N° 79 | July 2013

Strategies to Increase Fruit and Vegetable Consumption

The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Higher intake of fruits and vegetables (F&V) may reduce the risk of many chronic diseases1 including heart disease2, stroke3, diabetes4, and some cancers5. In addition, replacing higher caloric foods with F&V may aid in a healthy weight management1,6,7. Policy and environmental changes that improve community access to and promotion of a wide variety of affordable, high quality F&V may make it easier for adults and children to choose and consume more F&V8.

The US Centers for Disease Control and Prevention (CDC) provided guidance on strategies that may increase F&V access and availability and ultimately consumption among Americans in The CDC Guide to Strategies to Increase the Consumption of Fruits and Vegetables9 summarized below.

Promote food policy councils:
Food policy councils and related coalitions provide support for improved food environments as a way to encourage healthy eating by bringing diverse stakeholders together to examine and develop recommendations for improvements to food systems.

Improve access to retail stores:
Access to retailers, including supermarkets, grocery stores, convenience stores, corner stores, specialty food stores, and mobile vending, may be improved through a variety of ways, including attracting new stores to underserved areas through financial incentives, improving transportation to these stores, and upgrading the facilities at existing stores.

Start or expand farm-to-institution programs:
Farm-to-institution programs and policies allow regional farms to sell F&V directly to community institutions such as schools, universities, medical centers, faith-based organizations, and government and non-government workplaces to facilitate access to fresh produce.

Start or expand farmers markets in all settings:
Farmers markets are a venue for selling products from regional farms and can augment access to F&V from typical retail stores or provide a retail venue for F&V in areas lacking such stores.

Start or expand community supported agriculture programs in all settings:
Community supported agriculture is a partnership between a farm and individuals in the community in which individuals generally pay a membership fee in return for a share of a farmer’s harvest.

Ensure access to F&V in workplace cafeterias and other food service venues:
Workplaces, including medical centers, universities, and other community and business establishments, can ensure that F&V are available at cafeterias and other on-site dining facilities and can implement strategies to promote F&V, such as preferential pricing and providing point-of-sale information.

Ensure access to F&V at workplace meetings and events:
Employers can ensure that FV are available at all meetings, conferences, and other workplace events and gatherings.

Support and promote community and home gardens:
Community gardens are collaborative projects created by community members in which participants share the maintenance and products of the garden. A home garden also yields produce to be eaten by individuals, and their families, neighbors, and friends.

Incorporate F&V activities into schools:
Schools can promote F&V consumption among students by incorporating activities such as gardening, farm to school, farm visits, F&V preparation, and tasting demonstrations into curricula.

Include F&V in emergency food programs:
Emergency food programs can improve client access to F&V by partnering with local grocery retailers, farmers markets and other venues to supply these foods and by getting donations of surplus F&V from individual farmers.

Elaboration of these strategies and examples are available in The CDC Guide to Strategies to Increase the Consumption of Fruits and Vegetables9. Additional resources and research provide more detail on interventions, strategies and best practices that may increase F&V access and availability10-13. The combined efforts of interventions spanning multiple sectors and across settings may be necessary to facilitate healthier choices among both children and adults14.

  1. United States Department of Agriculture, United States Department of Health and Human Services. Dietary Guidelines for Americans 2010. Washington, D.C.: U.S. Government Printing Office, December 2010.
  2. He FJ, Nowson CA, Lucas M, MacGregor GA. Increased consumption of fruit and vegetables is related to a reduced risk of coronary heart disease: meta-analysis of cohort studies. J Hum Hypertens. 2007;21(9):717-728.
  3. He FJ, Nowson CA, MacGregor GA. Fruit and vegetable consumption and stroke: metaanalysis of cohort studies. Lancet. Jan 28 2006;367(9507):320-326.
  4. Montonen J, Knekt P, Jarvinen R, Reunanen A. Dietary antioxidant intake and risk of type 2 diabetes. Diabetes care. Feb 2004;27(2):362-366.
  5. World Cancer Research Fund. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Washington DC: American Institute for Cancer Research 2007.
  6. Rolls BJ, Ello-Martin JA, Tohill BC. What can intervention studies tell us about the relationship between fruit and vegetable consumption and weight management? Nutrition reviews. Jan 2004;62(1):1-17.
  7. Tohill BC, Seymour J, Serdula M, Kettel-Khan L, Rolls BJ. What epidemiologic studies tell us about the relationship between fruit and vegetable consumption and body weight. Nutrition reviews. Oct 2004;62(10):365-374.
  8. Story MT, Kaphingst KM, Robinson-O’Brien R, Glanz K. Creating healthy food and eating environments: policy and environmental approaches. Annu Rev Public Health 2008;29(1):253–72.
  9. Centers for Disease Control and Prevention. Strategies to Prevent Obesity and Other Chronic Diseases: The CDC Guide to Strategies to Increase the Consumption of Fruits and Vegetables. Atlanta: U.S. Department of Health and Human Services; 2011.
  10. Kim SA, Grimm KA, May AL, Harris DM, Kimmons J, Foltz JL. Strategies for pediatric practitioners to increase fruit and vegetable consumption in children. Pediatr Clin North Am. 2011;58(6):1439-53.
  11. Centers for Disease Control and Prevention. Recommended Community Strategies and Measurements to Prevent Obesity in the United States. Mordibity and Mortality Weekly Report. 2009; 58(RR07):1-26.Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5807a1.htm.
  12. Foltz JL, May AL, Belay B, Nihiser AJ, Dooyema CA, Blanck HM. Population-Level Intervention Strategies and Examples for Obesity Prevention in Children. Annu. Rev. Nutr. 2012; 32:391–415.
  13. Foltz JL, Harris DM, Blanck HM. Support Among U.S. Adults for Local and State Policies to Increase Fruit and Vegetable Access. Am J Prev Med 2012;43(3S2):S102–S108.
  14. IOM (Institute of Medicine). 2012. Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation. Washtington, DC: The National Academics Press. Howlett A, Burton S, Newman C, Faupel A. The positive influence of state agricultural marketing programs on adults’ fruit and vegetable consumption. September/October 2012, Am J of Health Promot, 2012; Vol. 27: 17-20.
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