Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Association between fruit and vegetable intake and change in body mass index among a large sample of children and adolescents in the United States

Abstract

OBJECTIVE: To assess whether intake of fruits and vegetables was associated with change in body mass index (BMI) among a large sample of children and adolescents in the United States.

DESIGN: Prospective cohort study of children and adolescent who were 9–14?y of age in 1996, when the study began.

SUBJECTS: The subjects included 8203 girls and 6715 boys in an ongoing cohort study who completed at least two questionnaires between 1996 and 1999.

MEASUREMENTS: Fruit and vegetable intake was assessed in 1996–1998 with a validated food frequency questionnaire designed specifically for children and adolescents. The outcome measure was change in age- and gender-specific z-score of BMI (kg/m2). Self-reported weight and height, which were used to calculate BMI, were collected annually from 1996 to 1999.

RESULTS: During 3 years of follow-up, annual changes in BMI were slightly greater among the boys than the girls. After controlling for Tanner stage of development, age, height change, activity and inactivity, which are known or suspected predictors of change in BMI, among the girls there was no relation between intake of fruits, fruit juice, or vegetables (alone or combined) and subsequent changes in BMI z-score. Among the boys, intake of fruit and fruit juice was not predictive of changes in BMI, however, vegetables intake was inversely related to changes in BMI z-score (β per serving=−0.003). However, after adjusting for caloric intake, the magnitude of the effect was diminished and no longer significant.

CONCLUSION: Our results suggest that the recommendation for consumption of fruits and vegetables may be well founded, but should not be based on a beneficial effect on weight regulation.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

References

  1. Rimm EB, Ascherio A, Giovannucci E, Speigelman D, Stampfer MJ, Willett WC . Vegetable, fruit, and cereal fiber intake and risk of coronary heart disease among men. JAMA 1996; 275: 447–451.

    Article  CAS  Google Scholar 

  2. Willett WC . Diet and health: what should we eat? Science 1994; 264: 532–537.

    Article  CAS  Google Scholar 

  3. Travani A, La Vecchia C . Fruit and vegetable consumption and cancer risk in a Mediterranean population. Am J Clin Nutr 1995; 61(Suppl): 1374S–1377S.

    Article  Google Scholar 

  4. US Public Health Service. Healthy People 2000: National Health Promotion and Disease Prevention Objectives. DHHS Pub No. (PHS 91-50212). Washington DC: US Department of Health and Human Services, 1991.

  5. Subar AF, Heimendinger J, Patterson BH, Krebs–Smith SM, Pivonka E, Kessler R . Fruit and vegetable intake in the United States: the baseline survey of the Five a Day for Better Health Program. Am J Health Promot 1995; 9: 352–360.

    Article  CAS  Google Scholar 

  6. Butrum RR, Clifford CK, Lanza E . NCI dietary guidelines: rationale. Am J Clin Nutr 1988; 48: 888–895.

    Article  CAS  Google Scholar 

  7. Krebs-Smith SM, Cook A, Subar A, Cleveland L, Friday J . US adults' fruit and vegetable intakes, 1989 to 1991: a revised baseline for the Healthy People 2000 Objective. Am J Public Health 1995; 85: 1623–1629.

    Article  CAS  Google Scholar 

  8. Dennison BA, Rockwell HL, Baker SL . Excess fruit juice consumption by preschool-aged children is associated with short stature and obesity. Pediatrics 1997; 99: 15–22.

    CAS  PubMed  Google Scholar 

  9. Skinner JD, Carruth BR, Moran III J, Houck K, Coletta F . Fruit juice is not related to children's growth. Pediatrics 1999; 103: 58–64.

    Article  CAS  Google Scholar 

  10. Sahota P, Rudolf MC, Dixey R, Hill AJ, Barth JH, Cade J . Randomised controlled trial of primary school based intervention to reduce risk factors for obesity.BMJ 2001; 323: 1029–1032

    Article  CAS  Google Scholar 

  11. Epstein LH, Gordy CC, Raynor HA, Beddome M, Kilanowski CK, Paluch R . Increasing fruit and vegetable intake and decreasing fat and sugar intake in families at risk for childhood obesity. Obes Res 2001; 9: 171–178.

    Article  CAS  Google Scholar 

  12. Gortmaker SL, Peterson K, Wiecha J, Sobol AM, Dixit S, Fox MK, Laird N . Reducing obesity via a school-based Interdisciplinary intervention among youth: planet health. Arch Pediatr Adolesc Med 1999; 153: 409–418.

