Morbidity and Mortality Weekly Report
Weekly / Vol. 59 / No. 35 September 10, 2010

State-Specific Trends in Fruit and Vegetable Consumption Among Adults — United States, 2000–2009
A diet high in fruits and vegetables can reduce the risk for many leading causes of death (1–3) and can play an important role in weight management (4). Healthy People 2010 objectives for fruits and vegetables include targets of increasing to 75% the proportion of persons aged ≥2 years who consume two or more servings of fruit daily and to 50% those who consume three or more servings of vegetables daily.* To assess states’ progress over the past decade in meeting these targets among adults and to provide an update of the 2005 subgroup estimates (5), CDC analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS). This report describes the results of that analysis, which indicated that, in 2009, an estimated 32.5% of adults consumed fruit two or more times per day and 26.3% consumed vegetables three or more times per day, far short of the national targets. Overall, the proportion of adults who met the fruit target declined slightly, but significantly, from 34.4% in 2000 to 32.5% in 2009; no significant change was observed in meeting the vegetable target. No state met either target, and substantial variability occurred among states. Only one state had statistically significant increases in the percentages of adults meeting each target. These findings underscore the need for interventions at national, state, and community levels, across multiple settings (e.g., worksites, community venues, and restaurants) to improve fruit and vegetable access, availability, and affordability, as a means of increasing individual consumption. BRFSS is an ongoing, state-based, telephone survey of the noninstitutionalized U.S. civilian population aged ≥18 years. Data are used to monitor the prevalence of health behaviors and progress toward national and state-specific health objectives. BRFSS uses a multistage design based on random-digit dialing methods to gather a representative sample from each state. Data were included from all 50 states and the District of Columbia (DC) for years in which the fruit and vegetable
* Objectives 19-5 and 19-6. Additional information available at http://www. healthypeople.gov/document/pdf/volume2/19nutrition.pdf.

module was included in the core survey: 2000 (N = 179,139), 2002 (N = 238,852), 2003 (N = 255,657), 2005 (N = 347,278), 2007 (N = 420,217), and 2009 (N = 420,968). Median survey response rates by state, calculated using Council of American Survey Research Organizations (CASRO) guidelines,† were 48.9% (range: 28.8%–71.8%) for 2000 and 52.5% (range: 37.9–66.9%) for 2009. Median cooperation rates were 53.2% (range: 35.5%–77.7%) for 2000 and 75.0% (range: 55.5%– 88.0%) for 2009. For each survey year, prevalence estimates were weighted to the respondent’s probability of being selected for the age-, race-, and sex-specific distributions for the state based on U.S. Census data. Logistic regression analysis was used to assess temporal changes in consumption during 2000–2009, including year as a continuous variable and controlling for changes in state distributions of age through standardization to the 2000 U.S. standard population; a p-value of