Influential factors in fruit and vegetable consumption among low-income U.S. women Open Access

Stallings, Tiffany Lynn (2012)

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Consumption of fruits and vegetables (F&V) is below recommended amounts in the United States and intake is generally lower among low-income individuals. Previous research has indicated that recipients of the Special Supplemental Nutrition Program for Women, Infants, and Children
(WIC) had higher F&V intake than WIC non-recipients with similar incomes (≤185% of the Poverty Index Ratio (PIR)). Other studies found WIC recipients who participated in the Farmers' Market Nutrition Program (FMNP) increased F&V intake and learned nutrition competencies. This dissertation included three analyses that examined factors influencing F&V consumption and the nutrition environment among low-income women.

The first analysis used data from the Infant Feeding Practice Study II to examine variation in F&V intake recipients/ ≤185% of PIR, WIC non-recipients/≤185% of PIR, and >185% of PIR) among pregnant and postpartum women using Kruskal-Wallis tests and logistic regression. In general, F&V intakes were found to be lowest among NonWIC/≤185% PIR and only prenatal vegetable consumption varied (p=0.04). Additionally, postnatal F&V intake was higher among breastfeeding than non-breastfeeding women (fruit: p<0.0001; vegetable: p=0.006).

The second analysis used data from the Emory WIC FMNP study to examine influences of the FMNP on F&V intake and nutrition knowledge and competencies using bivariate analyses and logistic regression. Study participants received WIC food vouchers and nutrition education, and the FMNP group received $30 of F&V coupons. Nutrition knowledge and F&V intake did not significantly vary participants reported learning new F&V competencies and these participants increased F&V consumption (p=0.03).

The third analysis also used data from the Emory WIC FMNP study to explore the agreement between perceived and actual nutrition environment measures of F&V availability, quality, and affordability/price using kappa statistics and sensitivity/specificity. All agreements were poor (kappa values<0.3).

My study findings of higher F&V intake among WIC recipients could support increased efforts to inform WIC non-recipients/≤185% of PIR that they may meet remaining eligibility requirements for WIC benefits. Also, the Emory WIC FMNP study results could support WIC-led nutrition education programs to teach nutrition competencies and the nutrition environment.

Table of Contents

Chapter 1: Importance of Fruit and Vegetable Intake... 1
References: Chapter 1... 55
Chapter 2: Project 1 Maternal Nutrition Knowledge and Competencies and Fruit and Vegetable Intake of Mother and Child... 69
Appendix: Chapter 2... 195
References: Chapter 2... 206
Chapter 3: Project 2 Actual and Perceived Nutrition Environments of Fresh, Canned, and Frozen Fruits and Vegetables... 213
Appendix: Chapter 3... 272
References: Chapter 3... 276
Chapter 4: Project 3 Examination of Prenatal and Postnatal Fruit and Vegetable Intake by WIC/Poverty-Level Status... 280
Appendix: Chapter 4... 315
References: Chapter 4... 336
Chapter 5: Dissertation Summary... 340
References: Chapter 5... 350

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