Skip to main content
Top
Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

A cross-sectional study of US rural adults’ consumption of fruits and vegetables: do they consume at least five servings daily?

Authors: M Nawal Lutfiyya, Linda F Chang, Martin S Lipsky

Published in: BMC Public Health | Issue 1/2012

Login to get access

Abstract

Background

Rural residents are increasingly identified as being at greater risk for health disparities. These inequities may be related to health behaviors such as adequate fruits and vegetable consumption. There is little national-level population-based research about the prevalence of fruit and vegetable consumption by US rural population adults. The objective of this study was to examine the prevalence differences between US rural and non-rural adults in consuming at least five daily servings of combined fruits and vegetables.

Methods

Cross-sectional analysis of weighted 2009 Behavioral Risk Factor Surveillance Survey (BRFSS) data using bivariate and multivariate techniques. 52,259,789 US adults were identified as consuming at least five daily servings of fruits and vegetables of which 8,983,840 were identified as living in rural locales.

Results

Bivariate analysis revealed that in comparison to non-rural US adults, rural adults were less likely to consume five or more daily servings of fruits and vegetables (OR = 1.161, 95% CI 1.160-1.162). Logistic regression analysis revealed that US rural adults consuming at least five daily servings of fruits and vegetables were more likely to be female, non-Caucasian, married or living with a partner, living in a household without children, living in a household whose annual income was > $35,000, and getting at least moderate physical activity. They were also more likely to have a BMI of <30, have a personal physician, have had a routine medical exam in the past 12 months, self-defined their health as good to excellent and to have deferred medical care because of cost. When comparing the prevalence differences between rural and non-rural US adults within a state, 37 States had a lower prevalence of rural adults consuming at least five daily servings of fruits and vegetables and 11 States a higher prevalence of the same.

