Research Current Research| Volume 106, ISSUE 9, P1405-1411, September 2006

Download started.


Motivating 18- to 24-Year-Olds to Increase Their Fruit and Vegetable Consumption



      This study assessed the effectiveness of a 4-month intervention using stage-based newsletters, computer-based communication, and motivational interviewing to increase fruit and vegetable consumption by college students aged 18 to 24 years.


      Participants were stratified by stage of change for fruit and vegetable consumption and randomized to an intervention or control group. Participants completed the staging algorithm for fruit and vegetable intake, which included a one-item food frequency question, a 26-item food frequency questionnaire (FFQ), an 18-item decisional balance questionnaire, and a five-item self-efficacy questionnaire at baseline and completion of study.


      A convenience sample of 437 college students enrolled in a rural, land grant university was enrolled in the study. Only nondietetics majors between ages 18 to 24 years were included in the study. A total of 314 students finished the study for a completion rate of 72%.


      After baseline staging and randomization, the intervention group participants received four stage-based newsletters, one motivational interview, and an individually tailored e-mail follow-up over a 4-month period. Control group participants only received assessment at baseline and at completion.

      Main Outcome Measures

      Two fruit and vegetable instruments, a one-item food frequency question, and a 26-item FFQ measured daily consumption of fruits and vegetables at baseline and postintervention.

      Statistical Analyses Performed

      The SAS system for Windows, version 8 (1999, SAS Institute, Inc, Cary, NC), was used for analysis, including the following tests: PROC GLM, PROC FREQ, and PROC NPAR1WAY, Kruskal-Wallis, Fisher, Wilcoxon rank sum, and χ2.


      Fruit and vegetable consumption increased significantly more for the intervention group than the control group. Consumption increased in the intervention group by one serving a day for both instruments compared with 0.4 servings a day in the control group for a one-item instrument and no change in the control group for a 26-item FFQ.


      This intervention is an effective way to increase fruit and vegetable consumption by young adults.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • US Census Bureau
        Table A-5. The population 14 to 24 years old by high school graduate status, college enrollment, attainment, sex, race, and Hispanic origin: October 1967 to 2000. 2001 (Available at: Accessed August 2, 2002.)
        • Betts N.M.
        • Amos R.J.
        • Georgiou C.
        • Hoerr S.L.
        • Ivaturi R.
        • Keim K.S.
        • Tinsley A.
        • Voichick J.
        What young adults say about factors affecting their food intake.
        Ecol Food Nutr. 1995; 34: 59-64
        • Lampe J.W.
        Health effects of vegetables and fruit.
        Am J Clin Nutr. 1999; 70: 475S-490S
        • Hu F.B.
        • Rimm E.B.
        • Stampfer M.J.
        • Ascherio A.
        • Speigelman D.
        • Willett W.C.
        Prospective study of major dietary patterns and risk of coronary heart disease in men.
        Am J Clin Nutr. 2000; 72: 912-921
        • Smith-Warner S.A.
        • Elmer P.J.
        • Tharp T.M.
        • Fosdick L.
        • Randall B.
        • Gross M.
        • Wood J.
        • Potter J.D.
        Increasing vegetable and fruit intake.
        Cancer Epidemiol Biomarkers Prev. 2000; 9: 307-317
        • Liu S.
        • Manson J.E.
        • Lee I.-M.
        • Cole S.R.
        • Hennekens C.H.
        • Willett W.C.
        • Buring J.E.
        Fruit and vegetable intake and risk of cardiovascular disease.
        Am J Clin Nutr. 2000; 72: 922-928
        • Joshipura K.J.
        • Ascherio A.
        • Manson J.E.
        • Stampfer M.J.
        • Rimm E.B.
        • Speizer F.E.
        • Hennekens C.H.
        • Spiegelman D.
        • Willett W.C.
        Fruit and vegetable intake in relation to risk of ischemic stroke.
        JAMA. 1999; 282: 1233-1239
        • Van Duyn M.A.S.
        • Pivonka E.
        Overview of the health benefits of fruit and vegetable consumption for the dietetics professional.
        J Am Diet Assoc. 2000; 100: 1511-1521
        • Hwang M.Y.
        Why you should eat more fruits and vegetables.
        JAMA. 1999; 282: 1304
        • World Cancer Research Fund and American Institute for Cancer Research
        Food, Nutrition and the Prevention of Cancer. American Institute for Cancer Research, Washington, DC1997
      1. Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Data. Prevalance Data: Nationwide and South Dakota. “What is your average frequency of fruit and vegetable consumption per day?” Available at: Accessed July 31, 2002.

      2. South Dakota Department of Health. Behavioral Risk Factor Surveillance System: 1999 South Dakota Summary. Available at: Accessed July 31, 2002.

