The Fruit and Vegetable Consumption Challenge: How Federal Spending Falls Short of Addressing Public Health Needs

This report was developed to determine the extent to which the United States federal government has made fruits and vegetables (FV) a national public health priority. High-level federal officials from the US Department of Agriculture (USDA) and the US Department of Health and Human Services (HHS) have extolled the health benefits of increased fruit and vegetable consumption and reiterated the need to commit additional federal resources to close the consumption gap that exists. Whether or not federal actions have been consistent with that rhetoric can largely be answered through an examination of federal spending data. The results:

There is an Ongoing Fruit and Vegetable Consumption Gap

An analysis of the latest USDA food-use data shows that the average American consumes only 43% of the daily intake of fruit and only 57% of vegetables, as recommended in the Dietary Guidelines, an average of 51% of the recommended levels for FV combined. Fruit and vegetable consumption has remained relatively flat for the past 20 years.

The Public Health and Economic Stakes Associated With
the Fruit and Vegetable Consumption Gap Are Very
High and Growing Rapidly

An economic analysis in the report shows that the health care and other costs of inadequate fruit and vegetable consumption for just three diet-related, chronic diseases—coronary heart disease, stroke, and cancer—grew by 92% between Fiscal Year (FY) 1999 and FY 2008 and currently stands at $56 billion a year.

The Large USDA Fruit and Vegetable Spending Gap
Parallels the Consumption Gap and Is Inconsistent with
Dietary Guideline Priorities

The analysis found that USDA spends more than twice the amount of its funds on the meat group, which comprises only 8% of the daily servings recommended in the Dietary Guidelines, than it spends on FV, which comprise 41% of the daily recommended food servings. USDA would have to more than double its spending for FV (by adding $3.6 billion) to bring USDA food group spending in line with Dietary Guideline recommendations.

A Large Gap in Spending on Nutrition Education
Reinforces the Fruit and Vegetable Consumption Gap

USDA spending on nutrition education for low-income Americans, which promotes the consumption of FV, represents only 1.3% of total spending on nutrition assistance programs, despite the fact that the fruit and vegetable consumption gap has historically been higher than average for that segment of our population. At the National Institutes of Health (NIH), nutrition education research also continues to be a very low funding priority. As a percentage of its nutrition projects, NIH nutrition education projects overall comprise 1%, while nutrition education projects specifically promoting fruit and vegetable consumption comprise less than 1%.

Fruits and Vegetables Are a Low Priority at HHS Despite the Health Risks of the Consumption Gap

NIH spending for fruit and vegetable research associated with three major chronic diseases (i.e., cancer, coronary heart disease, and stroke) accounted for 0.78% (less than one percent) of total research spending on those diseases, despite the fact that inadequate fruit and vegetable consumption accounts for 6%-20% of the risk associated with those illnesses. A comparison of the respective health risks of inadequate fruit and vegetable consumption with tobacco use found that both NIH and CDC grossly under-fund fruit and vegetable related programs and that both spend a higher, disproportionate amount on anti-tobacco projects.

Nearly $5 Billion in Cost-Effective Annual Spending
Would Be Needed to Close the Total Federal Fruit and
Vegetable Spending Gap

In the financial year 2008, USDA, NIH, and the CDC spent about $126 billion on activities related to food, agriculture, and public health. Less than 3% of those combined budgets was spent on programs and projects related directly to FV. Closing the fruit and vegetable consumption gap will require closing the fruit and vegetable spending gap. USDA and HHS would have to more than double their spending on fruit and vegetable related projects, an increase of about $4.8 billion, to close the total fruit and vegetable spending gap. By comparison, the $56.3 billion annual economic cost of the fruit and vegetable consumption gap with respect to cancer, coronary heart disease, and stroke is nearly 12 times the amount needed to close the fruit and vegetable spending gap.

Data for most of the analyses undertaken in this report were obtained from federal sources or secondary sources that provided federal data and estimates. Recommended levels of daily servings of each of the major food groups for the average American were derived from the 2005 U.S. Dietary Guidelines for Americans. Per capita food consumption data were obtained from the “U.S. Per Capita Loss-Adjusted Food Availability” website of USDA’s Economic Research Service. USDA spending data for food group specific programs were drawn from federal budget documents, the websites of the Agricultural Marketing Service, the Farm Security Agency and the Food and Nutrition Service, USDA’s CRIS research website, the Environmental Working Group’s Farm Subsidy Database, and numerous USDA agency documents. NIH and CDC spending data were obtained from federal budget and appropriations documents and the NIH Reporter website. Other data on NIH research projects were drawn from the NIH Reporter website. Estimates of the contributions of diet and the fruit and vegetable consumption gap to the risk of coronary heart disease, cancer, and stroke were obtained from the scientific literature, nonprofit public health organizations’ websites, and federal sources. Inflation factors used throughout the report were computed from the Bureau of Labor Statistics’ Consumer Price Index website.

The full report can be found at: