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Hawaii Value:
Percentage of adults age 65 and older who reported consuming two or more fruits and three or more vegetables daily
Hawaii Rank:
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Percentage of adults age 65 and older who reported consuming two or more fruits and three or more vegetables daily
US Value: 7.3%
Top State(s): Vermont: 13.3%
Bottom State(s): Oklahoma: 3.0%
Definition: Percentage of adults age 65 and older who reported consuming two or more fruits and three or more vegetables daily
Data Source and Years(s): CDC, Behavioral Risk Factor Surveillance System, 2021
Suggested Citation: America's Health Rankings analysis of CDC, Behavioral Risk Factor Surveillance System, United Health Foundation, AmericasHealthRankings.org, accessed 2024.
Diets high in fruits and vegetables reduce the risk of many chronic diseases, such as Type 2 diabetes, obesity, heart disease and stroke. Consuming fruits and vegetables three or more times daily — which is less than the federal recommendations — is still associated with decreased cardiovascular deaths.
Among older adults — many of whom may already have developed chronic diseases — adequate fruit and vegetable consumption still contributes to a healthy diet and helps older adults meet nutrient recommendations. Consuming whole fruits and vegetables daily can reduce the risk of physical disability, digestive disorders, hypertension and atherosclerosis in older adults. Additionally, high fruit and vegetable consumption helps protect against cognitive decline and is linked to higher quality of life, longer physical functioning and higher bone density among older adults.
Barriers to regular consumption of fruits and vegetables include cost, accessibility — a major issue for older adults who live in areas identified as food deserts — and difficulty preparing and chewing fruits and vegetables.
According to America’s Health Rankings analysis, the prevalence of fruit and vegetable consumption is higher among:
The Centers for Disease Control and Prevention offers strategies to increase the consumption of fruits and vegetables, including:
Encouraging older adults to keep raw fruits and vegetables readily available in their homes can help increase the consumption of fruits and vegetables. Additionally, cooking workshops with nutrition education can equip older adults with the confidence and knowledge they need to incorporate more fruits and vegetables into their daily diet.
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.
Brewer, Dawn, Emily Dickens, Alyson Humphrey, and Tammy Stephenson. “Increased Fruit and Vegetable Intake among Older Adults Participating in Kentucky’s Congregate Meal Site Program.” Educational Gerontology 42, no. 11 (November 2016): 771–84. https://doi.org/10.1080/03601277.2016.1231511.
Brodeur, Jean-Marc, Danielle Laurin, Roland Vallee, and Diane Lachapelle. “Nutrient Intake and Gastrointestinal Disorders Related to Masticatory Performance in the Edentulous Elderly.” The Journal of Prosthetic Dentistry 70, no. 5 (November 1993): 468–73. https://doi.org/10.1016/0022-3913(93)90087-5.
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.
Drewnowski, Adam, and William J. Evans. “Nutrition, Physical Activity, and Quality of Life in Older Adults: Summary.” The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 56, Supplement 2 (October 1, 2001): 89–94. https://doi.org/10.1093/gerona/56.suppl_2.89.
Dutko, Paula, Michele Ver Ploeg, and Tracey Farrigan. “Characteristics and Influential Factors of Food Deserts.” Washington, D.C.: United States Department of Agriculture, Economic Research Service, August 2012. https://www.ers.usda.gov/webdocs/publications/45014/30940_err140.pdf.
Ellingsen, I., E. M. Hjerkinn, I. Seljeflot, H. Arnesen, and S. Tonstad. “Consumption of Fruit and Berries Is Inversely Associated with Carotid Atherosclerosis in Elderly Men.” British Journal of Nutrition 99, no. 3 (March 2008): 674–81. https://doi.org/10.1017/S0007114507832521.
Lloyd, Jean L. “Hunger in Older Adults: Challenges and Opportunities for the Aging Services Network.” Meals on Wheels America, February 2017. https://www.mealsonwheelsamerica.org/docs/default-source/research/hungerinolderadults-fullreport-feb2017.pdf?sfvrsn=2.
Moreau, Mireille, Hugues Plourde, Mary Hendrickson-Nelson, and Joanne Martin. “Efficacy of Nutrition Education-Based Cooking Workshops in Community-Dwelling Adults Aged 50 Years and Older.” Journal of Nutrition in Gerontology and Geriatrics 34, no. 4 (October 2, 2015): 369–87. https://doi.org/10.1080/21551197.2015.1084257.
Nicklett, Emily J., and Andria R. Kadell. “Fruit and Vegetable Intake among Older Adults: A Scoping Review.” Maturitas 75, no. 4 (August 1, 2013): 305–12. https://doi.org/10.1016/j.maturitas.2013.05.005.
Polidori, M. Cristina, Domenico Praticó, Francesca Mangialasche, Elena Mariani, Olivier Aust, Timur Anlasik, Ni Mang, et al. “High Fruit and Vegetable Intake Is Positively Correlated with Antioxidant Status and Cognitive Performance in Healthy Subjects.” Journal of Alzheimer’s Disease 17, no. 4 (July 23, 2009): 921–27. https://doi.org/10.3233/JAD-2009-1114.
Semba, Richard D., Fulvio Lauretani, and Luigi Ferrucci. “Carotenoids as Protection against Sarcopenia in Older Adults.” Archives of Biochemistry and Biophysics 458, no. 2 (February 2007): 141–45. https://doi.org/10.1016/j.abb.2006.11.025.
Tucker, Katherine L., Honglei Chen, Marian T. Hannan, L. Adrienne Cupples, Peter W. F. Wilson, David Felson, and Douglas P. Kiel. “Bone Mineral Density and Dietary Patterns in Older Adults: The Framingham Osteoporosis Study.” The American Journal of Clinical Nutrition 76, no. 1 (July 1, 2002): 245–52. https://doi.org/10.1093/ajcn/76.1.245.
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.
Wang, Lu, JoAnn E. Manson, J. Michael Gaziano, Julie E. Buring, and Howard D. Sesso. “Fruit and Vegetable Intake and the Risk of Hypertension in Middle-Aged and Older Women.” American Journal of Hypertension 25, no. 2 (February 1, 2012): 180–89. https://doi.org/10.1038/ajh.2011.186.
America’s Health Rankings builds on the work of the United Health Foundation to draw attention to public health and better understand the health of various populations. Our platform provides relevant information that policymakers, public health officials, advocates and leaders can use to effect change in their communities.
We have developed detailed analyses on the health of key populations in the country, including women and children, seniors and those who have served in the U.S. Armed Forces, in addition to a deep dive into health disparities across the country.