


































Food Science and Nutrition Studies 

ISSN 2573-1661 (Print) ISSN 2573-167X (Online) 

Vol. 2, No. 1, 2018 

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1 
 

Original Paper 

Knowledge and Determinants of Fruit and Vegetable 

Consumption among Adults in Hohoe Municipality, Ghana 

Thomas K. Awuni1*, Gideon Kye-Duodu2, Charles Duodu3, Francis B. Zotor4 & Basma Ellahi5 

1 Ghana Health Service, Municipal Health Directorate, Elmina, Ghana 

2 Department of Epidemiology and Biostatistics, University of Health and Allied Sciences, Ho, Ghana 

3 Ghana Health Service, Volta Regional Health Directorate, Ho, Ghana 

4 Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana 

5 Faculty of Health and Social Care, University of Chester, Chester, UK 

* Thomas Kwasi Awuni, Ghana Health Service, Municipal Health Directorate, 852-8102, Elmina, 

Ghana 

 

Received: October 28, 2017   Accepted: November 7, 2017   Online Published: December 4, 2017 

doi:10.22158/fsns.v2n1p1        URL: http://dx.doi.org/10.22158/fsns.v2n1p1 

 

Abstract 

The World Health Organization (WHO) recommends that a person consumes at least 400g of Fruit and 

Vegetable (FV) daily to prevent chronic disease risk. We assessed knowledge of current WHO 

guidelines and other determinants of FV intake among adults (≥ 18 years, n = 397) in Hohoe 

Municipality, Ghana. Face-to-face interviews using a questionnaire adopted from WHO Risk Factor 

Surveillance System were undertaken. Knowledge of FV daily servings and determinants of intake were 

evaluated by descriptive statistics and binary logistic regression. There was a 99.2% response rate with 

approximately 9% of participants correctly stating the WHO daily recommended amount (P = .296). 

Most (54%) of respondents’ FV intake was affected by unavailability of desired choice (P = .050). Odds 

of inadequate consumption for persons aware of adequate intake amount was 1.97 (95% CI: 0.64, 6.05, 

P = .234) higher than persons without awareness. Participants with problems accessing their desired 

choice of FV had 0.59 odds (95% CI: 0.36, 0.95, P = .030) of consuming inadequate amount compared 

to those with easy access. Adequate FV intake depends on availability of consumer prefered choice 

regardless of knowledge of recommendations. Individual home based FV cultivation is relevant for 

availability of preferred choice and adequate consumption for NCDs risk reductions among 

Ghanaians. 

Keywords 

Non-Communicable Diseases, awareness, Africa, recommendations 



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1. Introduction 

Inadequate Fruit and Vegetable (FV) consumption is ranked high among behavioural risk factors 

associated with increasing incidence of global Non-Communicable Diseases (NCDs) such as 

cardiovascular disease, ischaemic heart disease, stroke, and cancers (WHO, 2016; Oyebode, 

Gordon-Dseagu, & Walke, 2014; Vaidya, Oli, Aryal, Karki, & Krettek, 2013; Boeing et al., 2012; Hall, 

Moore, Harper, & Lynch 2009). Other research has also linked the phenomenon to disabilities and 

mortalities worldwide (WHO, 2016; Hall et al., 2009). Notably, in 2000, almost 27 million Disability 

Adjusted Life Years (DALYs) reported worldwide was associated with poor FV consumption (Hall et 

al., 2009). More regrettably, in 2013, low FV intake accounted for an estimated 5.2 million global 

deaths (WHO, 2016).  

Studies have shown positive associations between increased FV intake and NCDs risk prevention 

(WHO, 2016; Oyebode et al., 2014; Boeing et al., 2012). Consumers of FV hardly become obese and 

are less likely to develop chronic diseases (WHO, 2016; Oyebode et al., 2014; Boeing et al., 2012). 

This evidence underpins the World Health Organization (WHO) guidance on individual consumption of 

≥ 400g daily (≥ 5 servings of 80 g each) of varieties of FV as reported (Hall et al., 2009; Agudo, 2014). 