Conclusions

This enhanced understanding of fruit and vegetable consumption should prove useful to those seeking to lessen the disparity or inequity between rural and non-rural adults. Additionally, those responsible for health-related planning could benefit from the knowledge of how their state ranks in comparison to others vis-à-vis the consumption of fruits and vegetables by rural adults---a population increasingly being identified as one at risk for health disparities.
Appendix
Available only for authorised users
Literature
2.
go back to reference U.S. Department of Agriculture U.S. Department of Health and Human Services: Dietary Guidelines for Americans, 2010. 2010, U.S. Government Printing Office, Washington, DC, 7 U.S. Department of Agriculture U.S. Department of Health and Human Services: Dietary Guidelines for Americans, 2010. 2010, U.S. Government Printing Office, Washington, DC, 7
3.
go back to reference Carter P, Gray LJ, Troughton J, Khunti K, Davies MJ: Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. BMJ. 2010, 341: c4229-CrossRefPubMedPubMedCentral Carter P, Gray LJ, Troughton J, Khunti K, Davies MJ: Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. BMJ. 2010, 341: c4229-CrossRefPubMedPubMedCentral
4.
go back to reference Aatola H, Koivistoinen T, Hutri-Kähönen N, Juonala M, Mikkilä V, Lehtimäki T, Viikari JS, Raitakari OT, Kähönen M: Lifetime fruit and vegetable consumption and arterial pulse wave velocity in adulthood: the cardiovascular risk in young Finns study. Circulation. 2010, 122: 2521-2528.CrossRefPubMed Aatola H, Koivistoinen T, Hutri-Kähönen N, Juonala M, Mikkilä V, Lehtimäki T, Viikari JS, Raitakari OT, Kähönen M: Lifetime fruit and vegetable consumption and arterial pulse wave velocity in adulthood: the cardiovascular risk in young Finns study. Circulation. 2010, 122: 2521-2528.CrossRefPubMed
5.
go back to reference Dauchet L, Amouyel P, Hercberg S, Dallongeville J: Fruit and vegetable consumption and risk of coronary heart disease: a meta-analysis of cohort studies. J Nutr. 2006, 136: 2588-2593.PubMed Dauchet L, Amouyel P, Hercberg S, Dallongeville J: Fruit and vegetable consumption and risk of coronary heart disease: a meta-analysis of cohort studies. J Nutr. 2006, 136: 2588-2593.PubMed
6.
go back to reference He FJ, Nowson CA, MacGregor GA: Fruit and vegetable consumption and stroke: meta-analysis of cohort studies. Lancet. 2006, 367: 320-326.CrossRefPubMed He FJ, Nowson CA, MacGregor GA: Fruit and vegetable consumption and stroke: meta-analysis of cohort studies. Lancet. 2006, 367: 320-326.CrossRefPubMed
7.
go back to reference Michimi A, Wimberly MC: Associations of supermarket accessibility with obesity and fruit and vegetable consumption in the conterminous United States. Int J Health Geogr. 2010, 9: 49-CrossRefPubMedPubMedCentral Michimi A, Wimberly MC: Associations of supermarket accessibility with obesity and fruit and vegetable consumption in the conterminous United States. Int J Health Geogr. 2010, 9: 49-CrossRefPubMedPubMedCentral
8.
go back to reference Boggs DA, Palmer JR, Wise LA, Spiegelman D, Stampfer MJ, Adams-Campbell LL, Rosenberg L: Fruit and vegetable intake in relation to risk of breast cancer in the black women's health study. Am J Epidemiol. 2010, 172: 1268-1279.CrossRefPubMedPubMedCentral Boggs DA, Palmer JR, Wise LA, Spiegelman D, Stampfer MJ, Adams-Campbell LL, Rosenberg L: Fruit and vegetable intake in relation to risk of breast cancer in the black women's health study. Am J Epidemiol. 2010, 172: 1268-1279.CrossRefPubMedPubMedCentral
9.
go back to reference Fernández E, Gallus S, La Vecchia C: Nutrition and cancer risk: an overview. J Br Menopause Soc. 2006, 12: 139-142.CrossRefPubMed Fernández E, Gallus S, La Vecchia C: Nutrition and cancer risk: an overview. J Br Menopause Soc. 2006, 12: 139-142.CrossRefPubMed
10.
