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Effects of fruit and vegetable intakes on direct and indirect health outcomes

Background paper for the FAO/WHO international workshop on fruits and vegetables 2020










Gomes, F.S. and Reynolds, A.N. 2021. Effects of fruits and vegetables intakes on direct and indirect health outcomes  Background paper for the FAO/WHO International Workshop on fruits and vegetables 2020. Rome, FAO and PAHO.




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    Inadequate fruit and vegetable intake is a substantial contributor to the international burden of disease. Low fruit and vegetable intake is ranked among the leading dietary risk factors for mortality across low, middle, and high-income countries. But food decisions are complex. As a result, the reasons why people do not eat enough fruits and vegetables are complex. This paper, prepared as a contribution and input to the the FAO/WHO international workshop on fruits and vegetables 2020, reviews the challenges, opportunities and recommendations to develop effective policies and programmes promoting fruits and vegetables, from production to comsumption.
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    FAO and the World Health Organization (WHO) recommend a daily fruit and vegetable (F&V) intake of at least 400 grams/adult. However, low F&V intake has become a global public health problem. The promotion of F&Vs in the International Year of Fruits and Vegetables emphasizes unprocessed or minimally processed F&Vs, which are highly beneficial to health. However, processing can improve food safety, especially from microbiological contamination, and reduce loss and waste. Conversely, F&Vs which are highly processed can undermine the health benefits of F&V consumption.
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    The persistence of undernutrition and the increasing levels of overweight and obesity worldwide (with their associated societal costs) are calling for a transformation of food systems towards healthier diets. Fruits and vegetables are key components of a healthy diet; however, their consumption is considerably below the minimal levels recommended by the World Health Organization (WHO). This underconsumption is particularly pronounced in low- and middle-income countries and among low-income socio-economic groups in all countries. This paper uses the value chain approach to analyze the factors that affect the availability and affordability of fruits and vegetables. It examines major challenges across the value chain and identifies opportunities for improvement as seen through a nutrition-sensitive lens. Factors that negatively affect the availability and affordability of fruits and vegetables discussed in this paper include low production and productivity, the loss of agrobiodiversity, inadequate technology, logistics and infrastructure, weak organizational, business, and technical skills, and inefficient market linkages across the supply chain. The paper proposes a number of policy recommendations based on insights from documented cases of good practices and on lessons learned in domestic and export-oriented value chains. The paper makes a case for reviving native, underutilized, and neglected fruit and vegetable varieties to improve nutrition and increase agrobiodiversity. In addition, short value chains delivering to local markets are recommended as a resilience strategy for smallscale producers and low-income consumers in the face of climatic and economic shocks.

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