Healthy Lifestyle? Eat more fruit and vegetables? Not in the U.S.

According to a recent survey by the CDC only 15% of the american population eats fruits and vegetables regularly. The shocking facts: 76% americans did not meet fruit intake recommendations, and 87% did not meet vegetable intake recommendations.

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 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%.
Intake recommendations appropriate for adults who engage in Median frequency of reported fruit intake across all respondents was once per day, ranging from 0.9 in Arkansas to 1.3 times per day in California (Table). Median frequency of reported vegetable intake was 1.7 times per day, ranging from 1.4 in Louisiana, Mississippi, and North Dakota to 1.9 times per day in California and Oregon. Based on prediction equations, 13.1% of respondents met fruit recommendations, and 8.9% met vegetable recommendations. The percentage of state populations meeting recommendations for fruits ranged from 7.5% in Tennessee to 17.7% in California, and for vegetables, from 5.5% in Mississippi to 13.0% in California.
In 2013, most adults consumed too few fruits and vegetables, with substantial variation by state. This analysis enhances current surveillance efforts by enabling the comparison of fruit and vegetable intake from the BRFSS survey module with federal recommendations. Ongoing collection of relevant state-level nutritional status and program data help identify public health nutrition problems in each state and support the design, evaluation, and management of nutrition intervention programs, in addition to catalyzing local interest in nutrition programs and policies (7).
Because fruit and vegetable consumption affects multiple health outcomes (1) and is currently low across all states, continued efforts are needed to increase demand and consumption. Improving fruit and vegetable consumption for adults might start with improving intake during childhood. During 2007–2010, 60% of children consumed fewer cup equivalents of fruit than recommended, and 93% consumed fewer vegetables than recommended (2). Better dietary practices earlier in life might lead to better practices later in life, and places where children learn and play can have an integral role in improving intake. For example, school districts, schools, and early care and education providers can help increase children’s fruit and vegetable consumption by meeting or exceeding current federal nutrition standards for meals and snacks, serving fruit and vegetables whenever food is offered, and training staff to make fruit and vegetables more appealing and accessible.§ Improving fruit and vegetable accessibility, placement, and promotion in grocery stores, restaurants, worksites, and other community settings might improve intake in adults (8,9). For example, work sites can make it easier for employees to make healthy food choices and create social norms that support healthy eating by creating policies to ensure that fruits and vegetables are provided at work-site gatherings, including meetings, conferences, and other events (8). CDC funds state, local, tribal, and territorial health departments to improve environments in worksites, schools, child care, and community settings to expand access to fruits and vegetables and other healthy food and beverage choices for persons of all ages.¶
The findings in this report are subject to at least five limitations. First, self-reports of intake are based on a limited set of questions and are prone to measurement error and recall bias (10). Self-reported intake might overestimate intake in some populations and underestimate intake in others (10). Second, these results might not be generalizable to the entire U.S. adult population (4). BRFSS excludes those living in nursing homes, long-term care facilities, military installations, and correctional institutions (4), but the overall effect this would have on the estimation of intake is unclear. Moreover, territories were excluded because prediction models were derived from NHANES, which excludes territories.** Third, estimates do not include non-100% fruit juice or fried potatoes because BRFSS respondents are instructed not to include them. Including these sources results in 4%–6% higher estimates for fruit and 30%–44% higher estimates for vegetables (6) but federal dietary guidelines recommend limiting foods and beverages with added sugars and solid fats (1). Fourth, relatively low response rates for BRFSS might have biased the sample. Finally, using prediction equations to estimate intake might have resulted in measurement error. However, previous analyses showed that applying prediction equations to 2011 BRFSS frequency data yielded estimates comparable to 2007–2010 national estimates that used more accurate 24-hour recalls (6).
These results indicate that <18% of adults in each state consumed the recommended amount of fruit and <14% consumed the recommended amount of vegetables. Increased attention to food environments in multiple settings, including child care, schools, communities, and worksites, might help improve fruit and vegetable intake, and thus help prevent chronic disease.
1Division of Nutrition, Physical Activity, and Obesity Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC; 2Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health.
Corresponding author: Latetia V. Moore,, 770-488-5213.