go back to reference Lee JE, Männistö S, Spiegelman D, Hunter DJ, Bernstein L, van den Brandt PA, Buring JE, Cho E, English DR, Flood A, Freudenheim JL, Giles GG, Giovannucci E, Håkansson N, Horn-Ross PL, Jacobs EJ, Leitzmann MF, Marshall JR, McCullough ML, Miller AB, Rohan TE, Ross JA, Schatzkin A, Schouten LJ, Virtamo J, Wolk A, Zhang SM, Smith-Warner SA: Intakes of fruit, vegetables, and carotenoids and renal cell cancer risk: a pooled analysis of 13 prospective studies. Cancer Epidemiol Biomarkers Prev. 2009, 18: 1730-1739.CrossRefPubMedPubMedCentral Lee JE, Männistö S, Spiegelman D, Hunter DJ, Bernstein L, van den Brandt PA, Buring JE, Cho E, English DR, Flood A, Freudenheim JL, Giles GG, Giovannucci E, Håkansson N, Horn-Ross PL, Jacobs EJ, Leitzmann MF, Marshall JR, McCullough ML, Miller AB, Rohan TE, Ross JA, Schatzkin A, Schouten LJ, Virtamo J, Wolk A, Zhang SM, Smith-Warner SA: Intakes of fruit, vegetables, and carotenoids and renal cell cancer risk: a pooled analysis of 13 prospective studies. Cancer Epidemiol Biomarkers Prev. 2009, 18: 1730-1739.CrossRefPubMedPubMedCentral
11.
go back to reference Büchner FL, Bueno-de-Mesquita HB, Ros MM, Overvad K, Dahm CC, Hansen L, Tjønneland A, Clavel-Chapelon F, Boutron-Ruault MC, Touillaud M, Kaaks R, Rohrmann S, Boeing H, Nöthlings U, Trichopoulou A, Zylis D, Dilis V, Palli D, Sieri S, Vineis P, Tumino R, Panico S, Peeters PH, van Gils CH, Lund E, Gram IT, Braaten T, Sánchez MJ, Agudo A, Larrañaga N, Ardanaz E, Navarro C, Argüelles MV, Manjer J, Wirfält E, Hallmans G, Rasmuson T, Key TJ, Khaw KT, Wareham N, Slimani N, Vergnaud AC, Xun WW, Kiemeney LA, Riboli E: Variety in fruit and vegetable consumption and the risk of lung cancer in the European prospective investigation into cancer and nutrition. Cancer Epidemiol Biomarkers Prev. 2010, 19: 2278-2286.CrossRefPubMed Büchner FL, Bueno-de-Mesquita HB, Ros MM, Overvad K, Dahm CC, Hansen L, Tjønneland A, Clavel-Chapelon F, Boutron-Ruault MC, Touillaud M, Kaaks R, Rohrmann S, Boeing H, Nöthlings U, Trichopoulou A, Zylis D, Dilis V, Palli D, Sieri S, Vineis P, Tumino R, Panico S, Peeters PH, van Gils CH, Lund E, Gram IT, Braaten T, Sánchez MJ, Agudo A, Larrañaga N, Ardanaz E, Navarro C, Argüelles MV, Manjer J, Wirfält E, Hallmans G, Rasmuson T, Key TJ, Khaw KT, Wareham N, Slimani N, Vergnaud AC, Xun WW, Kiemeney LA, Riboli E: Variety in fruit and vegetable consumption and the risk of lung cancer in the European prospective investigation into cancer and nutrition. Cancer Epidemiol Biomarkers Prev. 2010, 19: 2278-2286.CrossRefPubMed
12.
go back to reference Benetou V, Orfanos P, Lagiou P, Trichopoulos D, Boffetta P, Trichopoulou A: Vegetables and fruits in relation to cancer risk: evidence from the Greek EPIC cohort study. Cancer Epidemiol Biomarkers Prev. 2008, 17: 387-392.CrossRefPubMed Benetou V, Orfanos P, Lagiou P, Trichopoulos D, Boffetta P, Trichopoulou A: Vegetables and fruits in relation to cancer risk: evidence from the Greek EPIC cohort study. Cancer Epidemiol Biomarkers Prev. 2008, 17: 387-392.CrossRefPubMed
13.
go back to reference McCabe-Sellers BJ, Skipper A, American Dietetic Association: Position of the American Dietetic Association: integration of medical nutrition therapy and pharmacotherapy. J Am Diet Assoc. 2010, 110: 950-956.CrossRefPubMed McCabe-Sellers BJ, Skipper A, American Dietetic Association: Position of the American Dietetic Association: integration of medical nutrition therapy and pharmacotherapy. J Am Diet Assoc. 2010, 110: 950-956.CrossRefPubMed
14.
go back to reference Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, Roccella EJ, National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure National High Blood Pressure Education Program Coordinating Committee: The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003, 289: 2560-2572.CrossRefPubMed Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, Roccella EJ, National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure National High Blood Pressure Education Program Coordinating Committee: The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003, 289: 2560-2572.CrossRefPubMed
