The Association Between Fruit and Vegetable Intake, Knowledge of the Recommendations, and Health Information Seeking Within Adults in the U.S. Mainland and in Puerto Rico

Abstract

Health information correlates of fruit and vegetable intake and of knowledge of the fruit and vegetable recommendations were examined using bivariate and multivariate regressions with data from the 2007–2008 U.S. National Cancer Institute's Health Information National Trends Survey in the United States and in Puerto Rico. Residents from Puerto Rico had the lowest reported fruit and vegetable intake and the lowest knowledge of the recommended servings of fruits and vegetables to maintain good health, compared with U.S. Hispanics, non-Hispanic Whites, and Blacks. Sixty-seven percent of Puerto Rican residents and 62% of U.S. Hispanics reported never seeking information on health or medical topics. In multivariate analysis, those who never sought information on health or medical topics reported significantly lower fruit and vegetable intake (coefficient = −0.24; 95% CI [−0.38, −0.09]), and were less likely to know the fruit and vegetable recommendations (OR = 0.32; 95% CI [0.20, 0.52]), compared with those who obtained information from their health care providers. Health promotion initiatives in the United States and Puerto Rico have invested in mass media campaigns to increase consumption of and knowledge about fruit and vegetables, but populations with the lowest intake are less likely to seek information. Strategies must be multipronged to address institutional, economic, and behavioral constraints of populations who do not seek out health information from any sources.

Acknowledgments

U. Colón-Ramos conceptualized the paper, designed the study analysis, and led the drafting and revisions of the manuscript. L. J. Finney Rutten and A. P. Ortiz were involved in the design and acquisition of data for HINTS-Puerto Rico. L. J. Finney Rutten also completed the analyses and drafted the methods section. R. P. Moser contributed importantly to the interpretation and revisions of analysis and tables. V. Colón-Lopez, A. P. Ortiz, and A. L. Yaroch provided substantial guidance on analysis and interpretation of the data. All authors were involved in revising the manuscript for important intellectual content, and all have given final approval of the version to be published. The authors acknowledge Dr. Guillermo Tortolero-Luna for the general supervision of the research group and acquisition of funding for the data collection.

Notes

^a “How many servings of fruits and vegetables do you think the average adult should eat each day for good health?”

^b “How many servings of fruits (vegetables) do you usually eat or drink each day?”

^c “The most recent time you looked for information about health or medical topics, where did you go first?” (only asked of respondents who reported that they had sought information about health or medical topics during the past 12 months)

^d “Never looked for information about health or medical topics.”

*p values <.05 are derived from chi-square or Wald F statistics to assess differences across racial/ethnic subgroups.

^a Model 1: a multivariable logistic regression for correct knowledge of fruit and vegetable recommendation (5–13 servings/day).

^b Model 2: negative binomial regression for reported fruit and vegetable intake. HINTS = Health Information National Trends Survey.

*Value is significantly different (p < .05) from the reference group.