Background The dietary choices we make affect our personal health and have consequences for the environment, both of which have serious implications for the 2030 Sustainable Development Agenda. There is a strong consensus that cutting on meat and dairy products in favour of fruit and vegetables and other plant-based diets would offer dual health and environmental benefits. In global reviews, the literature on meat, fruit, and vegetable consumption in sub-Saharan Africa (SSA) is limited. It is therefore essential to quantify meat, fruit, and vegetable consumption in sub-Saharan African populations.

Methods We systematically searched six databases to identify studies reporting meat, fruit and/or vegetable consumption in sub-Saharan African populations. Using STATA SE version 15, random effects meta-regression analyses were used to test the effect of year of data collection and method of data collection on population meat, fruit, and vegetable consumption. We also tested any association between age, sex, urban/rural residence or a country’s economic development, and population intake of meat, fruits and/or vegetables.

Results Richer SSA countries were likely to consume more meat (ß=36.76, p=0.04) and vegetables (ß=43.49, p=0.00) than poorer countries. Vegetable intake has increased dramatically over the last three decades from ≈10 g to ≈110 g (ß=4.43, p=0.00). Vegetable (ß=-25.48, p=0.00) consumption was higher in rural than urban residents. Although the trend of meat consumption has gone up (≈25 g to ≈75 g), the trend is non-significant (ß=0.63, N.S.). Daily average per capita meat consumption was however above recommended 70 g, while fruit and vegetable consumption remain below WHO’s recommendation, though consumption of both fruit and vegetable has increased over the last three decades. No clear differences in consumption were noticed between sexes.

Conclusion While dietary changes in SSA may offer the large absolute benefits, consideration of the magnitude of dietary change, particularly increasing meat consumption, will need to occur to ensure policy and interventions support the reduction of under-nutrition and micronutrient deficiencies without worsening NCD prevalence and environmental impacts.