Harnessing traditional knowledge and experiences on food consumption in Uganda: a mixed-methods study exploring indigenous fruits and vegetables with potential cardiometabolic benefits.

Introduction: Mitigating the ongoing nutrition transition and associated risks in sub-Saharan Africa may require cost-effective and community-based approaches. Thanks to their wealth of bioactive constituents, indigenous fruits and vegetables (IFV) constitute one of such approaches. However, in Uganda, consumption of IFV is pervasively low, despite a rich diversity. Our study aimed to harness traditional knowledge on consumption of IFV and catalogue IFV reputed for cardiometabolic benefits. Methods: In this qualitative study, we conducted focus group discussions (FGD), key informant interviews (KII) and market surveys. Participants for the FGD were recruited from the general population, while for KII, farmers, ethnobotanists, nutritionists, herbalists and health workers were interviewed. We conducted surveys in supermarkets and open-air markets together with explorative interviews with market vendors. Discussions were audio recorded, transcribed verbatim and analysed thematically. We performed phenolic profiling of the identified IFV using Phenol-Explorer and relevant publications as an initial step towards verifying the therapeutic claims ascribed to certain IFV. Results: Eleven FGD (84 participants), 19 KII and 12 food market surveys were conducted with participants aged 19-80 years. Three of the 11 FGD were conducted among younger adults (aged 19-34 years). Tamarindus indica Linn., Cleome gynandra, Solanum anguivi and Hibiscus sabdariffa were most cited as potent against cardiometabolic risks, and their total polyphenol content (mg/100 g) was 4755, 1330, 1710 and 2920, respectively. Consumption was influenced by sensory appeal, awareness of health benefits, seasonality and social misconceptions, whereby IFV are considered food for the poor. Other barriers were low food skills, food safety concerns and the diversity of fast foods. Early adults had low knowledge of IFV and were less willing to consume IFV. A food market survey revealed a scarcity of fresh and processed IFV. Conclusion: Our study showed that several IFV are purported to have beneficial cardiometabolic benefits, but consumption is affected by several food environment constraints.