By Loretta Waldman
A first-of-its-kind intervention study aimed at increasing fruit and vegetable consumption among low-income residents is the focus of a forthcoming paper by Kim Gans, a professor of Human Development & Family Studies and an InCHIP Principal Investigator and Core Director. Gans led the study conducted through an innovative, public-private partnership between the Institute for Community Health Promotion at Brown University, where she is an adjunct professor, and a Rhode Island produce distributor.
The study, Live Well Viva Bien, involved 15 subsidized Section 8 family, elderly and disabled housing sites. Eight of the sites participated in the intervention, which included access to a discount mobile market at each site offering high quality fruits and vegetables at lower-than-supermarket prices. The control group received physical activity and stress reduction interventions. The results were encouraging.
At 12 months, researchers saw a statistically significant mean increase in fruit and vegetable consumption. In elderly and disabled housing sites, they saw a difference in consumption of over 2/3 of a cup per day between the intervention and control sites.
Gans and her fellow researchers saw a need for sustainable interventions that increase year-round access to and availability of fresh fruits and vegetables. Prior to the study, there had been no rigorous randomized trials looking at the efficacy of fruit and vegetable market programs in boosting fruit and vegetable consumption, she says.
“This is the first randomized trial to ever look at the effectiveness of a fruit and vegetable market program,” says Gans. “There have been other evaluations and studies done, but none of them has been a randomized trial.”
Funded by a grant from the National Cancer Institute, the intervention also included nutritional education such as monthly newsletters, DVDs, recipe cards, cooking demonstrations and two six-week campaigns attempting to get people to eat more fruits and vegetables and to increase the variety of fruits and vegetables they eat.
Recruited residents had their fruit and vegetable consumption measured at baseline, six and 12 months, Gans said. The markets, dubbed Fresh To You, were held the first two weeks of the month for 12 months, both inside and outside, and prices were 15-25 percent below those at the supermarket. Interventions were offered in English and Spanish and also included a kick-off event and taste testing opportunities.
Americans do not eat adequate amounts of fruits and vegetables and prior to this study, researchers determined that 74 percent of Rhode Islanders don’t. The importance of fruits and vegetables in the diet is well-established, says Gans, as are the risks associated with not getting enough of them in our diets.
- Insufficient vegetable intake is among the top 10 selected risk factors for global mortality.
- Fruits and vegetables are high in micronutrients, dietary fiber, phytochemicals
- Insufficient intake of F&V is related to cancer, CVD, and stroke, obesity and diabetes
Other positive results of the study included a “dose response” effect showing that the more markets people came to the higher the change in their fruit and vegetable consumption was, Gans said. Those people who came to every market – roughly 12 percent of study participants– showed an increased fruit and vegetable consumption of over two cups per day, she said.
“We also saw a relationship between watching the DVD and intervention change,” Gans says. “People who watched the DVD showed a bigger increase in daily fruit and vegetable intake than those who did not.”
The market is now run by the Rhode Island Public Health Institute and has a new name – Food On The Move – as well as a new logo. Gans currently has a new intervention study in the works aimed at increasing physical activity in Latino men. It is built on a similar study involving Latino women.