Fruit and Vegetable Consumption in Missouri

Missouri

The 2020-2025 Dietary Guidelines for Americans, published jointly by the United States Departments of Agriculture (USDA) and Health and Human Services, recommends that adults consume 2 cups of fruit and 2.5 cups of vegetables daily. Diets high in fruits and vegetables can help lower blood pressure, reduce the risk of heart disease and stroke, and prevent some types of cancer. Consuming fruits and vegetables three or more times daily is associated with a lower overall mortality risk. Roughly half of all adults in the U.S. suffer from preventable chronic diseases related to poor diet and physical inactivity. 

Barriers to regular consumption of fruits and vegetables include cost, lack of access to fresh produce, concerns of spoilage, perceived lack of preparation time and lack of cooking knowledge. Affordability and geographic scarcity can create conditions of limited access, particularly in low-income areas, where there are fewer supermarkets and smaller stores charge higher prices for groceries and offer less healthy options. In 2023, households in the lowest income quartile spent an average of 32.6% of their after-tax income on food, while those in the highest-income quartile spent an average of 8.1%. 

Medical expenses and lost productivity associated with unhealthy diets have been estimated to cost the U.S. $1.1 trillion.

According to America’s Health Rankings analysis, the prevalence of fruit and vegetable consumption is higher among:

• Women compared with men.
• Adults ages 18-44 compared with those age 65 and older.
• College graduates compared with adults with lower educational attainment. The prevalence increases with increases in educational attainment.
• Adults with an annual household income of $75,000 or more compared with those who have lower incomes.
• Adults living in metropolitan areas compared with those in nonmetropolitan areas.

The Centers for Disease Control and Prevention offers strategies for states and communities to improve access to fruits and vegetables, including:

• Adopting policies to ensure access to fruits and vegetables in workplace cafeterias. 
• Encouraging farm-to-institution programs in schools, hospitals, workplaces and child care centers. 
• Expanding new and existing farmers’ markets for direct access to seasonal fruits and vegetables.
• Improving access to and availability of fruits and vegetables at local grocery stores. States with a higher density of healthy food retailers and farmers markets, particularly those that accept nutrition-assistance program benefits, report higher consumption of fruits and vegetables.

Funding is available from the USDA for projects that establish healthy retail outlets or otherwise improve food access in underserved areas. The USDA provides an interactive tool to identify low-income and low-access areas at the census tract level, as well as individual-level resources to improve one's diet. Additionally, the federal Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) can provide nutrition education and a monthly allowance to increase fruit and vegetable consumption for eligible households. 

Additionally, states, localities and organizations can either modify and expand current programs to increase consumption of fruits and vegetables, or they can introduce new fruit and vegetable voucher incentives and produce prescription programs.

The Community Preventive Services Task Force also suggests implementing community-based digital health interventions, such as coaching and counseling, social support, educational tools and goal-setting, to promote increased fruit and vegetable consumption.

Healthy People 2030 has multiple objectives related to nutrition and healthy eating, including increasing fruit consumption among people age two and older and increasing vegetable consumption among people age two and older.

Bazzano, Lydia A., Jiang He, Lorraine G. Ogden, Catherine M. Loria, Suma Vupputuri, Leann Myers, and Paul K. Whelton. “Fruit and Vegetable Intake and Risk of Cardiovascular Disease in US Adults: The First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study.” The American Journal of Clinical Nutrition 76, no. 1 (July 1, 2002): 93–99. https://doi.org/10.1093/ajcn/76.1.93.

Centers for Disease Control and Prevention. 2018 State Indicator Report on Fruits and Vegetables. Atlanta, GA: U.S. Department of Health and Human Services, 2018. https://www.cdc.gov/nutrition/downloads/fruits-vegetables/2018/2018-fruit-vegetable-report-508.pdf.

Centers for Disease Control and Prevention. Strategies to Prevent Obesity and Other Chronic Diseases: The CDC Guide to Strategies to Increase the Consumption of Fruits and Vegetables. Atlanta, GA: U.S. Department of Health and Human Services, 2011. https://stacks.cdc.gov/view/cdc/21639.

Hollis-Hansen, Kelseanna, Kathryn M. Janda, Marisa Tiscareño, Claire Filipowicz, and Alexandra van den Berg. “Objective and Perceived Barriers and Facilitators of Daily Fruit and Vegetable Consumption among Under-Resourced Communities in Central Texas.” Appetite 176 (September 1, 2022): 106130. https://doi.org/10.1016/j.appet.2022.106130.

Singleton, Chelsea R., Sydney Fouché, Rucha Deshpande, Angela Odoms-Young, Corey Chatman, and Connie Spreen. “Barriers to Fruit and Vegetable Consumption among Farmers’ Market Incentive Programme Users in Illinois, USA.” Public Health Nutrition 21, no. 7 (February 19, 2018): 1345–49. https://doi.org/10.1017/S1368980018000101.

The Rockefeller Foundation. True Cost of Food: Measuring What Matters to Transform the U.S. Food System. The Rockefeller Foundation, July 2021. https://www.rockefellerfoundation.org/wp-content/uploads/2021/07/True-Cost-of-Food-Full-Report-Final.pdf.

U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. Washington, D.C.: U.S. Department of Agriculture and U.S. Department of Health and Human Services, December 2020. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf.

Zhu, Allison Y. “Impact of Neighborhood Sociodemographic Characteristics on Food Store Accessibility in the United States Based on the 2020 US Census Data.” Delaware Journal of Public Health 8, no. 3 (August 2022): 94–101. https://doi.org/10.32481/djph.2022.08.016.