The guideline aims to achieve and maintain adequate FV intake globally for NCDs prevention and has 

since been translated into diverse national health promotion campaigns in different geographical areas 

(Agudo, 2004). Notably, in Ghana, the Ministry of Health (MoH) promoted FV intake as “medicine” as 

part of the regenerative health campaign strategy to enhance healthy eating and for averting increasing 

risk of NCDs among residents (MoH, 2008). Despite this, the MoH campaign seems to be silent on 

WHO recommendations. 

There is a lack of data on awareness of the WHO guidance for maintaining adequate intake in previous 

studies (Amo-Adjei & Kumi-Kyereme, 2015; Nti, Hagan, Bagina, & Seglah, 2011; Hall et al., 2009). In 

particular, Hall et al.’s global study and similar studies on FV intake in Ghana only focused on 

consumption (Amo-Adjei & Kumi-Kyereme, 2015; Nti et al., 2011; Hall et al., 2009). More 

importantly, subsequent assessments of interventions on FV consumption showed negligible successes 

and warrants further research (Amo-Adjei & Kumi-Kyereme, 2015; Nti et al., 2011; Tagoe & Dake, 

2011; Pomerleau, Karen, Cécile, & Mckee, 2005). We therefore aimed to assess knowledge on the 

WHO guideline of daily FV intake and determinants of consumption among adults in the Hohoe 

Municipality, Ghana, to provide evidence for future interventions.  

 

2. Materials and Methods 

2.1 Study Population and Design  

A cross-sectional study was undertaken in three locations (urban, peri-urban and rural) in the Hohoe 

Municipality, Volta region of Ghana using a multistage sampling method. The Municipality is located 

in the northern part of Volta region, and shares its border with the Eastern part of the Republic of Togo. 

Most of the residents are farmers who cultivate cash crops and vegetables and also rear livestock. 



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Farming activity is more popular among the rural dwellers whilst trading and other industrial activities 

are undertaken by most of the urban inhabitants. 

A total sample size (n) of 397 adults (18 years and above) was estimated using low FV intake 

population prevalence (p = 38%), margin of error (e = 5%), confidence level desired (Zα/2 = 1.96), 95% 

confidence interval (CI) and published formula n = (Zα/2)
2 P (1-P) ÷ е2 (Hall et al., 2009; Snedecor & 

Cochran, 1989). Selected adults are eligible since in Ghana they represent a constitutionally acceptable 

and self-informed decision-making body whose decisions can invariably impact households eating 

habits. Adolescents below 18 years and those whose mental judgement could influence responses 

including proxy respondents were excluded in this study. 

2.1.1 Sampling Techniques  

Eligible respondents were selected with probability proportionate to sample size in each location: urban 

(232), sub-urban (117) and rural (48). This ensures that the information gathered represent rural/urban 

dynamics. Researchers grouped the municipality into three strata and one community was randomly 

selected from each stratum using lottery method where individual units were interviewed. 

In the chosen community, the investigators located the centre, spun a pen on the ground and followed 

the direction in which the head of the pen indicated to select the first house where a household was 

interviewed at random. This method (spin-the-pen) for selecting respondents has been discussed 

elsewhere (Grais, Angela, & Jean-Paul, 2007). Subsequently, the investigators visited the next house 

whose entrance was facing them in that manner until the number of respondents was interviewed. The 

procedure was repeated throughout in each selected stratum. 

2.1.2 Ethical Approval 

Individual written informed consent was obtained from all participants. The study was approved by 

Ghana Health Service Ethical Review Committee (GHS-ERC, ID: 02/04/15). 

2.1.3 Data Collection  

A face-to-face interview was undertaken between May and June 2015 by trained research assistants 

using the pre-tested semi-structured questionnaire adapted from WHO STEP wise approach to 

surveillance of Non-Communicable Diseases (NCDs) FV module (WHO, 2015; WHO, 2008). The tool 

is reported to be valid and data gathered reflects the usual consumption reflecting positively on 

respondents’ habitual rather than actual intake (Agudo, 2004). The questionnaire was translated from 

English to the local language (Ewe and Akan) by an independent bilingual researcher or translator prior 

to field implementation for ease of understanding by the subjects and used as appropriate. It was back 

translated by members of the research team following (WHO, n.d). 

