Catalysts and barriers to increasing the consumption of fruits and vegetables and reducing the prevalence of hypertension: Monitoring metrics, dietary quality, and farmland capacity.
Conrad, Zach.
2015
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Abstract: Hypertension
is a prominent risk factor for cardiovascular disease (CVD), which is the leading cause
of death in the United States (US). Adequate consumption of fruits and vegetables
(F&V) is associated with a reduced risk of developing hypertension and CVD, yet most
Americans do not meet the recommended daily consumption amounts for F&V. National
public health goals for 2020 includ... read moree increasing the consumption of F&V and reducing
the prevalence of hypertension, but several barriers stand in the way of achieving these
goals. Three different dietary data collection programs are used to inform nutrition
policies, interventions, and messages, but the degree of agreement among the data
generated by these programs has not been examined. Additionally, although the Dietary
Approaches to Stop Hypertension (DASH) diet - which includes high amounts of F&V -
is associated with a reduced risk of hypertension, CVD, and all-cause mortality, the
rate of adherence continues to be low. Finally, most F&V consumed in the US are
produced domestically, but the capacity of the US agricultural system to accommodate
increased consumption of nutrient dense F&V is not well documented. The goal of this
dissertation is to examine several catalysts and barriers to achieving the national
public health nutrition goals of increasing the consumption of F&V and reducing the
prevalence of hypertension; this will be accomplished through three separate studies. In
the first study, I estimate the comparability of daily per capita F&V consumption
data generated from the National Health and Nutrition Examination Survey (NHANES),
2007-2010; the Behavioral Risk Factor Surveillance System (BRFSS), 2007-2011; and the
Loss-Adjusted Food Availability (LAFA) data series, 2007-2011; using statistical
agreement tests and descriptive means comparisons. In the second study, I develop a food
pattern model to examine whether consuming nutrient dense F&V, instead of those
currently consumed, without increasing the amount consumed, will provide enough fiber,
calcium, magnesium, and potassium for hypertensive adults to meet the nutrient targets
of the DASH diet. In the third study, I create geospatial models to investigate the
degree to which the US agricultural system can increase the production of selected
nutrient dense F&V in eleven major production centers. The results of these studies
are as follows. In the first study, I found that NHANES, BRFSS, and LAFA do not produce
the same results and should not be used interchangeably to estimate daily per capita
F&V consumption at the national level. In the second study, I found that consuming
nutrient dense F&V instead of those currently consumed, without increasing the
amount consumed, will not provide enough nutrients for hypertensive adults to meet the
nutrient targets of the DASH diet; yet by choosing more nutrient dense F&V and
increasing the number of servings consumed, hypertensive adults can meet the nutrient
targets with fewer servings than is recommended. In the third study, I found that there
is enough suitable agricultural land within the major production centers to accommodate
a substantial increase in demand for selected nutrient dense F&V, but that further
increases in the per capita availability of F&V are needed for hypertensive adults
to meet the DASH diet. This research is important for several reasons. It shows that
matching the research question to the appropriate data source is essential to computing
accurate estimates of daily per capita consumption of F&V. This research also
provides clinicians with information that can be used to help their hypertensive
patients adopt more healthy dietary patterns. Finally, this research highlights the
important role that smaller production centers and international food markets will play
if hypertensive adults adopt healthier eating
patterns.
Thesis (Ph.D.)--Tufts University, 2015.
Submitted to the Dept. of Agriculture, Food and Environment.
Advisor: Timothy Griffin.
Committee: Christian Peters, and Kenneth Chui.
Keywords: Nutrition, Public health, and Agriculture.read less - ID:
- d791st46h
- Component ID:
- tufts:20293
- To Cite:
- DCA Citation Guide EndNote
