Dietary Intake Among U.S. Adults With Disability

Purpose: Physical, mental, and financial barriers among individuals with disability may limit their access to fruit and vegetable. In this study, we examined the relationship between disability status and vegetable, fruit, and fruit juice intake among U.S. adults aged 18 years and older using a large nationally representative sample. Methods: Participants came from Behavioral Risk Factor Surveillance System 2011 wave, a nationally representative sample of U.S. adults. Outcomes included self-report daily vegetable, fruit, and pure fruit juice consumption frequency. Disability status was classified into 7 categories: limited in activities caused by physical, mental, or emotional problems (AL); health problem requiring use of special equipment (HP); either AL or HP; both AL and HP; unable to work because of disability or other reasons (UN); AL and HP and UN; and no disability (no AL or HP or UN). The associations between consumption and disability were estimated in multivariate regressions controlling for sociodemographics, body weight, and survey month/state and accounting for survey design. Results: U.S. adults with disability consumed vegetable and fruit significantly less frequently than those without disability. Across disability categories, daily vegetable consumption frequency among people with disability was 4%-15%, and daily fruit consumption frequency 7%-18% lower than people without disability. Fruit juice consumption frequency appeared slightly higher among people with disability, indicating some substitution effect. Part of the disparities in diet tends to be explained by the differences in education, marital status, and income between people with and without disability. Conclusions: Using recent data from a large nationally representative health survey, we found American adults with disability to consume fruit and vegetable significantly less frequently than those without disability. Policy interventions are warranted to increase fruit and vegetable consumption among people with disability and reduce disparities.