the included studies. This evidence supports the need to promote greater vegetable and fruit intake in South Africa.