Researchers also used a pictorial show card that presented samples of locally available FV and their 

amounts, excluding juices, in line with WHO standard amounts (modified from Hall et al., 2009; WHO, 

2008). Field pre-testing of the show card was undertaken prior to data collection. The show card 

supported the interview processes for standard estimation of serving size and number of servings as 

reported elsewhere (Hall et al., 2009; WHO, 2008; Agudo, 2004). This ensured participants understood 



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how each count was calculated in relation to the responding question and enhanced the content validity 

of the survey tool.  

The study examined data on sex, age, marital status, education, occupation and monthly income, and 

source of information. Knowledge of experts’ daily recommendation was measured by asking 

participants the following questions:  

1. In your opinion, are you eating enough FV to be healthy? Limited to a yes or no response. 

2. What is the WHO minimum recommended FV servings day/person? Responses selected from 1, 

2, 3, 4 and ≥ 5 servings respectively. 

Other determinants of FV intake were analysed by perceived barriers/facilitators including access to 

materials to cultivate, (land, seeds and equipment) quality, availability of preferred choice, initiatives 

and FV information source. 

2.1.4 Statistical Analysis  

Data was coded, entered and analysed using the Statistical Package for Social Sciences (SPSS) version 

20, 2011 (IBM Inc.). Of the 397 questionnaires, a total of 394 respondents’ completed questionnaires 

were analysed representing a 99.2% useable response rate due to 0.8% missing data. Participants’ 

knowledge of adequate FV consumption was classified based on their response to WHO defined 

criterion (Hall et al., 2009; Agudo, 2004). Dependent variables included FV intake grouped into 

inadequate serving (< 5 servings) and adequate intake (≥ 5 servings) whereas independent variables 

were respondents’ background characteristics, knowledge and factors of FV consumption. Statistical 

analysis performed included descriptive and binary logistic regression to establish odds ratio of factors 

influencing consumption among adequate (≥ 5 servings coded “0”) and inadequate (˂ 5 servings coded 

“1”) respondents. A chi-square test was used to test for statistical difference for categorical variables 

and p-value 0.05 was considered significant. 

 

3. Results 

The demographic characteristics for the respondents are provided in Table 1. Respondents mean age 

was 35.6 years (standard deviation [SD] ± 12.6y). Urban participants represented the majority (58.4%) 

and almost 52% were within low income group with 33.5% of them being traders. Junior High/Middle 

School and Tertiary graduates respectively dominated respondents’ educational background. Although, 

the respondents’ marital status, income and educational levels show no statistical significance with FV 

intake, there was a statistical significant relationship between their location, their occupation and FV 

consumption.  

 

 

 

 

 



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Table 1. Background Characteristic Stratified with Subjects’ Fruit and Vegetable Intake 

Variables 
Fruit and vegetable daily consumption P-value 

< 5, n = 108(27.4%) ≥ 5, n = 286(72.6%) Total n = 394(%)  

Age (years)     

Mean age 35.6(SD 12.6)     

18-29 55 (50.9) 114 (39.9) 169 (42.9) .287 

30-39 25 (23.1) 70 (24.5) 95 (24.1) 

40-49 17 (15.7) 54 (18.9) 71 (18.0)  

50-59 7 (6.5) 31 (10.8) 38 (9.6) 

60 plus 4 (3.7) 17 (5.9) 21 (5.3) 

Gender of respondents .820 

Male 45 (41.7) 124 (43.4) 169 (42.9) 

Female 63 (58.3) 162 (56.6) 225 (57.1) 

Marital status of respondents .748 

Single 34(31.5) 77(26.9) 111(28.2) 

