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Medicina de Estilos de Vida para Estudiantes

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3rd LATINOMARICAN CONFERENCE IN LIFESTYLE MEDICINE

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DOCENTES INVESTIGADORES EN REGINA

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Latin American Lifestyle Medicine Association

Título

ARTÍCULO DE REVISIÓN

REVISTA DE LA FACULTAD DE MEDICINA HUMANA 2019 - Universidad Ricardo Palma DOI 10.25176/RFMH.v19.n2.2077

CHALLENGES FOR THE CONSUMPTION OF FRUITS AND VEGETABLES

DESAFÍOS PARA EL CONSUMO DE FRUTAS Y VERDURAS

Mylene Rodríguez-Leyton1,a

1 Nutrition and Dietetics Program, Food and Human Behavior Research Group. Metropolitan University of Barranquilla-Colombia.
a Nutritionist-Dietitian.




ABSTRACT
Objective: Identify the problems to improve the low consumption of fruits and vegetables in Colombia. Methods: Documentary, descriptive and exploratory research carried out in 2016 and 2017. It was based on the search, selection, and revision of bibliographic references to analyze and reflect on the indicators of consumption and production of fruit and vegetable consumption. Also to identify the process to reach the WHO recommendations based on scientific evidence. Results: It states the nutritional contribution of fruits and vegetables and their benefits for human health, followed by production and consumption indicators as a topic of public health interest. The rules and guidelines of public policy that promote the consumption of a healthy diet as a lifestyle are being reviewed. The most significant challenges that sectors such as the food industry, the gastronomy, the government, the public social and sectoral policies in health, education, agriculture, social promotion, communication, as well as educators are to define effective strategies that increase the consumption indicators of fruits and vegetables. The goal is also to achieve a minimum per capita consumption of 5 servings or 400 g per day proposed by the World Health Organization (WHO). Conclusion: Several countries have been providing technical guidelines to encourage the consumption of fruits and vegetables; However, it is advisable to monitor the indicators periodically, perform outcome, impact evaluations, and research aimed at identifying the causes of low consumption and designing effective strategies appropriate to the context of the populations.
Key words: Fruits; Vegetables; Lifestyle; Healthy nutrition. (source: MeSH NLM)

RESUMEN
Objetivo: Identificar los desafíos a enfrentar para mejorar el bajo consumo de frutas y verduras en Colombia. Métodos: Investigación de tipo documental, descriptivo, exploratorio realizada en los años 2016 y 2017, a partir de la búsqueda, selección y revisión de referencias bibliográficas para analizar y reflexionar acerca de los indicadores de consumo y producción de consumo de frutas y verduras e identificar los desafíos para alcanzar las recomendaciones de la OMS a partir de la evidencia científica. Resultados: Se reafirma el aporte nutricional de las frutas y verduras y sus beneficios para la salud humana, seguida por los indicadores de producción y de consumo como un tema de interés en salud pública; se revisan las normas y lineamientos de política pública que promueven el consumo de una alimentación saludable como estilo de vida y se identifican los mayores desafíos que deben asumir sectores como la industria de alimentos, la gastronomía, el gobierno, las políticas públicas sociales y sectoriales en salud, educación, agricultura, promoción social, comunicación, así como la academia; para definir estrategias efectivas que incrementen los indicadores de consumo de frutas y verduras y permitan alcanzar las metas de un consumo per- cápita mínimo de 5 porciones ó 400 g diarios propuestas por la Organización Mundial de la Salud (OMS). Conclusión: Diversos países han venido impartiendo lineamientos técnicos para fomentar el consumo de frutas y verduras; sin embargo, es recomendable realizar seguimiento periódico a los indicadores, realizar evaluaciones de resultado e impacto e investigación orientada a identificar las causas de bajo consumo y diseñar estrategias efectivas adecuadas al contexto de las poblaciones.
Palabras clave: Frutas; Verduras; Estilo de vida; Alimentación saludable. (fuente: DeCS BIREME)

