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How Can We Get People to Eat More Fruits and Vegetables?

by Jennifer Novakovich

how_can_we_get_people_to_eat_more_fruits_and_vegetables_imagePoor nutrition is a leading cause of chronic diseases; low fruit and vegetable consumption is one of the biggest risk factors for death. Currently obesity, high cholesterol, poor fruit and vegetable intake, and high blood pressure are estimated to cause 25% of diseases each year. Furthermore, poor nutrition throughout pregnancy and early childhood has huge impacts for the quality of life and health of individuals later in life. Increasing intake of fruits and vegetables can result in a reduced incidence of disease, lower medical bills, and improved economies. When the health benefits of eating more fruits and vegetables are so obvious, why is the vast majority of the world’s population not getting adequate servings per day? Is it the lack of education, high cost of healthy foods, or maybe the mass advertisement of unhealthy foods? With chronic diseases and obesity on the rise, it is imperative to take action. How can we, as a population, support better health through increased intake of fruits and vegetables?

Why are fruits and vegetables so important to include in your diet? They are excellent sources of nutrients, fiber, and phytochemicals that significantly reduce risks for many chronic diseases including heart disease, stroke, hypertension, cancer, obesity, eye diseases, osteoporosis, dementia, asthma, and diabetes. Mechanisms for improved health include their effects at improving inflammation, insulin sensitivity, hormone metabolism, and glucose tolerance. Greater variety of vegetables and fruits is associated with improved overall health, but unfortunately large proportions of the world’s population don’t get enough servings per day. About 86% of U.S. adults and 91.5% of adolescents don’t get enough fruits and vegetables (5 daily servings). Furthermore, an estimated 2.7 million lives could be saved per year simply by increasing consumption. I’m always baffled to hear people say phrases like ‘I hate vegetables’ when they are such a vital component of healthy diets. Why do some people develop these habits when they are so detrimental to their long term health?

consumption_patterns_in_childhood_imageConsumption patterns in childhood are predictive of food preferences later in life. Childhood intake is largely determined by food availability, accessibility, and parental intake patterns. Children in higher income families are often exposed to more variety of fruits and vegetables, resulting in overall higher intakes; in turn, these children are more likely to develop healthy life-long preferences. Due to many factors, lower income families are often not as lucky. Studies indicate that fruit and vegetable consumption is directly associated with socioeconomic status. On the other hand, nationwide medical costs associated with obesity-related chronic diseases are estimate to rise by $48 to $66 billion per year, adding to the disparity of lower income families.

While obesity is rising overall, some populations are more burdened than others. For example, obesity rates for African Americans are 49.5%, Mexican Americans (40.4%), all Hispanics (39.1%) and non-Hispanic whites (34.3%). Income and education play important roles in the development of obesity in developed countries. There is an increase in energy-dense and nutrient poor food consumption; this is most prominent in individuals at a low socioeconomic status. When the price of a muffin, ringing in at 300+ calories is the same as the price of a fruit, under 100 calories, how can people with little money rationally buy something with so little energy? How will they meet their caloric needs? For this reason, the combination of increased availability through reduced prices as well as increased nutrition education can have a powerful impact on disadvantaged families

What are changes that have driven obesity in North America? There are too many to name, but the first one that is most obvious to me is advertisement, which has significant impacts on consumption patterns. The food industry is among one of the top U.S. advertisers; messages currently given are that eating certain foods are normal, rewarding, and fun. The primary goal of food manufacturing is to improve taste, typically through increased fat, calories, salt, or sugar. Advertisement can drive the consumption of these high calorie foods and have significant impacts on the health of given populations. Another change has been convenience. Convenient and ready-to-eat foods are available just about anywhere. If you don’t want to leave the house, you can even have it delivered. When unhealthy foods that have been heavily marketed are so readily available, it’s no wonder we are getting fat as a nation. Improved marketing and distribution explains why the daily calories have risen in the U.S. since the 1970s to 3900kcal per person, per day.

So with all of that said, what can be done to increase the consumption of fruits and vegetables? First things first, we could use the above factors that seem to be driving obesity and turn them in our favor (e.g. marketing, advertisement, and convenience). Second thing would be education. School programs that promote healthy diets have been shown to have huge impacts on the eating patterns of students. When we understand the “why,” we are typically more inclined to make changes. Education on nutrition should start young so children can carry what they learnt throughout their lives. Other interventions can be done at work, in homes, in retail food stores, and in restaurants.

availability_of_fruits_vegetables_imageA policy change may have the most significant outcomes by improving access and availability of fruits and vegetables on a population level. A price reduction of just 10% was projected to increase purchases of fruits by 7% and vegetables by 5.8%, although without ensuring a stable supply, this increased demand can result in rising prices. Larger policy changes that support an increased access to fruits and vegetables have the ability to empower everyone to make healthier choices, reducing the incidence of chronic diseases and promoting equality. Finally, incentivizing the purchase of locally grown fruits and vegetables and assisting local farmers would be another important step to promote consumption.

Clearly this isn’t an easy task; in order for change, we need to work together! I’ve given my input, now it’s your turn! What do you think would be a good idea to increase the consumption of fruits and vegetables?

Berthoud H. (2012) The neurobiology of food intake in an obesogenic environment. Proc Nutr Soc. 71(4):478–487.

Black et. Al. (2012) Food subsidy programs and the health and nutritional status of disadvantaged families in high income countries: a systematic review. BMC 12:1099.

Boeing et. Al. (2012) Critical review: vegetables and fruit in the prevention of chronic diseases. Eur J Nutr 51:637–663.

Chandon P, Wansink B. (2012) Does food marketing need to make us fat? A review and solutions. Nutr Rev 70(10):571–593.

Ganann et. Al. (2012) Community-based interventions for enhancing access to or consumption of fruit and vegetables among five to 18-year olds: a scoping review. BMC Public Health 12:711.

Hood C, Martines-Donate A, Meinen A. (2012) Promoting Healthy Food Consumption: A Review of State-Level Policies to Improve Access to Fruits and Vegetables. WMJ 111(6):283-8.

Swan et. Al. (2012) How science thinks and practice acts: bridging the gap in weight management interventions for adolescents. Family Practice 29:i117–i125.

See this and other articles on Jennifer Novakovich’s website JennovaFoodBlog.com

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