15.
go back to reference Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, Obarzanek E, Conlin PR, Miller ER, Simons-Morton DG, Karanja N, Lin PH, DASH-Sodium Collaborative Research Group: Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med. 2001, 344: 3-10.CrossRefPubMed Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, Obarzanek E, Conlin PR, Miller ER, Simons-Morton DG, Karanja N, Lin PH, DASH-Sodium Collaborative Research Group: Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med. 2001, 344: 3-10.CrossRefPubMed
16.
go back to reference Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001, 285: 2486-2497. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001, 285: 2486-2497.
18.
go back to reference Lovasi GS, Hutson MA, Guerra M, Neckerman KM: Built environments and obesity in disadvantaged populations. Epidemiol Rev. 2009, 31: 7-20.CrossRefPubMed Lovasi GS, Hutson MA, Guerra M, Neckerman KM: Built environments and obesity in disadvantaged populations. Epidemiol Rev. 2009, 31: 7-20.CrossRefPubMed
19.
go back to reference Lutfiyya MN, McCullough JE, Lipsky MS: A population-based study of health services deficits for U.S. adults with asthma. J Asthma. 2011, 48: 931-944.CrossRefPubMed Lutfiyya MN, McCullough JE, Lipsky MS: A population-based study of health services deficits for U.S. adults with asthma. J Asthma. 2011, 48: 931-944.CrossRefPubMed
20.
go back to reference Braveman P: Health disparities and health equity: concepts and measurement. Annu Rev Public Health. 2006, 27: 167-194.CrossRefPubMed Braveman P: Health disparities and health equity: concepts and measurement. Annu Rev Public Health. 2006, 27: 167-194.CrossRefPubMed
21.
go back to reference Phelan JC, Link BG, Tehranifar P: Social conditions as fundamental causes of health inequalities: theory, evidence, and policy implications. J Health Soc Behav. 2010, 51: S28-S40.CrossRefPubMed Phelan JC, Link BG, Tehranifar P: Social conditions as fundamental causes of health inequalities: theory, evidence, and policy implications. J Health Soc Behav. 2010, 51: S28-S40.CrossRefPubMed
22.
go back to reference Dubowitz T, Heron M, Bird CE, Lurie N, Finch BK, Basurto-Da´vila R, Hale L, Escarce JJ: Neighborhood socioeconomic status and fruit and vegetable intake among whites, blacks, and Mexican Americans in the United States. Am J Clin Nutr. 2008, 87: 1883-1891.PubMedPubMedCentral Dubowitz T, Heron M, Bird CE, Lurie N, Finch BK, Basurto-Da´vila R, Hale L, Escarce JJ: Neighborhood socioeconomic status and fruit and vegetable intake among whites, blacks, and Mexican Americans in the United States. Am J Clin Nutr. 2008, 87: 1883-1891.PubMedPubMedCentral
23.
go back to reference Devine CM, Wolfe WS, Frongillo EA, Bisogni CA: Life-course events and experiences: association with fruit and vegetable consumption in 3 ethnic groups. J Am Diet Assoc. 1999, 99: 309-314.CrossRefPubMed Devine CM, Wolfe WS, Frongillo EA, Bisogni CA: Life-course events and experiences: association with fruit and vegetable consumption in 3 ethnic groups. J Am Diet Assoc. 1999, 99: 309-314.CrossRefPubMed
24.
go back to reference Yeh MC, Ickes SB, Lowenstein LM, Shuval K, Ammerman AS, Farris R, Katz DL: Understanding barriers and facilitators of fruit and vegetable consumption among a diverse multi-ethnic population in the USA. Health Promot Int. 2008, 23: 42-51.CrossRefPubMed Yeh MC, Ickes SB, Lowenstein LM, Shuval K, Ammerman AS, Farris R, Katz DL: Understanding barriers and facilitators of fruit and vegetable consumption among a diverse multi-ethnic population in the USA. Health Promot Int. 2008, 23: 42-51.CrossRefPubMed
25.
go back to reference Baker AH, Wardle J: Sex differences in fruit and vegetable intake in older adults. Appetite. 2003, 40: 269-275.CrossRefPubMed Baker AH, Wardle J: Sex differences in fruit and vegetable intake in older adults. Appetite. 2003, 40: 269-275.CrossRefPubMed
