Less than 15 percent of U.S. adults eat enough fruits daily to meet federal recommendations, but the numbers are even worse in some states, dipping as low as 7.5 percent in Tennessee, according to a new study.
Even fewer adults eat enough vegetables to meet recommendations, Centers for Disease Control and Prevention (CDC) researchers found.
"Fruit and vegetable intake has been persistently low for years but we just recently developed a way to look at how each state is doing" in terms of meeting recommendations, said lead author Latetia V. Moore of the National Center for Chronic Disease Prevention and Health Promotion at the CDC.
"It is surprising how low intake is in some southern states but how disappointingly low it is across the U.S.," Moore told Reuters Health by email.
Moore and her coauthors analyzed the most recent Behavioral Risk Factor Surveillance System survey for all 50 states and the District of Columbia, using a new scoring procedure to compare state-reported numbers, which are usually expressed as "frequency of intake," to federal requirements, normally counted in "cups per day."
Overall, in 2013, half of respondents consumed fruit less than once per day and vegetables less than 1.7 times per day.
Researchers compared their responses to the Dietary Guidelines for Americans, which recommend that adults who get less than 30 minutes of moderate to vigorous physical activity each day should eat 1.5 to 2 cups of fruit and two to three cups of vegetables daily. More active people may be able to consume more without adding too many calories to their diet.
"All types of fruits and vegetables count, but the Dietary Guidelines for Americans recommend that most of our fruit intake come from whole fruit rather than fruit juice and that we eat fruits and vegetables that have limited amounts of added sugars and solid fat," Moore said. "The guidelines also recommend that we increase our intake of dark green and orange vegetables as well as beans."
Overall, 13 percent of people in the U.S. reported eating enough fruit and 8.9 percent reported eating enough vegetables to meet that recommendation.
Fruit consumption was lowest in Tennessee, with about seven percent of people meeting the recommendation, and highest in California, with 17.7 percent meeting the recommendation, Moore's team writes in CDC Morbidity and Mortality Weekly Report.
The proportion of Americans meeting vegetable recommendations ranged from 5.5 percent in Mississippi to 13 percent in California.
The results are limited in that they rely on self-reported food consumption, which may not always be accurate, and because they did not include those living in nursing homes, long-term care facilities, military installations and correctional institutions, the study team cautions.
It's also not possible to know whether these numbers represent an increase or decrease in fruit and vegetable consumption by state from the period prior to 2010, since the surveys changed the way they asked about produce consumption during that time, Moore said.
"We do know that how many times per day adults eat fruits and vegetables did not change much from 2000 to 2009," and that children did start eating more fruits, but not vegetables, during that time, she said.
Worksites, schools, childcare, and community settings should all have access to fruits and vegetables that are competitively priced, prominently displayed and promoted, she said.
"Fruits and vegetables are major contributors of important nutrients that are typically lacking from Americans' diets and they can protect against many leading causes of illness and death like heart disease, stroke and some cancers," Moore said. "Eating fruits and vegetables in place of foods that are high in calories, added sugars, and solid fat can also help with weight management."