201268 Use of a case-specific recommendation for fruit and vegetable intake in health behavior research

Wednesday, November 11, 2009: 12:30 PM

Betty L. Kaiser, PhD, RN , School of Nursing, University of Wisconsin-Madison, Madison, WI
Linda C. Baumann, PhD, APRN, BC , School of Nursing, University of Wisconsin-Madison, Madison, WI

Current USDA Dietary Guidelines for Americans recommend that adults consume 5 to 13 daily servings of fruits and vegetables, with specific amounts determined by a person's gender, age, and activity level. Five daily servings represents inadequate intake for most adults, but “5-a-day” continues to be widely used as an outcome measure in health behavior research. We report on a personalized measure of adequate fruit and vegetable intake based on current recommendations.


For a survey study of 137 low-income adults, we collected self-report data on daily servings of fruits and vegetables, physical activity, height, weight, age, and gender. Using algorithms underlying the MyPyramid Food Guidance System, we classified participants into 12 food intake patterns and calculated an overall fruit and vegetable recommendation for each participant. We created a "healthy diet" ratio comparing self-reported fruit and vegetable servings to recommended servings.


Thirty-six percent of participants (n = 49) ate five or more daily servings of fruits and vegetables. In contrast, only 8% of participants (n = 9) had healthy diet ratios of at least 1.0, indicating that their daily fruit and vegetable intake met or exceeded their individualized recommendation. The median healthy diet ratio was 0.36, corresponding to fruit and vegetable intake that was about 7 daily servings less than recommended.


The healthy diet ratio measure is a feasible method of incorporating current dietary guidelines into health behavior research. This measure yields data that more accurately reflect the prevalence of consuming adequate amounts of fruits and vegetables.

Learning Objectives:
Describe a limitation of the standard of “5-a-day” as a measure of adequate intake of fruits and vegetables.

Keywords: Dietary Assessment, Behavioral Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PhD-prepared RN, and my presentation is based on my dissertation research. I have presented other aspects of my research to numerous academic, community, and professional groups.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.