26.
go back to reference Savoca MR, Arcury TA, Leng X, Bell RA, Chen H, Anderson A, Kohrman T, Quandt SA: The diet quality of rural older adults in the South as measured by healthy eating index-2005 varies by ethnicity. J Am Diet Assoc. 2009, 109: 2063-2067.CrossRefPubMedPubMedCentral Savoca MR, Arcury TA, Leng X, Bell RA, Chen H, Anderson A, Kohrman T, Quandt SA: The diet quality of rural older adults in the South as measured by healthy eating index-2005 varies by ethnicity. J Am Diet Assoc. 2009, 109: 2063-2067.CrossRefPubMedPubMedCentral
27.
go back to reference Eikenberry N, Smith C: Healthful eating: perceptions, motivations, barriers, and promoters in low-income Minnesota communities. J Am Diet Assoc. 2004, 104: 1158-1161.CrossRefPubMed Eikenberry N, Smith C: Healthful eating: perceptions, motivations, barriers, and promoters in low-income Minnesota communities. J Am Diet Assoc. 2004, 104: 1158-1161.CrossRefPubMed
29.
go back to reference Montez JK, Eschbach K: Country of birth and language are uniquely associated with intakes of fat, fiber, and fruits and vegetables among Mexican-American women in the United States. J Am Diet Assoc. 2008, 108: 473-480.CrossRefPubMed Montez JK, Eschbach K: Country of birth and language are uniquely associated with intakes of fat, fiber, and fruits and vegetables among Mexican-American women in the United States. J Am Diet Assoc. 2008, 108: 473-480.CrossRefPubMed
30.
go back to reference Hosler AS, Rajulu DT, Fredrick BL, Ronsani AE: Assessing retail fruit and vegetable availability in urban and rural underserved communities. Prev Chronic Dis. 2008, 5: A123-PubMedPubMedCentral Hosler AS, Rajulu DT, Fredrick BL, Ronsani AE: Assessing retail fruit and vegetable availability in urban and rural underserved communities. Prev Chronic Dis. 2008, 5: A123-PubMedPubMedCentral
31.
go back to reference Sharkey JR, Johnson CM, Dean WR: Food access and perceptions of the community and household food environment as correlates of fruit and vegetable intake among rural seniors. BMC Geriatr. 2010, 10: 32-CrossRefPubMedPubMedCentral Sharkey JR, Johnson CM, Dean WR: Food access and perceptions of the community and household food environment as correlates of fruit and vegetable intake among rural seniors. BMC Geriatr. 2010, 10: 32-CrossRefPubMedPubMedCentral
32.
go back to reference Kanungsukkasem U, Ng N, Van Minh H, Razzaque A, Ashraf A, Juvekar S, Masud Ahmed S, Huu Bich T: Fruit and vegetable consumption in rural adult population in INDEPTH HDSS sites in Asia. Glob Health Action. 2009, 2: Kanungsukkasem U, Ng N, Van Minh H, Razzaque A, Ashraf A, Juvekar S, Masud Ahmed S, Huu Bich T: Fruit and vegetable consumption in rural adult population in INDEPTH HDSS sites in Asia. Glob Health Action. 2009, 2:
33.
go back to reference Berke EM: Geographic Information Systems (GIS): recognizing the importance of place in primary care research and practice. J Am Board Fam Med. 2010, 23: 9-12.CrossRefPubMedPubMedCentral Berke EM: Geographic Information Systems (GIS): recognizing the importance of place in primary care research and practice. J Am Board Fam Med. 2010, 23: 9-12.CrossRefPubMedPubMedCentral
34.
go back to reference Cummins S, Curtis S, Diez-Roux AV, Macintyre S: Understanding and representing ‘place’ in health research: a relational approach. Soc Sci Med. 2007, 65: 1825-1838.CrossRefPubMed Cummins S, Curtis S, Diez-Roux AV, Macintyre S: Understanding and representing ‘place’ in health research: a relational approach. Soc Sci Med. 2007, 65: 1825-1838.CrossRefPubMed
35.
go back to reference Lutfiyya MN, Lipsky MS, Wisdom-Behounek J, Inpanbutr-Martinkus M: Is rural residency a risk factor for overweight and obesity for U.S. children?. Obesity (Silver Spring). 2007, 15: 2348-2356.CrossRef Lutfiyya MN, Lipsky MS, Wisdom-Behounek J, Inpanbutr-Martinkus M: Is rural residency a risk factor for overweight and obesity for U.S. children?. Obesity (Silver Spring). 2007, 15: 2348-2356.CrossRef
