Association Between Socio-Demographic, Behavioural, and Health-Related Factors and Fruit, Vegetable, and Salt...

Background/Objectives: Low fruit and vegetable consumption and unhealthy salt-related behaviours are important modifiable risk factors for non-communicable diseases. Nationally representative data on these dietary patterns in Kazakhstan remain limited. We aimed to assess fruit, vegetable, and salt-related behaviours among adults aged 18-69 years and examine the socio-demographic and geographic factors associated with inadequate fruit and vegetable consumption and unfavourable salt-related knowledge, attitudes, and behaviours. Methods: We conducted a nationally representative cross-sectional survey of 6720 adults across all 17 administrative units of Kazakhstan in 2021-2022 using multistage stratified cluster sampling and the WHO STEPS questionnaire. Fruit and vegetable consumption, as well as salt-related knowledge, attitudes, and behaviours, were assessed by interview. Associations were examined using weighted logistic regression. Results: Mean fruit and vegetable consumption was 3.0 (SD 2.3) servings/day, and only 15.7% of respondents met the WHO recommendation of ≥5 servings/day. Women were more likely than men to meet the WHO recommendation (17.9% vs. 13.4%), and men had lower adjusted odds of adequate fruit and vegetable consumption (aOR 0.72, 95% CI 0.62-0.84). Adequate fruit and vegetable consumption was most common in southern regions and least common in northern and urban areas. Although 80.6% of participants were aware of the health risks of high salt consumption, only 41.7% considered salt reduction very important, while 64.6% reported adding salt during cooking and 39.6% at the table, and 29.2% frequently consumed salty processed foods. Less favourable salt-related patterns were more common among men, younger adults, less educated respondents, smokers, and residents of several administrative units. Conclusions: Adults in Kazakhstan show insufficient fruit and vegetable consumption and suboptimal salt-related behaviours. Targeted, geographically adapted, multisectoral measures are needed to support healthier dietary practices.