Abstract
BackgroundRural residents are increasingly identified as being at greater risk for health disparities. These inequities may be related to health behaviors such as adequate fruits and vegetable consumption. There is little national-level population-based research about the prevalence of fruit and vegetable consumption by US rural population adults. The objective of this study was to examine the prevalence differences between US rural and non-rural adults in consuming at least five daily servings of combined fruits and vegetables.MethodsCross-sectional analysis of weighted 2009 Behavioral Risk Factor Surveillance Survey (BRFSS) data using bivariate and multivariate techniques. 52,259,789 US adults were identified as consuming at least five daily servings of fruits and vegetables of which 8,983,840 were identified as living in rural locales.ResultsBivariate analysis revealed that in comparison to non-rural US adults, rural adults were less likely to consume five or more daily servings of fruits and vegetables (OR = 1.161, 95% CI 1.160-1.162). Logistic regression analysis revealed that US rural adults consuming at least five daily servings of fruits and vegetables were more likely to be female, non-Caucasian, married or living with a partner, living in a household without children, living in a household whose annual income was > $35,000, and getting at least moderate physical activity. They were also more likely to have a BMI of <30, have a personal physician, have had a routine medical exam in the past 12 months, self-defined their health as good to excellent and to have deferred medical care because of cost. When comparing the prevalence differences between rural and non-rural US adults within a state, 37 States had a lower prevalence of rural adults consuming at least five daily servings of fruits and vegetables and 11 States a higher prevalence of the same.ConclusionsThis enhanced understanding of fruit and vegetable consumption should prove useful to those seeking to lessen the disparity or inequity between rural and non-rural adults. Additionally, those responsible for health-related planning could benefit from the knowledge of how their state ranks in comparison to others vis-à-vis the consumption of fruits and vegetables by rural adults---a population increasingly being identified as one at risk for health disparities.
Highlights
Rural residents are increasingly identified as being at greater risk for health disparities
Similar to the US Healthy People 2000 (HP 2000) and HP 2010 objectives, Healthy People 2020 (HP2020) [1] contains nutrition related objectives that recommend Americans increase their consumption of both fruits and vegetables [2]
Increasing the consumption of fruits and vegetables is deemed an important public health issue since adequate fruit and vegetable consumption may reduce the risk for several major causes of morbidity and mortality in the U.S including type 2 diabetes [3], heart disease [4,5], stroke [6] and obesity [7]
Summary
Rural residents are increasingly identified as being at greater risk for health disparities. These inequities may be related to health behaviors such as adequate fruits and vegetable consumption. Increasing the consumption of fruits and vegetables is deemed an important public health issue since adequate fruit and vegetable consumption may reduce the risk for several major causes of morbidity and mortality in the U.S including type 2 diabetes [3], heart disease [4,5], stroke [6] and obesity [7]. In addition to reducing the risk of developing many chronic diseases, there is an increasing and compelling body of clinical evidence supporting the benefit of diet and physical activity in health maintenance and disease prevention and for disease treatment, a process referred to as Medical Nutrition Therapy (MNT) [13]. Several widely disseminated clinical practice guidelines advise eating diets high in whole foods such as fruit, vegetables, and whole grains along with limiting animal protein and avoiding high energy low nutrient foods as an important component of disease management
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