36.
go back to reference Jackson JE, Doescher MP, Jerant AF, Hart LG: A national study of obesity prevalence and trends by type of rural county. J Rural Health. 2005, 21: 140-148.CrossRefPubMed Jackson JE, Doescher MP, Jerant AF, Hart LG: A national study of obesity prevalence and trends by type of rural county. J Rural Health. 2005, 21: 140-148.CrossRefPubMed
37.
go back to reference Schwartz F, Ruhil AV, Denham S, Shubrook J, Simpson C, Boyd SL: High self-reported prevalence of diabetes mellitus, heart disease, and stroke in 11 counties of rural Appalachian Ohio. J Rural Health. 2009, 25: 226-230.CrossRefPubMed Schwartz F, Ruhil AV, Denham S, Shubrook J, Simpson C, Boyd SL: High self-reported prevalence of diabetes mellitus, heart disease, and stroke in 11 counties of rural Appalachian Ohio. J Rural Health. 2009, 25: 226-230.CrossRefPubMed
38.
go back to reference Krishna S, Gillespie KN, McBride TM: Diabetes burden and access to preventive care in the rural United States. J Rural Health. 2010, 26: 3-11.CrossRefPubMed Krishna S, Gillespie KN, McBride TM: Diabetes burden and access to preventive care in the rural United States. J Rural Health. 2010, 26: 3-11.CrossRefPubMed
39.
go back to reference Mokdad AH, Stroup DF, Giles WH: Behavioral Risk Factor Surveillance Team. Public health surveillance for behavioral risk factors in a changing environment: recommendations from the Behavioral Risk Factor Surveillance Team. MMWR. 2003, 52 (RR-9): 1-12. Mokdad AH, Stroup DF, Giles WH: Behavioral Risk Factor Surveillance Team. Public health surveillance for behavioral risk factors in a changing environment: recommendations from the Behavioral Risk Factor Surveillance Team. MMWR. 2003, 52 (RR-9): 1-12.
40.
go back to reference U.S. Office of Management and Budget: 2010 standards for delineating metropolitan and micropolitan statistical areas; Notice. Fed Regist. 2010, 75: U.S. Office of Management and Budget: 2010 standards for delineating metropolitan and micropolitan statistical areas; Notice. Fed Regist. 2010, 75:
41.
go back to reference Isserman AM: In the national interest: defining rural and urban correctly in research and public policy. Int Reg Sci Rev. 2005, 28: 465-499.CrossRef Isserman AM: In the national interest: defining rural and urban correctly in research and public policy. Int Reg Sci Rev. 2005, 28: 465-499.CrossRef
43.
go back to reference Woods M: Rural geography: blurring boundaries and making connections. Prog Hum Geogr. 2009, 33: 849-858.CrossRef Woods M: Rural geography: blurring boundaries and making connections. Prog Hum Geogr. 2009, 33: 849-858.CrossRef
45.
go back to reference Hall JN, Moore S, Harper SB, Lynch JW: Global variability in fruit and vegetable consumption. Am J Prev Med. 2009, 36: 402-409.CrossRefPubMed Hall JN, Moore S, Harper SB, Lynch JW: Global variability in fruit and vegetable consumption. Am J Prev Med. 2009, 36: 402-409.CrossRefPubMed
46.
go back to reference United States Department of Agriculture: 2007 Census of Agriculture United States Summary and State Data. Geographic Area Series Part 51. 2009, 1: United States Department of Agriculture: 2007 Census of Agriculture United States Summary and State Data. Geographic Area Series Part 51. 2009, 1:
47.
go back to reference Terry P, Terry JB, Wolk A: Fruit and vegetable consumption in the prevention of cancer: an update. J Intern Med. 2001, 250: 280-290.CrossRefPubMed Terry P, Terry JB, Wolk A: Fruit and vegetable consumption in the prevention of cancer: an update. J Intern Med. 2001, 250: 280-290.CrossRefPubMed
48.
