Fruit and Vegetable Consumption - Age 65+ in Michigan

Michigan

The 2020-2025 Dietary Guidelines for Americans recommends that adults consume two cups of fruit and two and a half 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. Roughly half of all adults in the United States suffer from preventable chronic diseases related to poor diet and physical inactivity. 

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, 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 among low-income areas, where there are fewer supermarkets and smaller stores charge more for groceries and have less healthy food available. In 2023, households in the lowest income quartile spent an average of 32.6% of their income after taxes on food, while those in the highest-income quartile spent an average of 8.1%. 

The estimated annual cost of medical expenses and lowered productivity attributable to unhealthy diets in the U.S. is $1.1 trillion.

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

• Older women compared with older men.
• Older adults with a college education compared with those with less education.
• Older adults with an annual household income of $75,000 or more compared with those with lower incomes.
• Older adults living in metropolitan areas compared with those living in nonmetropolitan areas. 

The Centers for Disease Control and Prevention offers strategies to increase the consumption of fruits and vegetables, including:

• Improving access to and availability of fruits and vegetables at local grocery stores. States with a higher density of healthy food retailers, farmers’ markets and acceptance of nutrition-assistance program benefits by farmers’ markets report higher consumption of fruits and vegetables.
• 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.
• Partnering with organizations that deliver produce or full meals to older adults, such as Meals on Wheels. Meal delivery programs have been shown to increase fruit and vegetable consumption for older adults in senior centers, and are recommended by the Community Preventive Services Task Force.

Cooking workshops with nutrition education can help equip older adults with the confidence and knowledge they need to incorporate more fruits and vegetables into their daily diet. The American Heart Association has tips for food preparation and simple meal modifications to make changing your diet less daunting and easier to maintain. 

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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.

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.

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.

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.

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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.

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.

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.