        • Ma J.
        • Betts N.M.
        • Horacek T.M.
        Measuring stage of change for assessing readiness to increase fruit and vegetable intake among 18- to 24-year-olds.
        Am J Health Promot. 2001; 16: 88-97
        • Finckenor M.
        • Byrd-Bredbenner C.
        Nutrition intervention group program based on preaction-stage-oriented change processes of the Transtheoretical Model promotes long-term reduction in dietary fat intake.
        J Am Diet Assoc. 2000; 100: 335-342
        • Greene G.W.
        • Rossi S.R.
        • Reed G.R.
        • Willey C.
        • Prochaska J.O.
        Stages of change for reducing dietary fat to 30% of energy or less.
        J Am Diet Assoc. 1994; 94: 1105-1110
        • Campbell M.K.
        • DeVellis B.M.
        • Strecher V.J.
        • Ammerman A.S.
        • DeVellis R.F.
        • Sandler R.S.
        Improving dietary behavior.
        Am J Public Health. 1994; 84: 783-787
        • Prochaska J.O.
        • Velicer W.F.
        The Transtheoretical Model of Health Behavior Change.
        Am J Health Promot. 1997; 12: 38-48
        • Prochaska J.O.
        • Velicer W.F.
        • Rossi J.S.
        • Goldstein M.G.
        • Marcus B.H.
        • Rakowski W.
        • Fiore C.
        • Harlow L.L.
        • Redding C.A.
        • Rosenbloom D.
        • Rossi S.R.
        Stages of change and decisional balance for 12 problem behaviors.
        Health Psychol. 1994; 13: 39-46
        • Ma J.
        • Betts N.M.
        • Horacek T.
        • Georgiou C.
        • White A.
        • Nitzke S.
        The importance of decisional balance and self-efficacy in relation to stages of change for fruit and vegetable intakes by young adults.
        Am J Health Promot. 2002; 16: 157-166
        • Resnicow K.
        • Jackson A.
        • Wang T.
        • Anindya K.D.
        • McCarty F.
        • Dudley W.N.
        • Baranowski T.
        A motivational interviewing intervention to increase fruit and vegetable intake through Black churches.
        Am J Public Health. 2001; 91: 1686-1693
        • Walton J.
        • Hoerr S.
        • Heine L.
        • Frost S.
        • Roisen D.
        • Berkimer M.
        Physical activity and stages of change in fifth and sixth graders.
        J Sch Health. 1999; 69: 285-289
        • Vallis M.
        • Ruggiero L.
        Predictors of successful behavior change for healthy eating.
        Diabetes. 2003; 52 ([abstract]): A420
        • Warneke C.L.
        • Davis M.
        • De Moor C.
        • Baronowski T.
        A 7-item versus 31-item food frequency questionnaire for measuring fruit, juice, and vegetable intake among a predominantly African-American population.
        J Am Diet Assoc. 2001; 101: 774-779
        • Thompson F.E.
        • Subar A.F.
        • Smith A.F.
        • Midthune D.
        • Radimer K.L.
        • Kahle L.L.
        • Kipnis V.
        Fruit and vegetable assessment.
        J Am Diet Assoc. 2002; 102: 1764-1772
        • Field A.E.
        • Colditz G.A.
        • Fox M.K.
        • Byers T.
        • Serdula M.
        • Bosch R.J.
        • Peterson K.E.
        Comparison of 4 questionnaires for assessment of fruit and vegetable intake.
        Am J Public Health. 1998; 88: 1216-1218
        • Thompson F.E.
        • Kipnis V.
        • Subar A.F.
        • Krebs-Smith S.M.
        • Kahle L.L.
        • Midthune D.
        • Potischman N.
        • Schatzkin A.
        Evaluation of 2 brief instruments and a food-frequency questionnaire to estimate daily number of servings of fruit and vegetables.
        Am J Clin Nutr. 2000; 71: 1503-1510
        • Stevens V.J.
        • Glasgow R.E.
        • Toobert D.J.
        • Karanja N.
        • Smith S.K.
        Randomized trial of a brief dietary intervention to decrease consumption of fat and increase consumption of fruits and vegetables.
        Am J Health Promot. 2002; 16: 129-134
        • Harris J.
        • Murray L.
        The relationship between social cognitive model variables and fruit and vegetable consumption among college students.
        Am J Health Studies. 1997; 13: 133-140
        • Krebs-Smith S.M.
        • Heimendinger J.
        • Subar A.F.
        • Patterson B.H.
        • Pivonka E.
        Using food frequency questionnaires to estimate fruit and vegetable intake.
        J Nutr Educ. 1995; 27: 80-85


      A. Richards is a child nutrition program specialist, Child and Adult Nutrition Services, Pierre, SD; at the time of the study, she was a master’s degree student at South Dakota State University, Brookings.


      K. K. Kattelmann is an associate professor, Nutrition, Food Science, and Hospitality Department, and director, Didactic Program.


      C. Ren is an assistant professor of statistics, Plant Science Department, South Dakota State University, Brookings.