Married/co-habiting 66(61.1) 185(64.7) 251(63.7) 

Divorced 2(1.9) 9(3.1) 11(2.8) 

Widowed/Widower 6(5.6) 15(5.2) 21(5.3)  

Respondents Community of residents .001 

Urban 80 (74.1) 150 (52.4) 230 (58.4) 

Sub-urban 23 (21.3) 93 (32.5) 116 (29.4) 

Rural 5 (4.6) 43 (15.0) 48 (12.2) 

Educational level of respondents .593 

None  6 (5.6) 18 (6.3) 24 (6.1) 

Primary  20 (18.5) 38 (13.3) 58 (14.7) 

Junior High School 39 (36.1) 122 (42.7) 161(40.9) 

Senior High School 23 (21.3) 52 (18.2) 75 (19.0) 

Tertiary 20 (18.5) 56 (19.6) 76 (19.3) 

Occupation of respondents .044 

Artisan 28 (25.9) 64 (22.4) 92 (23.4) 

Farming  6 (5.6) 34 (11.9) 40 (10.2) 

Government/private employee 16 (14.8) 62 (21.7) 78 (19.8) 

Trading 37 (34.3) 95 (33.2) 132 (33.5) 

Unemployed  21 (19.4) 31 (10.8) 52 (13.2) 

Income status of respondents    .800 

Low 145 (50.7) 58 (53.7) 203 (51.5) 

Average 127 (44.4) 44 (40.7) 171(43.4) 

High 14 (4.9) 6 (5.6) 20 (5.1) 

SD: Standard Deviation, n: sample size; % Per cent; < Less than; ≥ Greater than or equal to. 



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Table 2 shows there is no significant association between knowledge of recommended daily quantity of 

FV and its consumption. Although the majority (80.2%) of respondents affirmed they consumed 

adequate FV to remain healthy (P = .667), this did not reflect their knowledge as only 8.9% could 

indicate correctly the WHO recommendation (P = .296). About 43% and 39% of the respondents had 

access to land and seed/equipment respectively for their own FV cultivation. Majority (more than 80%) 

of both adequate and inadequate consumption participants indicated they could easily obtain good 

quality FV (P = .288). However, a significant association existed between availability of the kind of FV 

and what kind a participant’s desire to eat at a particular time (season of the year). Of 54.3% 

participants who were challenged with their desired choice of FV, 46.3% consumed below WHO 

predefined standard (P = .050). 

In relation to where knowledge is obtained from the highest proportion (78%) of participants reported 

they were informed about FV intake via radio (P = .903), compared to television (45.6%) (P = 1.00) 

and 37.3% by health workers (P = 1.00) though there was no statistically significant association 

(Bonferroni correction due to multiple comparison). 

 

Table 2. Knowledge and Factors of Fruit and Vegetable Consumption among Respondents  

Variables Daily Amount of fruit and vegetable consumed P-value 

< 5, n = 108(27.4%) ≥ 5, n = 86(72.6%) Total n = 394 

In your opinion, are you eating enough fruit and vegetable to be healthy?  .667 

Yes 84 (77.8) 232 (81.1) 316 (80.2) 

No 13 (12.0) 26 (9.1) 39 (9.9) 

Don’t know 11 (10.2) 28 (9.8) 39 (9.9) 

What is the WHO daily recommended minimum amount of fruit and vegetable per person? .296 

1 serving 15(13.9) 33(11.5) 48(12.2) 

2-4 servings 16(14.8) 36(12.6) 52(13.2) 

≥ 5 servings 5 (4.6) 30(10.4) 35 (8.9) 

Do not know 72(66.7) 187(65.4) 259(65.7) 

Do you think eating a diet high in fruit and vegetable can decrease chances of developing NCDs?  