INTRODUCTION
Reaching the recommendation of the World Health Organization (WHO) of a minimum per-capita consumption of 5 servings or 400 g of fruits and vegetables per day1, as a lifestyle. This recommendation is a challenge for health policies in Colombia and other countries of the world.
The following is a summary of documentary research aimed at demonstrating the difficulties that Colombia faces to achieve the optimum consumption of fruits and vegetables based on the scientific evidence, its nutritional contribution and the benefits for human health are recognized, followed by production and consumption indicators as a topic of interest in Public Health.
The rules and guidelines of public policy for the promotion of fruit and vegetable consumption in Colombia are identified. These rules are a fundamental element of the systems that promote healthy eating as a way of life and recognize the most significant challenges to achieve the goals of WHO.
METHODS
The documentary, descriptive and exploratory research was carried out in 2016 and 2017. These researches were based on the search, selection, and revision of bibliographical references on databases dialnet, scielo, redalyc, ovid, web pages of specific organizations and government from 2012 to 2017 with the search criteria consumption of fruits and vegetables, benefits consumption, relationship with health, chemical composition, and nutrient intake. Also, normative documents and technical reports were reviewed.
In the case of the original articles of research, the articles with the fixed period were selected. When the search found no information in the chosen period, sources before the fixed period were used. These sources helped to obtain scientific evidence to analyze and reflect on consumption and production indicators of fruit and vegetable consumption and identify the challenges to reach the recommendations of the WHO
RESULTS
The consumption of fruits and vegetables is closely related to a lifestyle, defined by WHO as a general way of life. This way of life is based on the interaction between living conditions and individual patterns of behavior, incorporating a set of values, norms, attitudes, habits, and behaviors including healthy eating2.
The healthy diet allows reaching the growth and development of the child, the maintenance of the health, the activity of the adult and the survival and well-being of the elderly. A healthy diet favors and enables a good state of health and reduces the risk of chronic related diseases3. It incorporates a variety of foods including many fruits and vegetables that contribute to raising the index of the quality of the diet and protect against the development of diseases.
Nutritional characteristics of fruits and vegetables fruits and vegetables
Fruits and vegetables are a significant source of water and nutrients such as vitamins, minerals, and fiber. They have components that give them nourishing properties, appearance, texture, and color specific to this group of foods11, table 1.
Benefits for human health from the consumption of fruits and vegetables
There is ample scientific evidence about the human health benefits of fruit and vegetable consumption due to the properties derived from its composition and combinations of nutrients; as well as the presence of chemical compounds that intervene in the metabolism and release of energy in the human organism4, table 2.
Production of fruits and vegetables in Colombia
Colombia has different forms of ecosystems, due to its geographical, climatic and biological diversity. All these combinations of the cultural richness and its equatorial location allows you to produce a great variety of plant species throughout the year; in an area close to 14 million ha for the production of food and human capital for work the dirt. The National Agricultural Census in Colombia - 2014, showed that the dispersed rural area of 111.5 million Ha; 14.6% (998,097 Ha) planted fruits and 4.2% (233,703) in vegetables, and legumes, producing 7,746,235 t. in a variety of fruit and 1,433,022 t. of vegetables18. See table 3.
Consumption of fruits and vegetables
In Europe the average consumption of vegetables, legumes, and nuts is 220 g per day and fruit is 166 g per day, which means an average consumption between fruits and vegetables of 386 g per day19. The prospective study of urban-rural epidemiology (PURE) in 18 countries carried out in 143.305 people ranked by income level showed average intake of 2.19 servings of vegetables with a range of 2.13 - 2.25 and fruits 1.62, with a range of 1.53 - 1.62. It was observed that low-income countries have lower total fruit consumption and vegetables: 2.14 portions (1.93 - 2.36), while in the medium-high income was 4.31 portions (4.09- 4.53) in the medium-low income 3.17 proportions(2.99 - 3.3520.


Table 1. Nutritional characteristics of fruits and vegetables.
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Table 2. Human health benefits from fruit and vegetable consumption.
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In Mexico, 34.4% of children between 6 and 12 years old, complied with the daily recommendations of consumption of fruits and vegetables, the remaining 65.6% did not21; While in Argentina, the consumption per-capita of fruits and vegetables in the population does not reach 200gr per day22.
It has been shown that Colombia has a variety of products in the domestic fruit market. According to the Colombia Internacional Corporation, in 2012, 42 types of fruits and 30 different vegetables were offered in local markets; the regularity of the offer depends on the farmers' decisions determined by the price, the supply and the sanitary status of the crops. Regarding consumption, the National Profile of the Consumption of fruits, and vegetables of the year 2012, showed that the Colombian population consumes on average 50g of vegetables and 94g of fruit per day, compared with the recommendation established by WHO, correspond to a percentage of adequacy of 36%, the highest rate was occupied by Bogotá, DC with 44%; figure that is still significantly below what is desired23.
About the daily consumption of fruits and vegetables in the Colombian population from 5 to 64 years old, 35.3% of the people did not consume any fruit in their daily diet, and 27.9% did not intake any vegetables, a similar behavior for all population groups older than two years old24. There was a higher preference for fruits, with a consumption of 66.8%, who registered a daily intake of three or more times a day in 20.5%. Regarding vegetables, 28.1% of the population of the same age group consumed them daily, 21.7% once per day, 5.0% twice a day and 1.4% three or more times a day25. Table 4 shows the percentage of people who consume fruits and vegetables preferred by the Colombian population and grams per capita consumed by each of them23.


Table 4.Consumption of fruits and vegetables in Colombia.
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Norms, guidelines, and policies for the promotion of the consumption of fruits and vegetables in Colombia
Colombia accepts and adapts to the guidelines, international standards and national public policies that legislate the promotion of fruit consumption and vegetables. See table 5.


Table 5. Standards, guidelines, and policies for the promotion of fruit and vegetable consumption in Colombia.
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Challenges for the consumption of fruits and vegetables in Colombia
The existence of regulatory frameworks demonstrates that in Colombia, government authorities have been assuming significant obstacles to achieve goals regarding the consumption of fruits and vegetables, but different sectors still face great challenges34.


Table 6. Challenges to achieving the consumption of fruits and vegetables.
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CONCLUSION
The scientific evidence broadly reflects that fruits and vegetables constitute a group of healthy foods for human beings, due to their high content of nutrients.
Colombia has good production and significant availability, but little variety selection that is reflected in the low preference and consumption of fruits and vegetables as demonstrated in the study of the consumption profile. Indicators of moderate consumption of fruits and vegetables are coherent with the health situation and the double burden of malnutrition in the country45,46. Colombia has been issuing technical guidelines as a way to take on the challenge of improving fruit and vegetable consumption; However, these normative frameworks are not sufficient to guarantee the effectiveness of the interventions, which must be evaluated, strengthened, adjusted and/or renewed.
It is necessary to design effective strategies appropriate to the social, cultural and economic context of the populations. This should be done to periodically monitor the indicators, result and impact evaluations to develop research aimed at identifying the causes of low consumption, identify and intervene the barriers and restrictions, considering the high supply of food consumed as substitutes.


Authors Contributions: The author participated in the genesis of the idea, project design, data collection and interpretation, preparation of the manuscript and approval of the final version of the article.

Financing:: Self-financed.

Conflict of interests: The author declares no conflict of interest.

Recibido: November 18, 2018.

Aprobado: January 22, 2019.


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