Agronegocios

CHAPTER

8

Trends in US Adult Fruit and Vegetable

Consumption

Sarah Stark Casagrande1 and Tiffany L. Gary-Webb1,2
1

Department of Epidemiology, Johns Hopkins Bloomberg School

of Public Health, Baltimore, Maryland, USA

2
Welch Center for Prevention, Epidemiology, and Clinical Medicine,

Medical Institutions, Baltimore, Maryland, USA


1. EVIDENCE SUMMARY

1.1 Fruit andVegetable Consumption
Consuming a diet high in fruits and vege­
tables is associated with a decreased risk of cer­
tain chronic diseases including cardiovascular
disease [1–4], cancer [1,5], and diabetes [6–9].
Previous literature indicates that US adult
fruit and vegetable consumption is below
recommendations [10–16]. Beginning in 1985,
the United States Department of Agriculture
(USDA)Dietary Guidelines for Healthy Americans
(Guidelines hereafter) recommended consuming
at least two servings of fruit and three servings
of vegetables daily [17,18]. In 1991, the 5-ADay Program for Better Health was initiated
by the National Cancer Institute and the
Produce for Better Health Foundation to
increase public awareness of the importance of
eating at least five fruits andvegetables daily
Bioactive Foods in Promoting Health: Fruits and Vegetables

[19]. This was done through advertising cam­
paigns, education, and school and workplace
interventions. In 2005, the USDA Guidelines
were revised to emphasize fruit and vegetable
intakes based on individual energy require­
ments and recommended 5–9 servings per day.
Lastly, in 2007, the Produce for Better HealthFoundation launched the Fruits and Veggies –
More Matters campaign to reflect the 2005
Guideline revisions.
Previous research indicates that only a small
proportion of Americans meet the USDA
Guidelines for daily servings of fruits and vege­
tables [13,20,21]. An evidence table summariz­
ing fruit and vegetable consumption studies is
referenced in Table 8.1. Twenty-four hour die­
tary recalldata from the Second National
Health and Nutrition Examination Survey
(NHANES) (1976–1980) estimated that only
27% of adults consumed the three or more ser­
vings of vegetables and 29% of adults

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TABLE 8.1

8. TRENDS IN US ADULT FRUIT AND VEGETABLE CONSUMPTION

Evidence Summary for Fruit and Vegetable (F&V) Consumption

ReferenceStudy

Population

Measures

Results

Patterson
et al. [13]

NHANES II, 1976–
1980

11,648 adults

24-hour dietary recall
45% no fruit servings
administered by a trained 22% no vegetable servings
interviewer
27% consumed 3 + vegetables
29% consumed 2 + fruits
9% consumed both
Consumption low

Swanson
et al. [15]

Population survey in
three areas of US

881 AfricanAmericans and
1095 white adults

Patterson
et al. [14]

1987 National Health 20,143 adults
Interview Survey
(NHIS)

Food frequency data

African Americans were more fre­
quent consumers of F&V than
whites

Food Frequency
Questionnaire

Females consumed more F&V, fewer
meats and high-fat foods
Whites consumed a more varied diet
than African Americans or Hispanics
Hispanicsconsumed the lowest
amounts of high-fat foods; African
Americans the most

Basiotis [16] NHANES 1999–2002

8070 age > 2 yrs

Healthy Eating Index

28% consumed Z3 servings
vegetables
17% consumed Z2 servings fruit

Gary et al.
[12]

2172 African
American adults

Modified Block
Questionnaire

8% met fruit recommendations (Z2)

Few met F&V recommendations
Project DIRECT16% met vegetable recommendations
(Z3)
Intake increased with higher income
and more education

Casagrande
et al. [11]

NHANES III, 1988–
1994 and NHANES
1999–2002

NHANES III:
14,997 adults

24-hour dietary recall

NHANES 1999–
2002: 8910 adults

consumed the two or more servings of fruit
recommended by USDA and DHHS [13]. Only
9% of adults met both fruit and vegetable...