Yes 77 (71.3) 206 (72.0) 283 (71.8) .626 

No 19 (17.6) 41 (14.3) 60 (15.2) 

Don’t know. 39 (13.6) 12 (11.1) 51 (12.9) 

Is it easy for you to get good quality fruit and vegetable? .288 

Yes 87(80.6) 243(85.0) 330(83.8) 

No 21(19.4) 43(15.0) 64(16.2) 

Do you have problem getting your choice of fruit and vegetable to consume? .050 

Yes 50(46.3) 164(57.3) 214(54.3) 

No 58(53.7) 122(42.7) 180(45.7) 

Do you have access to an area to grow your own fruit and vegetable? .066 



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Yes 38 (35.2) 130(45.5) 168(42.6)  

No 70 (64.8) 156(54.5) 226(57.4)  

Can you easily obtain seeds/equipment you need to grow your own fruit and vegetable in 

your area? 

.079 

Yes 33(30.6) 120(42.0) 153(38.8)  

No 5(4.6) 13(4.5) 18(4.6)  

Not Applicable 70(64.8) 153(53.5) 223(56.6)  

Are there initiatives promoting fruit and vegetable intake? .617 

Yes 75(69.4) 207(72.4) 282(71.6)  

No 33(30.6) 79(27.6) 112(28.4)  

Where do you get information on fruit and vegetable intake?  

Radio 50(84.7) 138(75.8) 188 (78.0) .903 

Television  24(40.6 86(47.3) 110(45.6) 1.000 

Newspaper 1(1.69) 7(3.8) 8(3.3) 1.000 

Leaflet 1(1.6) 7(3.8) 8(3.3) 1.000 

Poster  2(3.4) 15(37.9) 17(7.1) 1.000 

Health workers 21(35.5) 69(37.9) 90(37.3) 1.000 

% Per cent; < Less than; ≥ Greater than or equal to; n: sample size. 

 

Table 3 illustrates possible influence of availability on FV consumption using binary logistic regression 

analysis. The Odds Ratio (OR) of consuming inadequate serving of FV was 0.59 (95% CI: 0.36, 0.95, P 

= .030) among participants with problem getting a desired choice of FV compared with persons without 

problem of choice. This result was statistically significant. The OR of having inadequate servings for 

persons who are aware of what an adequate serving is, was 1.97 (95% CI: 0.64, 6.05, P = .234). This is 

higher than persons with no awareness, although the result is not statistically significant.  

 

Table 3. Logistics Regression Analysis of Knowledge and Determinants of Fruit and Vegetable 

Intake 

< 5 Fruit and Vegetable Servings β S.E. P-Value 
Odds 

Ratio 

95% CI 

Lower Upper 

Is it easy for you to get good quality fruit and vegetable? -.431 0.313 .168 0.650 0.352 1.199 

Do you have area to grow fruit and vegetable? -.384 0.238 .107 0.681 0.427 1.087 

Do you get your desired choice of fruit and vegetable? -.531 0.245 .030 0.588 0.364 0.950 

Can fruit and vegetable intake prevent NCDs? -.003 0.260 .990 0.997 0.599 1.658 

Do you know the recommended amount fruit and 

vegetable to be consumed daily? 
.680 0.572 .234 1.974 0.644 6.054 

Are there initiatives promoting fruit and vegetable intake? .035 0.263 .893 1.036 0.619 1.734 

< Less than; β: Regression Coefficient; S.E: Standard Error of the Mean, CI: Confidence Interval. 



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4. Discussion 

We established that less than 10% of the respondents are correctly aware of WHO predefined daily 

minimum intake amount of FV (P = .296). This finding did not correspond with the majority who 

indicated they consumed adequate amounts to remain healthy (P = .667). The odds ratio of having 

inadequate servings to persons aware of adequate servings was rather higher (OR > 1) than among 

persons without awareness. Therefore, awareness about WHO predefined criterion had no positive 

influence on quantity of FV consumption. Indeed, the low level of knowledge found in this study 

corroborates a previous study in Ghana (Aitken et al., 2014). In contrast, a review that extensively 

discussed adequate FV intake and chronic diseases risk reduction benefits fell short of finding out 

whether people know what adequate consumptions are (Boeing et al., 2012). Of note, Hall and 

colleagues reported intake below standard globally, including Ghana (Hall et al., 2009). Studies 

conducted in three zones of Ghana involving the study region also documented poor intake (Amo-Adjei 

& Kumi-Kyereme, 2015; Nti et al., 2011). However, these studies did not adequately address subjects’ 

knowledge of health experts’ recommended amount that could possibly trigger individual adequate 

consumption and this is a clear limitation to assessing population FV consumption (Agudo, 2004). 

