Fruit and Vegetable Consumption, Body Mass Index, and Dieting Behaviors among Florida Middle and High School Youth

The purpose of this study was to examine fruit and vegetable consumption reported by Florida middle school and high school students and to determine if consumption was associated with: (1) demographic characteristics; (2) body mass index (BMI); and/or (3) weight loss behaviors. Data from the 2009 Florida YRBS and the MSHBS were used. Both surveys used a two-stage cluster sample design, producing a representative sample of students. In addition to sociodemographic variables, independent variables included engaging in weight loss behaviors. Dependent variables were adequate fruit and adequate vegetable consumption. Descriptive, chi-square and logistic regression analyses were performed. Results indicated that less than 25% of youth reported consumption of adequate amounts of fruit and less than 10% reported consuming adequate amounts of vegetables. No significant relationships were found between BMI and either fruit or vegetable consumption. Exercising, both exercising and dieting, fasting, and using pills /powders to lose weight were significantly associated with adequate fruit and vegetable consumption. Dieting to lose weight was significantly associated with adequate vegetable but not adequate fruit consumption. Interventions promoting healthy weight for children and adolescents need to address positive and negative behaviors and encourage greater consumption of fruits and vegetables. Florida Public Health Review, 2016; 13, 41-48. BACKGROUND Dietary surveys in the United States (U.S.) have consistently indicated lower than recommended fruit and vegetable consumption among children and adolescents (CDC, 2010; Granner et al., 2012; Lorson et al., 2009; Rasmussen et al., 2006; Neumark-Sztainer et al., 2002; Kimmons et al., 2009). Adolescents seem particularly to display a pattern of low consumption (Lorson et al., 2009; Kimmons et al., 2009). Simultaneously, there exists a well-recognized epidemic of overweight and obesity among U.S. children and youth (CDC, 2015a). Seven out of 10 obese adolescents develop into obese adults (Zhao et al., 2011) and obesity during childhood is associated with the development of type 2 diabetes and cardiovascular disease throughout the lifecycle (Allcock et al., 2009). Therefore, the childhood obesity epidemic potentiates the need for promoting healthy behaviors to mitigate the risk in the development of these obesity related cardio-metabolic diseases. Increasing fruit and vegetable consumption has been suggested as a possible means to achieve a healthy weight status (Lowry et al., 2008; Tohill et al., 2004; Rolls et al., 2004). Fruits and vegetables are cited as having a low caloric density due to their relatively high fiber and water content. A small number (n=2) of epidemiologic studies in children, as reviewed by Tohill et al. (2004), showed mixed results in terms of an association between fruit and vegetable consumption and body weight. Interventions which have included a component to increase fruit and vegetable consumption have shown some success in the promotion of a healthy weight, especially when combined with other strategies such as calorie control and increased energy through exercise (Lowry et al., 2008; Rolls et al., 2004). Of interest is the extent to which children and adolescents outside of an intervention setting practice both positive and negative behaviors related to the desire to achieve weight loss. An older study of adolescents based on YRBS data reported an association between dieting and exercise with increased fruit and vegetable consumption (Pesa et al., 2001). Another report did not find fruit and