Definition

The percentage of adults who reported consuming vegetables at least 3 times per day in the past month.

Numerator

The number of survey respondents who reported consuming vegetables at least 3 times per day in the past month.

Denominator

The total number of survey respondents.

Data Interpretation Issues

Vegetable questions were revised in 2011, so rates cannot be compared with the years prior to 2011. To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology in 2010 and began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method.

Why Is This Important?

Vegetables contain essential vitamins, minerals, fiber, and other compounds that may help prevent many chronic diseases. Compared with people who consume a diet with only small amounts of fruits and vegetables, those who eat more generous amounts as part of a healthful diet are likely to have reduced risk of chronic diseases, including stroke and perhaps other cardiovascular diseases, and certain cancers.^1^ Fruits and vegetables also help people to achieve and maintain a healthy weight because they are relatively low in energy density.^2^ To promote health and prevent chronic diseases, the U.S. Department of Agriculture recommends 2.5 cups of vegetables per day in a standard 2,000-calorie diet for those between the ages of 19 and 59.^3^ Specific recommendations based on an individual's age, gender, and activity level can be found in the [https://www.dietaryguidelines.gov/resources/2020-2025-dietary-guidelines-online-materials/ 2020-2025 Dietary Guidelines for Americans].[[br]] [[br]] ---- 1. MyPlate U.S. Department of Agriculture [https://www.myplate.gov/eat-healthy/vegetables/ "Vegetables"][[br]] 2. CDC [https://www.cdc.gov/healthy-weight-growth/healthy-eating/index.html "Tips for Healthy Eating for a Healthy Weight"] [[br]] 3. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at [https://www.dietaryguidelines.gov/ Dietary Guidelines for Americans].

Other Objectives

[https://health.gov/healthypeople/objectives-and-data/browse-objectives/nutrition-and-healthy-eating/increase-vegetable-consumption-people-aged-2-years-and-older-nws-07/healthy-people-in-action '''Healthy People 2030 Objective NWS-07''']:[[br]] Increase vegetable consumption by people aged 2 years and older.[[br]] '''U.S. Target''': 0.84 cup equivalents per 1,000 calories[[br]] [[br]] Increase the proportion of persons aged 18 years and older who consume vegetables at least 3 times a day.[[br]] '''Utah Target:''' 18%

How Are We Doing?

Only 12.6% of Utah adults in 2021 reported eating vegetables 3 or more times a day in the past month (age-adjusted rate). The percentage of adults consuming 3 servings of vegetables per day has generally declined since 2012 in Utah (18.2% in 2012 vs. 12.6% in 2021).

How Do We Compare With the U.S.?

The percentage of adults consuming 3 servings of vegetables per day in Utah (12.6%) is less than the national average (13.7%) in 2021.

What Is Being Done?

The Utah Department of Health and Human Services Healthy Environments Active Living (HEAL) Program plays a key role in improving the health of residents in the state of Utah. The program was formed in July 2013 (as Healthy Living through Environment, Policy, and Improved Clinical Care: EPICC), through a new funding opportunity from the Centers of Disease Control and Prevention (CDC). This allowed for the merging of three previously existing programs: the Heart Disease and Stroke Prevention Program, the Diabetes Prevention and Control Program, and the Physical Activity, Nutrition and Obesity Program, as well as the addition of a school health program. HEAL was recently restructured as part of a strategic planning process. This new program model focuses on staff and partners working together to address the social determinants of health while advancing health equity and increasing policy, systems, and environmental changes. HEAL works: In schools:[[br]] HEAL encourages [https://heal.utah.gov/schools/ schools] to adopt the [https://www.cdc.gov/healthyschools/professional_development/e-learning/CSPAP/index.html/ Comprehensive School Physical Activity Program]. This framework encourages students to be physically active for 60 minutes a day through school, home, and community activities. HEAL also works with schools to apply the [https://www.cdc.gov/healthyschools/wscc/index.htm/ Whole School, Whole Community, Whole Child Model], which emphasizes the role of the community in supporting academic and health success for students. In worksites:[[br]] HEAL offers training on developing worksite wellness programs called Work@Health. HEAL partners with local health departments to encourage worksites to complete the CDC Scorecard and participate in yearly health risk assessments for their employees. HEAL provides toolkits and other resources for employers interested in implementing wellness programs at [https://heal.utah.gov/worksite-wellness/ Worksite Wellness]. In communities:[[br]] HEAL receives federal funding to partner with worksites, community-based organizations, and local health departments to increase access to [https://heal.utah.gov/nutrition/ fresh fruits and vegetables] in worksite and community settings. HEAL also partners with local health departments to work with cities and/or counties within their jurisdictions to foster a built environment that encourages [https://heal.utah.gov/physical-activity/ physical activity]. In healthcare:[[br]] HEAL works with health care systems to establish community clinical linkages to support individuals [https://heal.utah.gov/diabetes/ at risk for or diagnosed with diabetes] or hypertension to engage in lifestyle change programs such as chronic disease self-management and diabetes prevention programs. In childcare:[[br]] HEAL works with state and local partners through the Childcare Obesity Prevention workgroup to implement policy and systems changes in early care and education across agencies statewide. Ten local health departments statewide have implemented the [https://heal.utah.gov/top-star-providers/ TOP Star Program], which aims to improve the nutrition, physical activity, and breastfeeding policies and environments to achieve best practices in childcare centers and homes.