Certainly, measuring population FV consumption in relation to the quantity consumed to derived health 

benefits strongly reinforces public health strategies of which our study supports (Agudo, 2004). 

In this study, we affirm that media advertisement serves as one of such platform to facilitate increased 

FV intake, notwithstanding the result of our study showing no statistical significance. Radio and 

television were two main ways found in this study to have informed segment of Ghanaian population 

about the nutritional benefits of FV as had been reported (Nti et al., 2011). Adequate health education 

on healthy lifestyle benefits supposedly influences healthy behaviour changes among African American 

women (Delores, Harville, Efunbumi, & Martin, 2015). A well-informed people likely adopted healthy 

lifestyles and equally applied such information obtained based on the source (Delores, 2015). Also, 

several other reviews of wide ranges of worldwide intervention and local policies on FV intake 

implemented provide evidence to suggest that intensification of healthy life campaigns may be a 

determinant of improvement in FV intake, though data revealed just modest increase on the amount 

consumed (Amo-Adjei et al., 2015; Tagoe et al., 2011; Pomerleau et al., 2005). 

Interestingly though, awareness of the WHO recommendation reflected poorly on quantity consumed, 

evidence from this study suggest that lack of desired choice of FV and location negatively influenced 

subjects’ consumption. Our result shows association between participants’ consumption at a particular 

time (season of the year) and availability of choice and their locations. Indeed, the greater proportion of 

the respondents who could easily obtain good quality FV even consumed poorly as a result of not 

finding what they desired for and this increased disproportionally from among rural to urban 

respondents (P = .288). In our study, we also established that the odds ratio of consuming inadequate 

serving for persons who had challenges accessing their desired choice of FV was lower compared with 

persons without problem of desired choice. Possibly, the respondents limited access to land and 



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materials for cultivating their own FV threatened availability and thus consumption. The decision to 

consume FV has strong linkages with numerous factors ranging from personal to the environment 

(Amo-Adjei et al., 2015; Ting, Wojciech, Sarpong, Manjeet, & Anna, 2014; Marie, Minot, & Lisa, 2004; 

Pollard, Kirk, & Cade, 2002). Previous studies elucidated individual preference, accessibility and 

availability (quality and quantity), sensory appeal (taste or texture) and location, all of which our result 

substantiates (Ting et al., 2014; Marie et al., 2004; Pollard et al., 2002). Indeed, we confirmed that 

those who consumed adequate FV actually got their best choice that they wanted regardless of what 

health experts have indicated to be the appropriate amount. Moreover, although we did not examine 

ethnicity and cultural preference, which has strong influence, it has been reported in other studies (Di 

Noia, Monica, Cullen, Pérez-Escamilla, Gray, & Sikorskii, 2015; Marie et al., 2004). Our finding 

therefore advances the understanding of drivers of FV intake and recognition of WHO guideline and 

practices.  

This study employed quantitative terms to defining FV intake and used same to explain respondents’ 

views about experts’ advice on consumption. This method has been proven valid for evaluating 

population FV consumption (Agudo, 2004). The WHO System for NCDs Risk-Factor Surveillance FV 

intake assessment model is validated, flexible and easily applicable and reports reliable estimate of 

usual consumption and therefore our finding from recruiting respondents from three strata enhanced 

views from diverse background is justified for population comparisons (WHO, 2008; Agudo 2004). 

