Jennifer Seymour

Trends in Fruit and Vegetable Consumption Among Adults in the United States: Behavioral Risk Factor Surveillance System, 1994–2000

OBJECTIVES We examined trends in fruit and vegetable consumption in the United States. METHODS A 6-item food frequency questionnaire was used to assess consumption among 434 121 adults in 49 states and the District of Columbia who were sampled in random-digit-dialed telephone surveys administered in 1994, 1996, 1998, and 2000. RESULTS Although the geometric mean frequency of fruit and vegetable consumption declined slightly, the proportion of respondents consuming fruits and vegetables 5 or more times per day did not change. With the exception of the group aged 18 to 24 years, which experienced a 3-percentage-point increase, little change was seen among sociodemographic subgroups. CONCLUSIONS Frequency of fruit and vegetable consumption changed little from 1994 to 2000. If increases are to be achieved, additional efforts and new strategies will be needed.

Reductions in Dietary Energy Density as a Weight Management Strategy

Reducing caloric intake is the cornerstone of dietary therapy for long-term healthy weight management. Strategies individuals have typically used include limiting portion sizes, food groups, or certain macronutrients. Although such restrictive approaches can lead to weight loss in the short term, they can result in feelings of hunger or dissatisfaction, which can limit their acceptability, sustainability, and long-term effectiveness. An alternative positive strategy to manage energy intake is for individuals to eat more foods that are low in calories for a given measure of food—that is, they are low in energy density (kcal/g). Data have shown that people eat a fairly consistent amount of food on a day-to-day basis; therefore, the energy density of the foods an individual consumes influences energy intake. Encouraging patients to eat more foods low in energy density and to substitute these foods for those higher in energy density allows them to decrease their energy intake while eating sati sfying portions, thereby controlling hunger and lowering energy intake. This type of diet fi ts with the current Dietary Guidelines for Americans in that it incorporates high quantities of fruits, vegetables, and fiber, which are often suboptimal in typical low-calorie diets, and it provides ample intakes of numerous micronutrients. Moreover, studies have found that individuals who consume lower-energy-dense diets consume more food by weight and have lower body weights compared with individuals who consume higher-energy-dense diets. This chapter reviews the evidence supporting the use of diets rich in low-energy-dense foods for weight management and provides practical approaches to lowering the energy density of the diet.