go back to reference Blanck HM, Gillespie C, Kimmons JE, Seymour JD, Serdula MK: Trends in fruit and vegetable consumption among U.S. men and women, 1994–2005. Prev Chronic Dis. 2008, 2: A35- Blanck HM, Gillespie C, Kimmons JE, Seymour JD, Serdula MK: Trends in fruit and vegetable consumption among U.S. men and women, 1994–2005. Prev Chronic Dis. 2008, 2: A35-
49.
go back to reference Liese AD, Weis KE, Pluto D, Smith E, Lawson A: Food store types, availability, and cost of foods in a rural environment. J Am Diet Assoc. 2007, 107: 1916-1923.CrossRefPubMed Liese AD, Weis KE, Pluto D, Smith E, Lawson A: Food store types, availability, and cost of foods in a rural environment. J Am Diet Assoc. 2007, 107: 1916-1923.CrossRefPubMed
50.
go back to reference Glanz K, Sallis JF, Saelens BE, Frank LD: Healthy nutrition environments: concepts and measures. Am J Health Promot. 2005, 19: 330-333. iiCrossRefPubMed Glanz K, Sallis JF, Saelens BE, Frank LD: Healthy nutrition environments: concepts and measures. Am J Health Promot. 2005, 19: 330-333. iiCrossRefPubMed
52.
go back to reference Deshmukh-Taskar P, Nicklas TA, Yang SJ, Berenson GS: Does food group consumption vary by differences in socioeconomic, demographic, and lifestyle factors in young adults? The Bogalusa Heart Study. J Am Diet Assoc. 2007, 107: 223-234.CrossRefPubMedPubMedCentral Deshmukh-Taskar P, Nicklas TA, Yang SJ, Berenson GS: Does food group consumption vary by differences in socioeconomic, demographic, and lifestyle factors in young adults? The Bogalusa Heart Study. J Am Diet Assoc. 2007, 107: 223-234.CrossRefPubMedPubMedCentral
53.
go back to reference Patterson BH, Harlan LC, Block G, Kahle L: Food choices of whites, blacks, and Hispanics: data from the 1987 National Health Interview Survey. Nutr Cancer. 1995, 23: 105-119.CrossRefPubMed Patterson BH, Harlan LC, Block G, Kahle L: Food choices of whites, blacks, and Hispanics: data from the 1987 National Health Interview Survey. Nutr Cancer. 1995, 23: 105-119.CrossRefPubMed
54.
go back to reference Gans KM, Burkholder GJ, Risica PM, Lasater TM: Baseline fat-related dietary behaviors of white, Hispanic, and black participants in a cholesterol screening and education project in New England. J Am Diet Assoc. 2003, 103: 699-706.CrossRefPubMed Gans KM, Burkholder GJ, Risica PM, Lasater TM: Baseline fat-related dietary behaviors of white, Hispanic, and black participants in a cholesterol screening and education project in New England. J Am Diet Assoc. 2003, 103: 699-706.CrossRefPubMed
55.
go back to reference Champagne CM, Bogle ML, McGee BB, Yadrick K, Allen HR, Kramer TR, Simpson P, Gossett J, Weber J, Lower Mississippi Delta Nutrition Intervention Research Initiative: Dietary intake in the lower Mississippi delta region: results from the foods of our delta study. J Am Diet Assoc. 2004, 104: 199-207.CrossRefPubMed Champagne CM, Bogle ML, McGee BB, Yadrick K, Allen HR, Kramer TR, Simpson P, Gossett J, Weber J, Lower Mississippi Delta Nutrition Intervention Research Initiative: Dietary intake in the lower Mississippi delta region: results from the foods of our delta study. J Am Diet Assoc. 2004, 104: 199-207.CrossRefPubMed
56.
go back to reference Larson NI, Story MT, Nelson MC: Neighborhood environments: disparities in access to healthy foods in the U.S. Am J Prev Med. 2009, 36: 74-81.CrossRefPubMed Larson NI, Story MT, Nelson MC: Neighborhood environments: disparities in access to healthy foods in the U.S. Am J Prev Med. 2009, 36: 74-81.CrossRefPubMed
57.
go back to reference Morton LW, Blanchard C: Starved for access: life in rural America’s food deserts. Rural Real. 2007, 1: 1-10. Morton LW, Blanchard C: Starved for access: life in rural America’s food deserts. Rural Real. 2007, 1: 1-10.
Metadata
Title
A cross-sectional study of US rural adults’ consumption of fruits and vegetables: do they consume at least five servings daily?
Authors
M Nawal Lutfiyya
Linda F Chang
Martin S Lipsky
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-280

Other articles of this Issue 1/2012

BMC Public Health 1/2012 Go to the issue