Adult Intake of Minimally Processed Fruits and Vegetables: Associations with Cardiometabolic Disease Risk Factors

Background The US Department of Agriculture launched ChooseMyPlate.gov nutrition recommendations designed to encourage increased fruit and vegetable intake, in part, as a strategy for improving weight control through the consumption of high-satiation foods. Objective The purpose of this cross-sectional study was to assess the relationship between adults' reported daily intake of fruits and nonstarchy vegetables (ie, those thought to have the lowest energy density) expressed as a proportion of their total daily food intake and objectively measured cardiovascular and metabolic disease risk factors using data from the 2009-2010 National Health and Nutrition Examination Survey (NHANES). Physical activity was included as a moderator variable. Design This study employed a cross-sectional examination of 2009-2010 NHANES data to assess how daily fruit and nonstarchy vegetable intake was associated with anthropometric measures and cardiometabolic blood chemistry markers. Participants/setting Adults free of cardiac or metabolic disease (n = 1,197) participated in 24-hour dietary recalls; a variety of cardiometabolic biomarkers and anthropometric measures were also collected from participants. Main outcome measures Among participants with complete data on all variables, the ratio of the combined cup-equivalents of fruit and nonstarchy vegetable intake to the total gram weight of all foods consumed daily (F/V ratio) served as the primary independent variable. Main dependent measures included fasting glucose, insulin, glycosylated hemoglobin, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, total cholesterol, waist circumference, and body mass index. Statistical analyses performed Demographic and behavioral predictors of the F/V ratio and the association between the F/V ratio and cardiometabolic disease risk factors were examined using multivariate regression. Results Body mass index (beta = -2.58; 95% CI -3.88 to -1.28), waist circumference (beta = -6.33; 95% CI -9.81 to -2.84), and insulin (beta = -0.21; 95% CI -0.37 to -0.05) were inversely associated with the F/V ratio. These associations were weakened for the subset that adhered to federal physical activity recommendations. No other statistically significant associations were found between F/V ratio and main dependent measures. Conclusions In this nationally representative sample, predicted inverse associations between the proportion of daily fruit and nonstarchy vegetable intake relative to total intake and measures reflective of body fat composition and fasting insulin were confirmed. Future research should examine whether a similar association is observed for other sources of resistant starch, such as whole grains, which are arguably more strongly linked with satiety and host insulin levels.