Improving Fruit and Vegetable Accessibility, Purchasing, and Consumption to Advance Nutrition Security and Health Equity in the United States

Abstract

In recent years, national and local efforts to improve diet and health in the United States have stressed the importance of nutrition security, which emphasizes consistent access to foods and beverages that promote health and prevent disease among all individuals. At the core of this endeavor is fruit and vegetable (FV) consumption, a dietary practice that is integral to attaining and sustaining a healthy diet. Unfortunately, significant inequities in FV accessibility, purchasing, and consumption exist, particularly among populations that are socially and economically disadvantaged. To achieve nutrition and health equity in the United States, the field must center the goal of nutrition security and initiatives that aim to increase FV consumption, specifically, in future work. The International Journal of Environmental Research and Public Health (IJERPH) Special Issue titled “Nutrition and Health Equity: Revisiting the Importance of Fruit and Vegetable Availability, Purchasing, and Consumption” features several scholarly publications from experts conducting timely research on these topics. In this commentary, we (1) summarize the U.S.-based literature on inequities in FV accessibility, purchasing, and consumption, (2) describe how the contributions to this IJERPH special issue can advance nutrition security and health equity, and (3) outline future research questions from our perspective.

Association between Fresh Fruit and Vegetable Consumption and Purchasing Behaviors, Food Insecurity Status and Geographic Food Access among a Lower-Income, Racially/Ethnically Diverse Cohort in Central Texas

“…Some scholars have found that Hispanics living in the US have greater fruit and vegetable consumption than non-Hispanic whites in studies using nationally representative data and in contexts such as New York City [ 23 , 28 , 29 ]. However, this interaction between race/ethnicity, food insecurity status, and fruit and vegetable consumption validates the call by Houghtaling and colleagues (2022) and Singleton and collaborators (2020) for using an intersectional approach that accounts for various sociodemographic characteristics simultaneously when examining behaviors such as fruit and vegetable consumption and purchasing [ 8 , 10 ].…”

“…This high prevalence of food insecurity is a public health concern, given that poor diet and health conditions such as undernutrition, anemia, obesity, diabetes, hypertension, and others have all been found to be directly associated with food insecurity [ 4 , 5 , 6 , 7 ]. Therefore, it is incredibly important to the advancement of field of public health nutrition and community health to further investigate food insecurity, various indicators, and how food insecurity could impact behaviors associated with chronic disease development, such as dietary behaviors [ 8 , 9 , 10 , 11 ].…”

“…These disparities are particularly concerning given the impact of food insecurity and low-quality diet on health, as mentioned previously. However, a commentary by Houghtaling and colleagues (2022) has called for greater exploration of the role of intersectionality, meaning the converging influence of multiple sociodemographic factors that simultaneously exist within an individual [ 31 ], and fruit and vegetable consumption [ 8 ].…”

Implementation of Food is Medicine Programs in Healthcare Settings: A Narrative Review

“…While higher fruit and vegetable (FV) intake is associated with positive health outcomes, 1 most adults in the United States (US) do not meet FV intake recommendations as advised by the Dietary Guidelines for Americans. 2,3 Racial and ethnic minority populations with low income face greater challenges in accessing FVs due to structural inequities, [4][5][6][7][8] contributing to a disproportionate burden of diet-related chronic disease. 1,9 Food and nutrition security strategies that ensure all Americans have consistent access to healthy foods to prevent or treat diet-related chronic disease 10 are gaining attention as a national priority 11 to supplement other forms of federal food assistance, such as the Supplemental Nutrition Assistance Program (SNAP).…”