Fruits, veggies a hard sell

Experts stuck on getting Americans to eat healthy

December 02, 2007|By Meredith Cohn | Meredith Cohn,Sun reporter

Eat your vegetables. Everyone has heard it, from a mom, a teacher or a commercial.

Yet, years after a concerted effort to boost consumption of healthful foods, Americans eat the same paltry amounts that they did in 1985, when the government first recommended two servings of fruit and three servings of vegetables daily.

The bad eating habits cross all socioeconomic levels. Researchers say those with higher incomes might eat out frequently and consume more fried foods than salads, and those with lower incomes could find fresh produce too pricey at their corner market.

Public health professionals are developing new ways to teach proper nutrition and lower the cost, but if they can't, they say, the consequences for the nation's already hobbled health could be dire. Two-thirds of adults are overweight or obese, and their fat is contributing to life-threatening ailments that include heart disease, cancer, strokes and diabetes.

All of this is disheartening to health experts who are coming to realize that America's bad habits are the nation's most challenging public health problem. Those habits have many roots: the hectic pace of modern life, unavailability of healthful food because of cost or location, the relentless marketing of ever-larger meals with high fat and sugar content, and the seductive taste and smell of fatty favorites such as french fries and burgers.

The bottom line: Americans are struggling with a dangerously stubborn addiction to unhealthful foods.

"I try and go for the apple or pear, but believe me, I'd rather have the cookie," said Brentt Naylor, a 33-year-old Baltimore resident who not only shops at the hyper-health-conscious Whole Foods, but belongs to a community program that allows him a weekly bounty of locally grown produce. "You really have to set aside time to make vegetables tasty. It's taste and time."

Catherine Fine, a 34-year-old Whole Foods shopper, said it was long hours at work that drove her to the vending machine despite all the healthful food she has at home. And then there was Bryan Rupert, a 20-year-old ordering a pizza for dinner recently from a South Baltimore shop. He said he wouldn't know what to do with vegetables if he bought them, which he doesn't.

Despite regular gym visits, he said, mac-'n'-cheese was a typical meal. And in an attempt to bulk up not too long ago, he ate two McDonald's double cheeseburgers a day for two and a half months and gained 15 pounds.

"I know it wasn't the right way," said Rupert, who does try to eat a piece of fruit a day. "I'm not going to let myself become a fat pig. I'll change my diet first."

Stymied researchers

Researchers are confounded by people like Rupert who cling to their old ways. They had expected at least a slight increase in fruit and vegetable consumption over time, said Sarah Stark Casagrande, an author of a study of the subject from 1988 to 1994 and 1999 to 2002. The results were published in April's American Journal of Preventive Medicine.

But only 11 percent of the people studied met U.S. Department of Agriculture guidelines for eating fruits and vegetables during both periods, said Casagrande, a pre-doctoral student in the Johns Hopkins Bloomberg School of Public Health.

Black men were the least likely to eat enough; those with higher incomes and more education were the most likely. Still, half the participants did not consume any fruit, and a quarter ate no vegetables.

(Guidelines were changed in 2005 to boost requirements and to account for variations in people's level of activity, but the authors didn't think the situation had improved.)

The study pointed to some of the same problems Naylor and the other Baltimore shoppers found: taste and convenience. It also blamed cost, large restaurant portions, advertising and confusing food guidelines.

The results, the report said, "should alarm public health officials. ... The implications of a diet low in fruits and vegetables are extensive."

The study was not the only one to report such news. Another recent study that examined price as a barrier to healthy eating also sounded alarms.

The report in the November Journal of the American Dietetic Association said that when produce was available in poorer neighborhoods, the cost was lower in some cases. But to meet the new federal guidelines, the average family of four would have to spend between 43 percent and 70 percent of its food budget on produce.

Obesity and health

That's a problem that requires public policy changes, the report said. "There is a need to educate consumers about the importance of increasing their consumption of fruits and vegetables, yet these ... programs must consider the trade-offs required for families to purchase more fruits and vegetables."

The cheapest food today does tend to be the most unhealthful, so it's not a coincidence that low-income areas tend to have higher rates of obesity and chronic diseases, researchers say.

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