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

Background

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.

Methods

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.

Results

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.

Conclusions

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.