DefinitionThe percentage of adults who reported consuming fruit two or more times a day
NumeratorThe number of survey respondents who reported consuming fruit two or more times a day.
DenominatorThe total number of survey respondents.
Data Interpretation IssuesIn 2011, the BRFSS changed its methodology from a landline only sample and weighting based on post-stratification to a landline/cell phone sample and raking as the weighting methodology. Raking accounts for variables such as income, education, marital status, and home ownership during weighting and has the potential to more accurately reflect the population distribution. More details about these changes can be found at: [https://ibis.health.utah.gov/pdf/opha/resource/brfss/RakingImpact2011.pdf].
Respondents are asked to think about number of times they ate fruit in the last 30 days, yet the numerator is based on "daily" basis.
Why Is This Important?Fruits and vegetables contain essential vitamins, minerals, fiber, and other compounds that may help prevent many chronic diseases. Compared with people who consume a diet with only small amounts of fruits and vegetables, those who eat more generous amounts as part of a healthful diet are likely to have reduced risk of chronic diseases, including stroke and perhaps other cardiovascular diseases, and certain cancers^1^. Fruits and vegetables also help people to achieve and maintain a healthy weight because they are relatively low in energy density^2^. To promote health and prevent chronic diseases, the 2015-2020 Dietary Guidelines for Americans recommend two cups of fruit per day for a standard 2,000 calorie diet, with recommendations based on an individual's age, gender, and activity level^3^.
1. CDC. ''Can eating fruits and vegetables help people to manage their weight?'' (Research to Practice Series No. 1) [Online Access] [http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/rtp_practitioner_10_07.pdf][[br]]
2. World Cancer Research Fund, American Institute for Cancer Research. ''Food, nutrition, physical activity and the prevention of cancer: a global perspective.'' November 2007. [Online Access] [http://www.dietandcancerreport.org] [[br]]
3. Dietary Guidelines for Americans, 2015-2020 [https://health.gov/dietaryguidelines/2015/guidelines/]
Healthy People Objective NWS-14:Increase the contribution of fruits to the diets of the population aged 2 years and older
U.S. Target: 0.90 cup equivalent per 1,000 calories
Other ObjectivesIncrease the proportion of persons aged 18 years and older who consume fruit two or more times each day. [[br]]
'''Utah Target:''' 34%
How Are We Doing?Please note that the fruit consumption questions were changed in 2011 and results cannot be compared with years prior to 2011.
In 2017, about one of three (34.7%) Utah adults reported eating fruit two or more times each day (age-adjusted rate).
Women report higher fruit consumption than men (38.6% vs. 29.9%, crude rate). Consumption increased with education. More college graduates (42.6%) and those with some post high school education (36.2%) reported eating fruit at least two times per day than those with lower levels of education (2017 data).
Consumption also increased with income, with higher consumption in households earning $75,000 or more (39.6%) than those earning less than $25,000 (28.2%).
Fruit consumption varied by local health district (LHD) in 2017, with TriCounty and Tooele LHDs having significantly lower rates (27.0% and 27.6%) than the state rate. Utah County LHD at 39.4% was significantly higher than the state. None of the other LHDs had rates statistically significantly different from the state.
Fruit consumption varied by Utah Small Areas for years 2015 and 2017. Seven small areas had rates of fruit consumption significantly higher than the state: Millcreek (East), West Jordan (Southeast), Daybreak, American Fork, Alpine, Provo/BYU, and San Juan (Other). Six small areas were identified with significantly lower rates than the state rate: Box Elder County (Other) V2, Ogden (Downtown), Salt Lake City (Downtown) V2, Tooele County (Other), Daggett and Uintah County, and Carbon County.
How Do We Compare With the U.S.?In 2017, 34.7% of Utah adults reported eating fruit two or more times each day, which is greater than than the U.S. rate of 33.2% (age-adjusted rates).
What Is Being Done?The Healthy Living through Environment, Policy, and Improved Clinical Care Program (EPICC) was established through funding from the Centers for Disease Control and Prevention (CDC).
EPICC focuses on Environmental Approaches that Promote Health, specifically promoting policies around healthy eating and active living. EPICC works:
1) Schools are encouraged to adopt the Comprehensive School Physical Activity Program. This framework encourages students to be physically active for 60 minutes a day through school, home and community activities.[[br]]
2) Height and weight trends are being tracked in a sample of elementary students to monitor Utah students.[[br]]
3) Action for Healthy Kids brings partners together to improve nutrition and physical activity environments in Utah's schools by implementing the school-based state plan strategies, working with local school boards to improve or develop policies for nutritious foods in schools. This includes recommendations for healthy vending options.
1) The Utah Health Improvement Plan--a public and private partnership--has selected worksites as their priority for the goal of Preventing Obesity and Related Chronic Conditions. A smaller workgroup, UHIP-O, works to create a Culture of Health within businesses in the state of Utah.
2) The Utah Council for Worksite Health Promotion recognizes businesses that offer employee fitness and health promotion programs.[[br]]
3) EPICC partners with local health departments to encourage worksites to complete the CDC Scorecard and participate in yearly health risk assessment for their employees. EPICC provides toolkits and other resources for employers interested in implementing wellness programs through the [http://choosehealth.utah.gov choosehealth.utah.gov] website: [http://choosehealth.utah.gov/worksites/why-worksite-wellness.php]
1) Local health departments (LHDs) receive federal funding to partner with schools, worksites, and other community based organizations to increase access to fresh fruits and vegetables through food service guidelines, farmers markets and retail stores. LHDs also work with cities within their jurisdictions to create a built environment that encourages physical activity.
1) EPICC works with health care systems to establish community clinical linkages to support individuals at risk for or diagnosed with diabetes or hypertension to engage in lifestyle change programs such as chronic disease self-management and diabetes prevention programs.
1) Ten local health departments statewide have implemented the TOP Star program, which aims to improve the nutrition, physical activity, and breastfeeding environments and achieve best practice in child care centers and homes.[[br]]
2) EPICC works with state and local partners through the Childcare Obesity Prevention workgroup to implement policy and systems changes in early care and education across agencies statewide.
Evidence-based PracticesThe EPICC program promotes evidence based practices collected by the Center TRT. The Center for Training and Research Translation (Center TRT) bridges the gap between research and practice and supports the efforts of public health practitioners working in nutrition, physical activity, and obesity prevention by:
*Reviewing evidence of public health impact and disseminating population-level interventions;
*Designing and providing practice-relevant training both in-person and web-based;
*Addressing social determinants of health and health equity through training and translation efforts; and
*Providing guidance on evaluating policies and programs aimed at impacting healthy eating and physical activity.[[br]]
Appropriate evidence based interventions can be found at: [[br]]