Impact of behavioral health policies on fruit and vegetable consumption and physical activity behavior among adolescent girls in sub-Saharan Africa

Physical inactivity and low consumption of fruits and vegetables are known risk factors for non-communicable diseases (NCDs). Recent projections from the World Health Organization (WHO) indicate that the prevalence of NCDs is increasing in sub-Saharan Africa. However, few studies have focused on NCDs risk during adolescence. In this study we examine the impact of fruit and vegetable (FV) and physical activity (PA) policies on adequate fruit consumption (>=2 servings daily), vegetable consumption (>=3 servings daily), fruit and vegetable consumption (5 servings of 2 fruits & 3 vegetables) and physical activity behavior (60 minutes daily) among adolescent girls. Information on health policies was obtained from the WHO and from a systematic review of literature on health policies. Countries were selected based on availability of the Global School-Based Student Health Survey (GSHS). The total analytic sample was 22,916 adolescent girls from 13 countries. We found that adequate fruit consumption was highest among girls in Seychelles (59%). Using logistic regression models, we found a significant positive association between presence of FV policy and adequate consumption of fruits {Adjusted Odds Ratio (AOR) = 1.54; 95%CI (1.44 – 1.64); p-value = 0.00} and adequate consumption of vegetables {AOR = 1.69; 95%CI (1.57 – 1.83); p-value = 0.00}. Presence of PA policy was positively associated with adequate daily physical activity {AOR = 1.22; 95%CI (1.06 – 1.41); p-value = 0.00}. The presence of policies in Sub-Saharan Africa provides a supportive environment for adolescent girls to consume adequate amounts of fruits and vegetables and to engage in adequate physical activity daily.