Understanding barriers and facilitators of fruit and vegetable consumption among a diverse multi-ethnic population in the USA

Abstract

A diet high in fruits and vegetables (F&V) has been associated with a decreased risk of certain cancers, reduced morbidity and mortality from heart disease, and enhanced weight management. Yet to date, most of the US population does not consume the recommended amount of F&V despite numerous interventions and government guidelines to promote consumption. Research has found various impediments to F&V consumption, such as high costs, an obesogenic environment and low socio-economic status. However, studies have not sufficiently focused on barriers and enablers to F&V intake among adult multi-ethnic populations. The present qualitative study examines 147 focus group participants' perceptions of impediments and enablers to F&V consumption. Twelve focus groups were conducted among African American, Hispanic and Caucasian men and women in North Carolina and Connecticut. Focus groups were audiotaped, transcribed verbatim and entered into QSR NVivo Software. Text data were systematically analyzed by investigators to identify recurrent themes both within and across groups and states. Focus group results indicate that most participants were aware of the health benefits associated with a diet rich in F&V. Yet many admitted not adhering to the Health and Human Service's recommendations. Individual impediments consisted of the high costs of F&V and a perceived lack of time. Early home food environment was perceived as affecting F&V consumption later in life. Other barriers reported were ethnic-specific. The African American participants reported limited access to fresh produce. This finding is consistent with numerous studies and must be addressed through health promotion intervention. Both the church and primary care clinics were described by African Americans as appropriate settings for health behavior interventions; these findings should be considered. Hispanic participants, mostly immigrants, cited inhibiting factors encountered in their adopted US environment. There is a need to improve the availability and access to fresh F&V commonly available in the home countries of Hispanic immigrants.

Perceived quality and availability of fruit and vegetables are associated with perceptions of fruit and vegetable affordability among socio-economically disadvantaged women

“…women with low education, low income and/or residing in disadvantaged neighbourhoods) consume diets that are less consistent with guidelines for health, including lower consumption of fruit and vegetables (1)(2)(3) . One explanation for this socio-economic gradient in fruit and vegetable consumption is that women of low SEP are more likely than their more advantaged counterparts to perceive fruit and vegetables as expensive (4)(5)(6)(7)(8)(9)(10) . Women's perceptions of fruit and vegetable affordability, rather than actual prices of fruit and vegetables, have been found to significantly mediate the relationship between SEP and fruit and vegetable consumption (11,12) .…”

Barreiras e fatores promotores do consumo de frutas e hortaliças entre usuários do Programa Academia da Saúde

“…Essa inadequação no consumo de frutas e hortaliças perpassa por questões individuais, socioculturais, econômicas, agrícolas e ambientais 2 , sendo preço, tempo e sabor identificados como as principais barreiras [7][8][9][10][11][12][13][14][15][16] . Entretanto, alguns fatores têm-se mostrado capazes de estimular a ingestão desses alimentos, entre eles sua ação promotora da saúde, manutenção do peso saudá-vel, preferência alimentar e apoio famíliar 9,[12][13][14][15][16][17] .…”

“…Entretanto, alguns fatores têm-se mostrado capazes de estimular a ingestão desses alimentos, entre eles sua ação promotora da saúde, manutenção do peso saudá-vel, preferência alimentar e apoio famíliar 9,[12][13][14][15][16][17] .…”

“…Dentre as barreiras citadas, o alto custo é o mais recorrente na literatura [7][8][9][10][11][13][14][15] , em contrapartida ao poder aquisitivo, encontrado apenas em Eikenberry & Smith 9 e Lucan et al 15 . Cassady et al 25 chamam atenção para o fato do preço nem sempre ser o maior empecilho para o consumo de frutas e hortaliças entre a população de baixa renda.…”

Quanto custa para as famílias de baixa renda obterem uma dieta saudável no Brasil?

“…Dentre os motivos que levam aos altos custos dos alimentos frescos e saudáveis, estão os grandes investimentos em armazenamento por parte dos produtores e comerciantes, os gastos com transporte e o maior desperdício por serem altamente perecíveis 20,23 . O contrário acontece com alimentos ricos em energia que são geralmente secos e tendem a ter maior tempo de prateleira 20 .…”