    Article  CAS  Google Scholar 

  13. Gortmaker SL, Cheung LW, Peterson KE, Chomitz G, Cradle JH, Dart H, Fox MK, Bullock RB, Sobol AM, Colditz G, Field AE, Laird N . Impact of a school–based interdisciplinary intervention on diet and physical activity among urban primary school children: eat well and keep moving. Arch Pediatr Adolesc Med 1999; 153: 975–983.

    Article  CAS  Google Scholar 

  14. CDC Growth Charts (http://www.cdc.gov/growthcharts/).

  15. Rockett HRH, Wolf AM, Colditz GA . Development and reproducibility of a food frequency questionnaire to assess diet of adolescents. J Am Diet Assoc 1995; 95: 336–340.

    Article  CAS  Google Scholar 

  16. Duke PM, Litt IF, Gross RT . Adolescents' self-assessment of sexual maturation. Pediatrics 1980; 66: 918–920.

    CAS  Google Scholar 

  17. Morris NM, Udry JR . Validation of a self-administered instrument to assess stage of adolescent development. J Youth Adolesc 1980; 9: 271–280.

    Article  CAS  Google Scholar 

  18. Neinstein LS . Adolescent self-assessment of sexual maturation. Clin Pediatr 1982; 21: 482–484.

    Article  CAS  Google Scholar 

  19. Shannon B, Smiciklas-Wright H, Wang MQ . Inaccuracies in self-reported weights and heights of a sample of sixth-grade children. J Am Diet Assoc 1991; 91: 675–678.

    CAS  PubMed  Google Scholar 

  20. Strauss RS . Comparison of measured and self–reported weight and height in a cross–sectional sample of young adolescents. Int J Obes Relat Metab Disord 1999; 23: 904–908.

    Article  CAS  Google Scholar 

  21. Goodman E, Hinden B, Khandelwal S . Accuracy of teen and parental reports of obesity and body mass index. Pediatrics 2000; 106: 52–58.

    Article  CAS  Google Scholar 

  22. SAS Institute Inc. SAS user's guide: statistics, 4th edn, Version 6. Cary, NC; 1990.

  23. Rosner B, Munoz A . Conditional linear models for longitudinal data. In: Dwyer JH, Feinleib M, Lippert P, Hoffneister H (eds). Monographs in epidemiology and biostatistics, Statistical models for longitdinal studies of health, vol. 16. Oxford University Press: New York; 1992.

    Google Scholar 

  24. Skinner JD, Carruth BR . A longitudinal study of children's juice intake and growth: the juice controversy revisited. J Am Diet Assoc 2001; 101: 432.

    Article  CAS  Google Scholar 

  25. Wolever TM, Jenkins DJ, Jenkins AL, Josse RG . The glycemic index: methodology and clinical implications. Am J Clin Nutr 1991; 54: 846–854.

    Article  CAS  Google Scholar 

  26. Foster-Powell K, Miller JB . International tables of glycemic index. Am J Clin Nutr 1995; 62: 871s–890s.

    Article  CAS  Google Scholar 

  27. Campfield LA, Smith FJ, Rosenbaum M, Hirsch J . Human eating: evidence for a physiological basis using a modified paradigm. Neurosci Biobehav Rev 1996; 20: 133–137.

    Article  CAS  Google Scholar 

  28. Ludwig DS, Majzoub JA, Al-Zahrani A, Dallal GE, Blanco I, Roberts SB . High glycemic index foods, overeating, and obesity. Pediatrics 1999; 103: e26.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank Catherine Berkey and Nan Laird for their comments and suggestions on analytic issues. The analysis was supported by a Special Interest Project grant (U48-CCU115807) from the Centers for Disease Control and Prevention, the Boston Obesity Nutrition Research Center (DK 46200), a research grant (DK-46834) from the National Institutes of Health, and the Kellogg Company.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A E Field.

Additional information

Department of Epidemiology, Harvard School of Public Health, USA

Rights and permissions

Reprints and permissions

About this article

Cite this article

Field, A., Gillman, M., Rosner, B. et al. Association between fruit and vegetable intake and change in body mass index among a large sample of children and adolescents in the United States. Int J Obes 27, 821–826 (2003). https://doi.org/10.1038/sj.ijo.0802297

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802297

Keywords

This article is cited by

Search

Quick links