Inter- and independent effects of region and race/ethnicity on variety of fruit and vegetable consumption in the USA: 2011 Behavioral Risk Factor Surveillance System (BRFSS).

OBJECTIVE
(i) To estimate the independent and combined effects of race/ethnicity and region on the variety of fruits and vegetables consumed in the USA in 2011; and (ii) to assess whether and to what extent race/ethnicity and region may synergistically influence variety of fruit and vegetable consumption.

DESIGN
Cross-sectional analysis. Multivariate logistic regression predicted the likelihood of meeting fruit and vegetable variety indicators independently and in combination for each race/ethnicity and region. Interaction effects models were used to test for interaction effects between race/ethnicity and region on fruit and vegetable variety.

SETTING
The 2011 Behavioral Risk Factor Surveillance System (BRFSS).

SUBJECTS
The sample consisted of 275 864 adult respondents.

RESULTS
Fewer than half of respondents consumed fruit and all vegetable subcategories at least once weekly. The adjusted likelihood of meeting fruit and vegetable variety indicators varied significantly by race/ethnicity and region (P<0·05). Significant interactions between race/ethnicity and region were found for at least once weekly consumption of beans, orange vegetables, all vegetables, and fruit and all vegetables (P<0·05).

CONCLUSIONS
Our results reinforce previous findings that the variety of vegetable consumption is lacking and is particularly evident among some population subgroups, such as non-Hispanic blacks in the Midwest USA, who may benefit from targeted dietary interventions.