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The Relationship Among Fruit and Vegetable Consumption, Exercise, and

Perceived Health Status: Assessing 2009 BRFSS Data


Dana Beals, BS, Catalina Esqueda, BS, Keya Sartin, BS, & Amber Haroldson, PhD, RD
Department of Family and Consumer Science, Ball State University, Muncie, IN

BACKGROUND

The aim of this study was to identify the relationship between


daily fruit/vegetable consumption and perceived health status,
controlling for physical activity through examination of national
data from the 2009 BRFSS. It was hypothesized that greater
daily fruit and vegetable consumption would be associated with
a more positive perception of overall health regardless of the
amount of physical activity an individual performed.

METHODS

34.5

35
31.9 31.6
30

25

27.9

Individuals with the best self-reported health were those


who both exercised and consumed six or more servings of
fruits and vegetables every day

27.1

22.8
20.8

Excellent
Very Good
Good
Fair
Poor

20

15
10.9
10
6.0
5

1.2

n=306449
76%

6<

Servings of Fruits and Vegetables per Day

Figure 2. Reported Health Status and Fruit/Vegetable Consumption of Adults


Participating in Vigorous Activity for 20 or more Minutes/Day

35.8
35

32.4

33.5

30.2

Excellent
Very Good
Good
Fair
Poor

23.5
19.5

20

19.3
15.4

15

13.8

12.4

13.2

8.8

10

5.2

5
5

0
0-1

6<

Servings of Fruits and Vegetables per Day

Of individuals that reported exercising for at least 20 minutes


each day, 37.8% of those consuming 6 or more fruits felt as
though they were in excellent health, while only 22.8% of
individuals that consumed 0-1 servings per day reported feeling
they were in excellent health
Met Exercise
Standard
Did not meet
Exercise Standard

Not all questions are asked every year; 2009 was the last
time fruit and vegetable intake data was collected
nationally

Strengths include large sample size and national outreach

32.2

30

25

Individuals may report a healthier lifestyle than they are


actually leading

CONCLUSIONS

40

Figure 3. Reported Health Status and Fruit/Vegetable Consumption of Adults


Not Participating in Vigorous Activity for 20 or more Minutes/Day

RESULTS

n=95419
24%

These results coincide with other research, linking fruits


and vegetables to an overall healthy eating pattern and
general health
Limitations include relying on self-reported data as a
measure of health, question wording during intake, and
collection of data via telephone

5.7

2.9

0-1

BRFSS data was analyzed through cross tabulation using the


Web Enabled Analysis Tool (WEAT).The BRFSS uses yearly
telephone surveys to collect health-related information about
U.S. residents. Random digit dialing is used to obtain telephone
numbers. Cellular telephones were not included in the 2009
sample. The data used in this analysis covers all 50 states, the
District of Columbia, and three U.S. territories. The total
sample size was n=401,918. Participants who take part in this
study are 18 years of age or older, and they are not compensated
monetarily. Only one adult per household is surveyed. The data
was weighted using post stratification to known proportions of
age, race and ethnicity, sex, [and] geographic region within a
population (BRFSS Frequently Asked Questions). The chosen
variables were fruit/vegetables (servings daily) and health status
(excellent, very good, good, fair, poor), controlling for physical
activity (reported participating in vigorous activity for 20 or
more minutes per day, at least three times a week). The
significance level was set to 0.05.

Survey responses are collected via telephone in all 50


states from more than 400,000 adults annually

Fruit and vegetable consumption is widely associated with


an overall healthy status

DISCUSSION

37.8

The Behavioral Risk Factor Surveillance System (BRFSS)


is a self-reported, national survey comprised of healthrelated questions

In addition to the core questions, each state can add


optional modules

37.9

1.1

Reported General Health Status (%)

The aim of this study was to identify the relationship between


daily fruit/vegetable consumption and perceived health status,
controlling for physical activity, through examination of
national data from the 2009 Behavioral Risk Factor
Surveillance System (BRFSS). Data was analyzed using the
Web Enabled Analysis Tool (cross tabulation) to determine
whether daily fruit/vegetable consumption was associated with
a personal feeling of overall wellness regardless of physical
activity. Categorical responses to the questions How often do
you eat fruits/vegetables? were compared to the 5-point Likert
scale responses to perceived health status (excellent, very good,
good, fair, poor), while controlling for physical activity
(reported participation in vigorous activity for 20 or more
minutes/day at least 3 times/week). Results indicated that, of
individuals reporting to meet the exercise standard and
consuming 0 to 1 servings of fruit/vegetables per day, 22.8%
felt they were in excellent general health, while 37.8% of
individuals with similar exercise habits, but consuming 6 or
more servings felt they were in excellent health. Results for
individuals who did not meet the exercise standard, with
comparable fruit/vegetable intake, indicated that 12.4% and
19.3% felt they were in excellent general health, respectively.
When stratified for other fruit/vegetable intake, similar patterns
were observed. When paired with regular exercise, consuming
the recommended fruit/vegetable servings per day is associated
with a better feeling of overall health status. Dietitians must
continue to promote regular exercise and incorporation of
fruit/vegetable consumption to their clients.

AIM
Reported General Health Status (%)

ABSTRACT

40

Of those reporting not exercising at least 20 minutes each day,


19.3% of individuals that consumed 6 or more fruits and
vegetables per day reported excellent health, compared to
12.4% of those who consumed one serving or less of fruits and
vegetables

Regular exercise combined with consuming the


recommended servings of fruit and vegetables contributes
to a greater feeling of overall wellness
Dietitians should continue to encourage individuals to
consume the daily recommended amount of fruit and
vegetables in addition to regular exercise for optimal
health
Further research should be conducted using different
methods to assess health instead of self-reporting, such as
weight, BMI, lipid profile, and blood pressure

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Figure 1. Percentage of sample participants exercising/not exercising for 20


minutes per day for a minimum of 3 times per week

U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 2020
Dietary Guidelines for Americans. 8th Edition.; 2015.
http://health.gov/dietaryguidelines/2015/guidelines/.
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