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      Trends in Fruit and Vegetable Consumption Among U.S. Men and Women, 1994–2005

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          Abstract

          Introduction

          Eating a diet high in fruits and vegetables as part of an overall healthful diet can help lower chronic disease risk and aid in weight management. Increasing the percentage of Americans who consume enough fruits and vegetables every day is part of the Healthy People 2010 objectives for the nation. Assessing trends in consumption of these foods is important for tracking public health initiatives to meet this goal and for planning future objectives.

          Methods

          We assessed total and sex-specific changes in daily consumption of fruits and vegetables among 1,227,969 adults in the 50 U.S. states and the District of Columbia who participated in the Behavioral Risk Factor Surveillance System from 1994 through 2005. To estimate changes in consumption according to dietary recommendations that were in place during the years examined, we used geometric mean and the percentage of people eating fruits or vegetables or both five or more times per day. Estimates were standardized for sex, age, and race/ethnicity and analyzed by multivariate regression.

          Results

          From 1994 through 2005, the geometric mean frequency of consumption of fruits and vegetables declined slightly (standardized change: men and women, −0.22 times/day; men, −0.26 times/day; women, −0.17 times/day). The proportion of men and women eating fruits or vegetables or both five or more times per day was virtually unchanged (men, 20.6% vs 20.3%; women, 28.4% vs 29.6%); however, we found small increases for men aged 18 to 24 years and for women who were aged 25 to 34 years, non-Hispanic black, or nonsmokers. Consumption of fruit juice and nonfried potatoes declined for both sexes.

          Conclusion

          The frequency of fruit and vegetable consumption changed little from 1994 through 2005. If consumption is to be increased, we must identify and disseminate promising individual and environmental strategies, including policy change.

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          Most cited references33

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          Overview of the health benefits of fruit and vegetable consumption for the dietetics professional: selected literature.

          Epidemiologic evidence of a protective role for fruits and vegetables in cancer prevention is substantial. The strength of this scientific base guides US national policymaking in diet and health issues and facilitates community and local programs that address national dietary goals to increase fruit and vegetable consumption. Current scientific evidence also suggests a protective role for fruits and vegetables in prevention of coronary heart disease, and evidence is accumulating for a protective role in stroke. In addition, a new scientific base is emerging to support a protective role for fruits and vegetables in prevention of cataract formation, chronic obstructive pulmonary disease, diverticulosis, and possibly, hypertension. This article provides an overview of the health benefits associated with fruit and vegetable consumption for each of these conditions, including brief discussions of underlying protective mechanisms, identifies key scientific findings regarding the health benefits of fruit and vegetable consumption, and outlines applications of these findings for dietetics professionals. The evidence reviewed provides additional support for increased consumption of a wide variety of vegetables, in particular, dark-green leafy, cruciferous, and deep-yellow-orange ones, and a wide variety of fruits, in particular, citrus and deep-yellow-orange ones. Continued attention to increasing fruit and vegetable consumption is a practical and important way to optimize nutrition to reduce disease risk and maximize good health.
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            Most Americans eat much less than recommended amounts of fruits and vegetables.

            To estimate the proportions of the population meeting recommendations for fruit and vegetable intake, we first estimated the usual intake distributions of total fruits and vegetables and then compared the results to the 5 A Day recommendation and to the recommendations for fruits and vegetables combined, found in the new US Department of Agriculture food guide, MyPyramid. The primary dataset was created from one 24-hour recall from each of 8,070 respondents in the 1999-2000 National Health and Nutrition Examination Survey. Variances were estimated using one or two 24-hour recalls from 14,963 respondents in the 1994-1996 Continuing Survey of Food Intakes by Individuals. The statistical method developed at Iowa State University was used for estimating distributions of usual intake of dietary components that are consumed daily. It was modified to allow the adjustment of heterogeneous within-person variances using an external estimate of heterogeneity. In 1999-2000, only 40% of Americans ate an average of five or more (1/2)-cup servings of fruits and vegetables per day. The proportions of sex-age groups meeting the new US Department of Agriculture recommendations ranged from 0.7% of boys aged 14 to 18 years, whose combined recommendation is 5 cups, to 48% of children aged 2 to 3 years, whose combined recommendation is 2 cups. Americans need to consume more fruits and vegetables, especially dark green and orange vegetables and legumes. Nutritionists must help consumers realize that, for everyone older than age 3 years, the new recommendations for fruit and vegetable intakes are greater than the familiar five servings a day.
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              Reliability and validity of measures from the Behavioral Risk Factor Surveillance System (BRFSS).

              To assess the reliability and validity of measures on the BRFSS, to assist users in evaluating the quality of BRFSS data, and to identify areas for further research. Review and summary of reliability and validity studies of measures on the BRFSS and studies of measures that were the same or similar to those on the BRFSS from other surveys. Measures determined to be of high reliability and high validity were current smoker, blood pressure screening, height, weight, and BMI, and several demographic characteristics. Measures of both moderate reliability and validity included when last mammography was received, clinical breast exam, sedentary lifestyle, intense leisure-time physical activity, and fruit and vegetable consumption. Few measures were of low validity and only one measure was determined to be of low reliability. Several other measures were of high or moderate reliability or validity, but not both. The reliability or validity could not be determined for some measures, primarily due to lack of research. Most questions on the core BRFSS instrument were at least moderately reliable and valid, and many were highly reliable and valid. Additional research is needed for some measures.
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                Author and article information

                Contributors
                Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity
                ,
                Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity, Atlanta, Georgia
                Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity, Atlanta, Georgia
                Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity, Atlanta, Georgia
                Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity, Atlanta, Georgia
                Journal
                Prev Chronic Dis
                Preventing Chronic Disease
                Centers for Disease Control and Prevention
                1545-1151
                April 2008
                15 March 2008
                : 5
                : 2
                : A35
                Affiliations
                Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity
                Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity, Atlanta, Georgia
                Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity, Atlanta, Georgia
                Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity, Atlanta, Georgia
                Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity, Atlanta, Georgia
                Article
                PCDv52_07_0049
                2396974
                18341771
                7515057b-b4b1-4fc4-8bf7-e40046413396
                Copyright @ 2008
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                Original Research

                Health & Social care
                Health & Social care

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