背景:粮食不安全在美国仍然是一个紧迫的问题,根据美国农业部(USDA)的报告,2023年约有12.8%的美国家庭经历了这一挑战。在威斯康星州,一个拥有著名农业遗产的州,2019年至2023年期间,粮食不安全的患病率平均为9.9%。越来越多的研究强调了食用富含水果和蔬菜的饮食对于保持最佳健康和降低各种慢性疾病风险的重要性。包括心血管疾病(CVD)和肥胖。水果和蔬菜是维生素等必需营养素的储库,矿物,抗氧化剂,和膳食纤维,共同促进整体福祉。尽管有据可查的水果和蔬菜的健康益处,相当比例的人口未能达到建议的每日至少五份的摄入量。这种差异强调了探索影响饮食行为的因素并确定促进遵守饮食指南的策略的重要性。
方法:调查由LaCrosse家庭医学住院医师诊所的工作人员分发,威斯康星州,在2023年4月和5月的例行访问期间。向家庭健康诊所(FHC)就诊的任何≥18岁的患者均有资格入选。如果患者由于智力/语言/其他障碍而无法阅读/回答调查问题,则将其排除在外。调查包括人口统计数据,如参与者的年龄,性别,种族,收入等级,和主要的运输方式。然后,共有122名参与者被问及他们一天吃了多少份100%的果汁,水果,豆子,绿色蔬菜,黄色/橙色蔬菜,和其他蔬菜,以及更多水果和蔬菜消费的障碍,以及他们对水果和蔬菜消费的态度以及与医疗保健提供者讨论的兴趣的李克特量表。通过图形表示分析了人口统计学特征,以阐明被调查人群的趋势和模式。我们使用条形图比较了不同的人口统计学与水果和蔬菜的障碍。
结果:水果和蔬菜摄入的主要障碍因年龄组而异:18-30岁的“成本”,31-50岁的“其他”,51-70岁的“成本”和“无”,70岁以上的“无”。对于性别,“无”是男性最常见的,而“成本”是女性最常见的。按收入,“成本”通常为0-20k美元和20-50k美元,50-10万美元的“无”,和“其他”,价格>10万美元。李克特量表评估了与医疗保健提供者讨论健康食品的兴趣。大多数回答是“中立的,“强烈同意”最高的是18-30岁,“同意”在31-50岁、51-70岁和70岁以上年龄组。
结论:这项研究的目的是确定水果和蔬菜获取的障碍,并确定患者对与医疗保健提供者讨论健康食物选择的态度。收入减少和年龄增加与将成本确定为水果/蔬菜摄入障碍的可能性之间似乎存在相关性。我们诊所发现的障碍包括便利/时间限制和成本。在我们的调查中,许多人还认为商店(可用性)缺乏优质或种类繁多的水果和蔬菜是食用它们的重要障碍。
BACKGROUND: Food insecurity remains a pressing issue in the United States, with approximately 12.8% of American households experiencing this challenge in 2023, as reported by the US Department of Agriculture (USDA). In Wisconsin, a state with a notable agricultural heritage, the prevalence of food insecurity averaged 9.9% between 2019 and 2023. A growing body of research underscores the importance of consuming diets rich in fruits and vegetables for maintaining optimal health and mitigating the risk of various chronic diseases, including cardiovascular disease (CVD) and obesity. Fruits and vegetables are reservoirs of essential nutrients such as vitamins, minerals, antioxidants, and dietary fiber, which collectively contribute to overall well-being. Despite the well-documented health benefits of fruits and vegetables, a considerable proportion of the population fails to meet the recommended daily intake of at least five servings. This disparity underscores the importance of exploring factors influencing dietary behaviors and identifying strategies to promote adherence to dietary guidelines.
METHODS: Surveys were distributed by staff at the family medicine residency clinic in La Crosse, Wisconsin, during routine visits in April and May 2023. Any patients ≥18 years old presenting to the Family Health Clinic (FHC) were eligible for inclusion. Patients were excluded if they were unable to read/answer survey questions due to intellectual/language/other barriers. Surveys included demographic data such as the participant\'s age, gender, race, income bracket, and primary mode of transportation. A total of 122 participants were then asked how many servings in a day they ate of 100% juice, fruits, beans, green vegetables, yellow/orange vegetables, and other vegetables, as well as about barriers to more fruit and vegetable consumption and a Likert scale about their attitudes toward fruit and vegetable consumption and interest in discussing it with a healthcare provider. Demographic characteristics were analyzed through graphical representation to elucidate trends and patterns among the surveyed population. We compared different demographics with the barriers to fruits and vegetables using bar graphs.
RESULTS: The primary barrier to fruit and vegetable intake varied by age group: \"cost\" for 18-30, \"other\" for 31-50, \"cost\" and \"none\" for 51-70, and \"none\" for over 70. For gender, \"none\" was most frequent for males while \"cost\" was for females. By income, \"cost\" was common for $0-20k and $20-50k, \"none\" for $50-100k, and \"other\" for >$100k. A Likert scale assessed interest in discussing healthy foods with healthcare providers. Most responses were \"neutral,\" with \"strongly agree\" highest in 18-30 and \"agree\" in 31-50, 51-70, and over 70 age groups.
CONCLUSIONS: The purpose of this study was to ascertain barriers to fruit and vegetable access and identify patients\' attitudes toward discussing healthy food choices with healthcare providers. There appears to be a correlation between decreasing income and increasing age and the likelihood of identifying cost as a barrier to fruit/vegetable intake. Barriers identified in our clinic included convenience/time constraints and cost. Many people in our survey also identified the lack of quality or good variety of fruits and vegetables at the store (availability) as a significant barrier to eating them.