Patterns of Fruits and Vegetable Consumption among adults aged 18 to 69 years in Tanzania: Results from the 2023 National STEPS survey

Background: Chronic under-consumption of fruits and vegetables contributes to micronutrient deficiencies and significantly drives the global burden of preventable non-communicable diseases. Evidence indicates that average intake remains below the World Health Organization recommended minimum of 400 grams per person per day. However, local and national evidence on the patterns, magnitude and determinants of inadequate fruit and vegetable consumption remains limited. Objective: To assess the patterns, prevalence and socio-demographic determinants of consuming zero or fewer than five servings of fruits and vegetables per day among individuals aged 18–69 years. Methods: A national population-based household survey employed a three-stage cluster sampling design based on the 2022 Tanzania Population and Housing Census, with 4,320 participants, conducted from September 2022 to September 2023. Data on major Non-Communicable Diseases (risk factors were collected using WHO STEPS methodology. Fruit and vegetable intake was assessed using WHO standards based on reported frequency and daily servings. Chi-square tests and modified Poisson regression were used to examine factors associated with inadequate fruit and vegetable consumption. Results: Overall, 92.4% (n=3262) consumed zero or fewer than five servings per day/ inadequate intake (zero or <5 servings/day). Rural residence was associated with significant increase in the likelihood of inadequate consumption (aPR=1.04, 95% CI: 1.01–1.06). All geographical zones exhibiting higher prevalence ratios compared to the Lake zone, ranging from aPR=1.14 in the Central zone to aPR= 1.28 in the Southwest Highlands. Participants who reported no engagement in leisure-time physical activity had a higher probability of inadequate dietary intake (aPR=1.04, 95% CI: 1.02–1.07). Conclusion: Inadequate fruit and vegetable intake is highly prevalent among Tanzanian adults, with significant disparities by residence, region and physical activity status. These findings underscore the need for targeted, context-specific interventions to improve dietary behaviours and reduce nutrition-related non-communicable disease risk across populations.