(P08-001-24) There Are Significant Food Environment Interactions and Gender Differences but Few Urban-Rural Differences in Diet Quality in Northern Nigeria

Objectives: Transforming food systems requires understanding food environments and diets. This study assessed food environments and diet quality, comparing diet quality by gender and urban-rural residence.

Methods: Representative data were collected in Bauchi, Kebbi, and Sokoto States. A two-stage, stratified, cluster randomized sampling design was used to select 2,921 households across the 3 states. Diet quality and food environment interactions data were collected from all men and women in the household ≥15 years old (total 4,457 men and 4,817 women). Food environment data were collected at household level. Diets were assessed using the globally standardized Diet Quality Questionnaire. Data were analyzed using complex survey design in Stata 18.

Results: The closest places where households could buy fresh fruits and vegetables required a 20-minute walk on average, versus an 11-minute walk to get cooked meals. About 53% of households had a vegetable garden and/or free access to fruit trees. Rural dwellers had higher access to vegetable gardens or fruit trees, but also higher walking time to buy fresh fruits and vegetables. Food purchase and preparation decisions were usually made by men only in 68% and 62% of households, respectively. Also, 65% of men consumed a mean of 5.4 meals/week away from home while 32% of women consumed 3.8 meals/week away from home. Consumption of the 5 food groups recommended daily in food-based dietary guidelines was low and achieved by significantly more men (41%) than women (32%). Men had higher noncommunicable disease (NCD)-Protect as well as NCD-Risk scores. There were no urban-rural differences in eating meals away from home or in consumption of the 5 recommended food groups. Rural dwellers had lower NCD-Risk scores but similar NCD-Protect scores as urban dwellers.

Conclusions: Diet quality in Northern Nigeria is inadequate. Household food environments may not sufficiently enable the consumption of fruits and vegetables. Diet quality and interactions with the food environment differed by gender but not as much by urban-rural residence. Assessing diet quality and food choice drivers for women alone, typical in Nigeria nutrition surveys, is insufficient to inform actions to transform food systems.

Funding Sources: USAID Advancing Nutrition and Bill & Melinda Gates Foundation grants to the Global Alliance for Improved Nutrition, Abuja, Nigeria.