Background: A sufficient daily consumption of fruits and vegetables (F&V) could help prevent chronic diseases. Since implementing the 5 A Day program, research has shown that awareness has increased, but average F&V intake among American adults remains under the minimum recommendation. This analysis examines factors related to increasing F&V intake among participants in the MENU study, a randomized trial with two intervention arms and one control arm.
Methods: In 2005, 2,513 confirmed HMO members, aged 21-65, from 5 geographically-diverse health plans completed an online enrollment survey, reporting F&V intake and personal and family health history. Mean change in combined F&V servings per day was assessed at 12 months post-baseline, using a validated self-report F&V food frequency questionnaire. Analysis of covariance adjusting for the baseline F&V intake, regardless of study arm, was performed for each factor considered.
Results: Of the 2,513, 80% were followed up at 12 months. Those with a family history of hypertension or diabetes increased their F&V consumption, p=.03 and p=.04 compared to those with no family history of these conditions, regardless of race. There were no observed differences in consumption increase by reported family history of cancer, heart disease or obesity. Participants with a high perceived risk of developing diabetes increased their intake by more than 0.6 servings than those with no perceived diabetes risk, p=.05, regardless of race. There were no statistical differences for consumption increase by risk of hypertension, heart disease or obesity. We tested for interactions between race and family history (FH) and perceived risk (PR) individually for each condition. Only FH of obesity was significant, p=.09 showing that whites with FH were more likely to increase F&V intake while blacks were not. The only significant interaction for PR was PR of cancer, p=.07. Interestingly, while the overall change was not significant for either race, whites with high PR increased F&V and blacks with a low PR increased F&V.
Conclusion: FH of hypertension and diabetes, as well as perceived higher risk for developing diabetes, were characteristics that contributed to increasing F&V consumption, regardless of race. FH of obesity and PR of cancer contributed to differences in F&V intake change between blacks and whites. Interventions addressing perceived risk of disease or family history of disease may be valuable in encouraging dietary lifestyle.