Awareness and Dietary Practices Related to Fruit and Vegetable Consumption for Cancer Prevention in Mogadishu, Somalia: A Community-Based Cross-Sectional Study.

BACKGROUND: Fruit and vegetable consumption is an important component of healthy dietary practices and noncommunicable disease prevention. However, evidence on awareness, dietary practices, and access barriers related to fruit and vegetable consumption remains limited in Somalia. This study assessed awareness and self-reported dietary practices related to fruit and vegetable consumption for cancer prevention among adults in Mogadishu. METHODS: A community-based cross-sectional study was conducted among 420 adults in Mogadishu, Somalia, from November 2025 to February 2026. Participants were selected using a multistage sampling approach across the 20 districts of Mogadishu. Data were collected through a structured interviewer-administered questionnaire covering sociodemographic characteristics, knowledge and attitudes, dietary practices, lifestyle factors, and accessibility barriers. Descriptive statistics and Pearson's chi-square tests were used to analyze the data, with statistical significance set at p<0.05. RESULTS: The response rate was 99.5%. Overall, 71.4% of participants had heard that fruits and vegetables may help reduce cancer risk, and 85.0% agreed or strongly agreed that they are important for health. However, only 30.0% reported daily fruit intake, 40.0% reported daily vegetable intake, and 40.0% consumed only 0-1 serving per day. Limited access and food insecurity were reported by 40.0% and 45.0% of participants, respectively. Education level was significantly associated with cancer-prevention awareness (p<0.001), belief that low intake increases cancer risk (p=0.003), and attitudes toward fruit and vegetable importance (p<0.001). Access to fruits and vegetables and food insecurity were significantly associated with daily servings (both p<0.001). CONCLUSION: Awareness and positive attitudes were common, but self-reported intake remained below recommended levels. Findings suggest a knowledge-practice gap associated with socioeconomic and accessibility barriers.