However, the study had limitations. FV intake knowledge was measured by self-reporting relying on 

respondent recall, thus there existed a natural tendency of recall bias, random error and social 

desirability (Oyebode et al., 2014; Agudo 2004). Additionally, cultural preferences were not assessed 

and determining the amount of servings pictorially from show card of which the questionnaire did not 

measure FV juices could lead to imprecise estimation of intake (Agudo, 2004). The strength of the 

study includes the use of field investigators who were trained using appropriate protocols (Hall et al., 

2009; WHO, 2008). They also explained the portion size and how it is counted from the show card to 

the participants before the interview enhancing understanding of reliability of information gathered.  

 

5. Conclusion 

We established poor knowledge on daily FV consumption based on the WHO guideline and 

furthermore the few knowledgeable participants tended to consume below the recommended levels. 

Importantly, the absence of desired choice of FV impacted negatively on consumption. Adequate FV 

intake depends on consumer preference and availability regardless of health experts’ advice. This 

suggests individual home based FV cultivation is relevant for availability of preferred choice and 

adequate consumption to mitigate risk of NCDs among Ghanaians. 

 

 

 



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Acknowledgements 

Trained Research Assistants who assisted with data collection led by Carl Agbitor (Nutritionist, Ghana 

Health Service), for data collection, and the participants who took part in the study. Wisdom Takrama 

of the Department of Epidemiology and Biostatistics, University of Health and Allied Sciences, Ho, 

Ghana who assisted with data analysis. 

 

References 

Agudo, A. (2004). Measuring intake of Fruit and Vegetables. Background Paper for the Joint 

FAO/WHO Workshop on Fruit and Vegetables for Health. Kobe, Japan. 

Aitken, A. et al. (2014). Street Food Vendors in Ghana: Fruit and Vegetable Knowledge and Influences 

on Vending Practice. Proceedings of the Nutrition Society Summer Meeting, Carbohydrates in 

Health: Friends or Foes. Gasgow, UK. 

Amo-Adjei, J., & Kumi-Kyereme, A. (2015). Fruit and Vegetable Consumption by Ecological Zone and 

Socioeconomic Status in Ghana. J Biosoc Sci., 47(5), 613-631. 

https://doi.org/10.1017/S002193201400025X 

Boeing, H. et al. (2012). Critical review: Vegetables and fruit in the prevention of chronic diseases. Eur 

J Nutr., 51(6), 637-663. https://doi.org/10.1007/s00394-012-0380-y 

Delores, J., Harville, C., Efunbumi, O., & Martin, M. (2015). Health Literacy Issues Surrounding 

Weight Management among African American Women: A Mixed Methods Study. J Hum Nutr 

Diet., Suppl 2, 41-49. 

Di Noia, J., Monica, D., Cullen, K. W., Pérez-Escamilla, R., Gray, H. L., & Sikorskii, A. (2016). 

Differences in Fruit and Vegetable Intake by Race/Ethnicity and by Hispanic Origin and Nativity 

among Women in the Special Supplemental Nutrition Program for Women, Infants, and Children. 

Prev Chronic Dis., 13, E115. https://doi.org/10.5888/pcd13.160130 

Grais, R. F., Angela, M. C., & Jean-Paul, G. (2007). Don’t spin the pen: Two Alternative Methods for 

Second stage sampling in Urban Cluster Surveys. Emerg Themes Epidemiol., 1, 4-8. 

https://doi.org/10.1186/1742-7622-4-8 

Hall, J. N., Moore, S., Harper, S. B., & Lynch, J. W. (2009). Global Variability in Fruit and Vegetable 

Consumption. Am J Prev Med., 36(5), 402-409. https://doi.org/10.1016/j.amepre.2009.01.029 

Marie, T. R., Minot, N., & Lisa, S. (2004). Patterns and Determinants of Fruit and Vegetable 

consumption in Sub-Saharan Africa. Background Paper for the Joint FAO/WHO Workshop on 

Fruit and Vegetables for Health. Kobe, Japan. 

Measurement and Methods Core of the Center for Aging in Diverse Communities. (2007). Guidelines 

for Translating Surveys in Cross-Cultural Research. University of California: San Francisco. 

