Inter- and independent effects of region and race/ethnicity on variety of fruit and vegetable consumption in the USA: 2011 Behavioral Risk Factor Surveillance System (BRFSS)

Objective: (i) To estimate the independent and combined effects of race/ethnicity and region on the variety of fruits and vegetables consumed in the USA in 2011; and (ii) to assess whether and to what extent race/ethnicity and region may synergistically influence variety of fruit and vegetable consumption. Design: Cross-sectional analysis. Multivariate logistic regression predicted the likelihood of meeting fruit and vegetable variety indicators independently and in combination for each race/ethnicity and region. Interaction effects models were used to test for interaction effects between race/ethnicity and region on fruit and vegetable variety. Setting: The 2011 Behavioral Risk Factor Surveillance System (BRFSS). Subjects: The sample consisted of 275 864 adult respondents. Results: Fewer than half of respondents consumed fruit and all vegetable subcategories at least once weekly. The adjusted likelihood of meeting fruit and vegetable variety indicators varied significantly by race/ethnicity and region (P < 0.05). Significant interactions between race/ethnicity and region were found for at least once weekly consumption of beans, orange vegetables, all vegetables, and fruit and all vegetables (P < 0.05). Conclusions: Our results reinforce previous findings that the variety of vegetable consumption is lacking and is particularly evident among some population subgroups, such as non-Hispanic blacks in the Midwest USA, who may benefit from targeted dietary interventions.