A high consumption of fruits and vegetables has been associated with many positive health outcomes. At the state and local level public health professionals are active in assessment of diet and in the promotion of these foods. 

Fruits and vegetables may be protective against cancer at many sites including the mouth, pharynx, larynx, esophagus, lung, stomach, colon, rectum, bladder, and cervix. These foods are high in fiber which may be beneficial for diabetics and those with diverticular disease. And these foods are relatively low in caloric density and may assist with weight maintenance, particularly where these foods may be substituted for high fat, high calorie items. Therefore the assessment of fruit and vegetable consumption is an important component in evaluating the health status of a population. 

The Washington State Behavioral Risk Factor Surveillance System (BRFSS) is an extension of the National BRFSS Program conducted in 49 states and the District of Columbia. The 1994 BRFSS included the CDC module on fruit and vegetable consumption. The sample for the state of Washington was selected by random digit dialing and represented a cross-section of the adult population greater than 18 years of age with a telephone.  Overall, 21.4% of Washington adults residents consume ò 5 servings of fruits and vegetables per day. Among both males and females the intake of fruits and vegetables is less than the goal of 5 servings per day.  Females were more likely than males to report consuming ò 5 servings of fruits and vegetables per day. When compared to the values from the 1994 BRFSS for all states, the percent of males consuming 5 or more servings per day was 17.8% and among females was 26.3%. The range among states for males was 29.1% (Washington DC) to 10.7% (Mississippi) and for females was 38.7% (Connecticut) and 16.7% (Mississippi). The Year 2000 National Health Objectives sited baseline national data for adults at 4.0 servings of fruits and vegetables per day. 

Among Washington State residents the intake of fruits and vegetables increased with increasing income and age. There was also a trend toward higher intakes of fruits and vegetables among non-smokers compared to smokers and among those who are non-sedentary compared to sedentary.  There was a very strong association between active/non-smokers and the use of fruits and vegetables compared to sedentary/smokers and the use of fruits and vegetables (Table). This relationship was also stronger among females than among males. However the confidence intervals for this analysis indicate there was a lack of precision in the analysis, that is the ability to set the point estimate for the level of association was limited by small numbers in the cells. These characteristics of individuals with higher use of fruits and vegetables has also been fairly consistent with national patterns, with females and older adults having higher consumption patterns. 

Unfortunately the data from the State BRFSS survey, while drawing subjects from local jurisdictions, does not have the number of subjects in each area to provide local health departments with regional estimates. It is recommended that local health jurisdictions incorporate fruit and vegetable assessment into their planning process. 
 

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