Available Services

Visit [http://heal.utah.gov/ HEAL website] for more information. The [http://www.choosemyplate.gov/ USDA My Plate] food guidance system provides consumer tools in English and Spanish to meet the Dietary Guidelines for Americans, including individualized plans, tools to track intake, and plans for early childhood, pregnancy, and lactation. The [https://www.uspm.com/fruits-and-veggies-more-matters/ Fruits and Veggies: More Matters] and [http://www.pbhfoundation.org/ Produce for Better Health] websites include educational brochures, recipes, and consumer tips for selecting, storing, and preparing vegetables.

Health Program Information

HEAL is a program within the Utah Department of Health and Human Services Office of Health Promotion and Prevention. HEAL focuses on enabling education and promoting change for public health by engaging its three main audiences: individuals, partners, and decision makers. HEAL champions public health initiatives and addresses the challenges of making health awareness and access truly universal and equitable in eight key areas: nutrition, heart health, diabetes, physical activity, schools, childcare, community health workers, and worksites. Staff from the HEAL Program work with healthcare providers, including diabetes educators, dietitians, pharmacists, community health centers, community health workers, worksites, and health plans to improve the care provided to Utahns across the state. [https://heal.utah.gov/about-us/ '''Overarching Goals''']:[[br]] Healthy People: Increase access to resources that empower all people in Utah to reach their full health potential. Healthy Communities: Increase the capacity of communities to support and promote healthy living for all individuals. Equitable Society: Increase opportunities for people who are under-resourced and under-represented in Utah to live healthy and thriving lives.

Relevant Population Characteristics

Adults with highest vegetable consumption were women, adults with high levels of education, and adults with high levels of income.

Risk Factors

There is some evidence that people who develop the habit of eating fruits and vegetables early in life are likely to maintain the behavior as adults.[[br]] [[br]]

Health Status Outcomes

People who eat few fruits and vegetables are at higher risk for developing several types of cancer, heart disease, stroke, and other chronic diseases.

The percentage of adults consuming three servings of vegetables per day have had a slight downward trend for both Utah and the U.S. since 2011. Data are collected in odd years.

Data Notes

In 2011, the BRFSS changed its methodology from a landline only sample and weighting based on post-stratification to a landline/cell phone sample and raking as the weighting methodology. Raking accounts for variables such as income, education, marital status, and home ownership during weighting and has the potential to more accurately reflect the population distribution. Due to changes in both sampling and the vegetable consumption question format, 2011 data should not be compared to previous years. U.S. data do not include U.S. territories, but do include District of Columbia. Age-adjusted to U.S. 2000 standard population.

Asian adults (18.8%) had the highest rate of consuming vegetables three or more times a day. This view combines two years of data (2019 and 2021) to obtain reliable estimates. Rates for American Indian and Alaskan Native adults are based on small numbers and to not meet standards for reliability.

Data Notes

Age-adjusted to U.S. 2000 standard population based on 3 age groups: 18-34, 35-49, and 50+. *Use caution in interpreting; the estimate has a coefficient of variation > 30% and is therefore deemed unreliable by Utah Department of Health and Human Services standards. The data for this indicator are collected only in odd years. This view combines two years of data to get reliable estimates. Note the total for the state refers to two years of combined data. Other indicators for vegetable consumption may have sufficient data for reliable estimates with one year of data.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]

Hispanic adults had a lower rate of consuming three servings of vegetables daily than non-Hispanic adults and Utahns overall.

Data Notes

Age-adjusted to U.S. 2000 standard population.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]

None of the local health districts had a rate of vegetable consumption that was statistically significantly different from the state rate.

Data Notes

Age-adjusted to U.S. 2000 standard population.[[br]]

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]

Females have higher rates of eating vegetables three or more times a day than males across every age group. The overall crude rate of consuming vegetabes 3 or more times a day for 2021 was 12.4% (not shown in the table).

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]

There was considerable variation in the percentage of adults consuming vegetables three or more times a day by Utah Small Area.

Data Notes

Age-adjusted to U.S. 2000 standard population. A description of the Utah Small Areas may be found on the Methodology and Guidelines page: [https://ibis.utah.gov/ibisph-view/resource/Guidelines.html].

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]

Adults in high-income households had higher rates of vegetable consumption than adults in low-income households.

Data Notes

Age-adjusted to U.S. 2000 standard population.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]

Adults who were college graduates had higher rates of consuming vegetables three or more times a day than adults with lower levels of education. Rates shown for this indicator are limited to adults aged 25 and over.

Data Notes

Age-adjusted to U.S. 2000 standard population. Percentages include only adults aged 25 or older.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]

References and Community Resources

CDC. ''Healthy Habits: Fruits and Vegetables to Manage Weight'' [https://www.cdc.gov/healthy-weight-growth/healthy-eating/fruits-vegetables.html] World Cancer Research Fund, American Institute for Cancer Research. [https://www.wcrf.org/dietandcancer/about/ Diet, Nutrition, Physical Activity and Cancer: a Global Perspective.] October 2018. [https://www.dietaryguidelines.gov/resources/2020-2025-dietary-guidelines-online-materials]