Eating more fruits and vegetables adds nutrients to diets, reduces the risk for heart disease, stroke, and some cancers, and helps manage body weight when consumed in place of more energy-dense foods (1). Adults who engage in <30 minutes of moderate physical activity daily should consume 1.5–2.0 cup equivalents of fruit and 2–3 cups of vegetables daily.* However, during 2007–2010, half of the total U.S. population consumed <1 cup of fruit and <1.5 cups of vegetables daily; 76% did not meet fruit intake recommendations, and 87% did not meet vegetable intake recommendations (2). Although national estimates indicate low fruit and vegetable consumption, substantial variation by state has been observed (3). Fruit and vegetable intake information from the Behavioral Risk Factor Surveillance System (BRFSS) is the sole source of dietary surveillance information for most states, but frequency of intake captured by BRFSS is not directly comparable to federal intake recommendations, which are expressed in cup equivalents. CDC analyzed median daily frequency of fruit and vegetable intake based on 2013 BRFSS data for the 50 states and the District of Columbia (DC) and applied newly developed prediction equations to BRFSS to calculate the percentage of each state's population meeting fruit and vegetable intake recommendations. Overall, 13.1% of respondents met fruit intake recommendations, ranging from 7.5% in Tennessee to 17.7% in California, and 8.9% met vegetable recommendations, ranging from 5.5% in Mississippi to 13.0% in California. Substantial new efforts are needed to build consumer demand for fruits and vegetables through competitive pricing, placement, and promotion in child care, schools, grocery stores, communities, and worksites.
BRFSS is an ongoing state-based random-digit–dialed telephone survey of noninstitutionalized, civilian adults aged ≥18 years residing in the United States. BRFSS collects data on health risk behaviors and conditions, chronic diseases and conditions, access to health care, and use of preventive health services and practices related to the leading causes of death and disabilities in the United States (4). BRFSS asks respondents how many times per day, week, or month they consumed 100% fruit juice, whole fruit, dried beans, dark green vegetables, orange vegetables, and other vegetables over the previous month as part of the rotating core questionnaire administered every other year. For these analyses, respondents were excluded if they did not reside in the 50 states or DC, were missing responses to one or more questions, or had implausible reports of fruit or vegetable intake (reported eating fruit >16 times per day or vegetables >23 times per day) (5); after excluding these 118,193 (24%) respondents, the resulting analytic sample size was 373,580. The 2013 median American Association of Public Opinion Research response rate across the 50 states and DC was 45.9%.
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