Retrieved March, 2015, from http://www.dgim.ucsf.edu/cadc/cores/measurement/ 

translationguide.pdf  

MoH. (2008). Regenerative Health and Nutrition: A New Paradigm for Health Promotion. Source 



www.scholink.org/ojs/index.php/fsns                Food Science and Nutrition Studies                     Vol. 2, No. 1, 2018 

11 
Published by SCHOLINK INC. 

Manual for the Training of Trainers. Ministry of Health, Ghana. Retrieved April 7, 2015, from 

http://www.rhnp.gov.gh/admindox/RHN%20SOURCE-%20MANUAL.pdf 

Nti, C. A., Hagan, J., Bagina, F., & Seglah, M. (2011). Knowledge of nutrition and health benefits and 

frequency of consumption of fruits and vegetables among Ghanaian homemakers. African Journal 

of Food Science, 5(6), 333-339. 

Oyebode, O., Gordon-Dseagu, V., Walke, A., & Jennifer, S. M. (2014). Fruit and Vegetable 

Consumption and all cause, Cancer and CVD Mortality: Analysis of Health Survey for England 

data. J Epidemiol Community Health, 0, 1-7. https://doi.org/10.1136/jech-2013-203500 

Pollard, J., Kirk, S. F. L., & Cade, J. E. (2002). Factors affecting food choice in relation to fruit and 

vegetable intake: A Review. Nutr Res Rev., 15(2), 373-387. https://doi.org/10.1079/NRR200244 

Pomerleau, J., Karen, L., Cécile, K., & Martin, M. (2005). Interventions Designed to Increase Adult 

Fruit and Vegetable Intake can be Effective: A Systematic Review of the Literature. J Nutr., 

135(10), 2486-2495.  

Snedecor, G. W., & Cochran, W. G. (1989). Statistical Methods (8th ed.). Ames: Iowa State Press.  

Tagoe, H. A., & Dake, F. A. A. (2011). Healthy lifestyle Behaviour among Ghanaian Adults in the 

phase of a health policy change. Global Health, 7, 7. https://doi.org/10.1186/1744-8603-7-7 

Ting, M., Wojciech, J. F., Sarpong, D., Manjeet, C., & Anna, V. A. (2014). Expenditure on Fresh 

Vegetables, Fresh Fruits, and Peanut Products in Urban Ghana: Does Location Matter? Selected 

Paper prepared for presentation at the Southern Agricultural Economics Association Annual 

Meeting. Dallas, TX.  

Vaidya, A., Oli, N., Aryal, U. R., Karki, D. B., & Krettek, A. (2013). Disparities In Fruit And Vegetable 

Intake By Socio Demographic Characteristics In Sub-urban Nepalese Adults: Findings From The 

Heart-Health Associated Research And Dissemination In The Community (HARDIC) Study, 

Bhaktapur, Nepal. Nepal Med Coll J., 2(3), 3-11. 

WHO STEP wise Approach to Non-Communicable Disease Risk Factor Surveillance (STEPS). (n.d.). 

WHO, Geneva. Retrieved March 23, 2015, from 

http://www.who.int/chp/steps/instrument/Q-byQ_STEPS_Instrument_V3.1.pdf?ua=1 

WHO. (2008). STEPS Surveillance Instrument. WHO. Retrieved April 11, 2015, from 

http://www.who.int/chp/steps/Part5.pdf  

WHO. (2008). STEPS Surveillance Training and Practical Guide. WHO. Retrieved April 11, 2015, 

from http://www.who.int/chp/steps/Part3.pdf  

WHO. (2016). Increasing fruit and vegetable intake to reduce the risk of non-communicable diseases: 

E-Library of Evidence for Nutrition Actions (e-LENA). Retrieved November 19, 2016, from 

http://www.who.int/elena/titles/fruit_vegetables_ncds/en/.html 

WHO. (n.d.). Management of Substance Abuse. Retrieved March, 2015, from 

http://www.who.int/substance_abuse/research_tools/translation/en/ 

 


