Protocol - Fruits and Vegetables Intake
Description
These questions from the Five-Factor Screener may be useful to assess an individual’s approximate intake of several foods. These particular questions address fruit and vegetable intake. No portion-size questions are asked. This screener does not attempt to assess total diet.
Specific Instructions
None
Availability
Protocol
These questions are about the different kinds of foods you ate or drank during the PAST MONTH, that is, the past 30 days. When answering, please include meals and snacks eaten at home, at work or school, in restaurants, and anyplace else. *Read text if the respondent needs further clarification about the information requested.
1. During the past month, how often did you drink 100% FRUIT JUICE, such as orange, mango, apple, and grape juices? Do NOT count fruit drinks. *Read if necessary: INCLUDE only 100% pure juices. Do NOT include fruit drinks with added sugar, like Kool-Aid®, Hi-C®, lemonade, cranberry cocktail, Gatorade®, Tampico®, and Sunny Delight®.
00 [ ] Never
01 [ ] 1-3 times last month
02 [ ] 1-2 times per week
03 [ ] 3-4 times per week
04 [ ] 5-6 times per week
05 [ ] 1 time per day
06 [ ] 2 times per day
07 [ ] 3 times per day
08 [ ] 4 times per day
09 [ ] 5 or more times per day
97 [ ] Refused
99 [ ] Don’t know
2. During the past month . . . How often did you eat FRUIT? COUNT fresh, frozen, or canned fruit. Do NOT count juices. *Read if necessary: Include fruits such as apples, bananas, applesauce, melon, berries, fruit salad, mangos, papayas, oranges, and grapes.
00 [ ] Never
01 [ ] 1-3 times last month
02 [ ] 1-2 times per week
03 [ ] 3-4 times per week
04 [ ] 5-6 times per week
05 [ ] 1 time per day
06 [ ] 2 times per day
07 [ ] 3 times per day
08 [ ] 4 times per day
09 [ ] 5 or more times per day
97 [ ] Refused
99 [ ] Don’t know
3. During the past month, how often did you eat a green leafy or lettuce SALAD, with or without other vegetables? *Read if necessary: INCLUDE spinach salads
00 [ ] Never
01 [ ] 1-3 times last month
02 [ ] 1-2 times per week
03 [ ] 3-4 times per week
04 [ ] 5-6 times per week
05 [ ] 1 time per day
06 [ ] 2 times per day
07 [ ] 3 times per day
08 [ ] 4 times per day
09 [ ] 5 or more times per day
97 [ ] Refused
99 [ ] Don’t know
4. During the past month . . . How often did you eat FRENCH FRIES, home fries, or hash brown potatoes?
00 [ ] Never
01 [ ] 1-3 times last month
02 [ ] 1-2 times per week
03 [ ] 3-4 times per week
04 [ ] 5-6 times per week
05 [ ] 1 time per day
06 [ ] 2 times per day
07 [ ] 3 times per day
08 [ ] 4 times per day
09 [ ] 5 or more times per day
97 [ ] Refused
99 [ ] Don’t know
5. During the past month . . . How often did you eat other WHITE POTATOES? COUNT baked potatoes, boiled potatoes, mashed potatoes and potato salad. *Read if necessary: Do NOT include yams or sweet potatoes. INCLUDE red-skinned and Yukon Gold potatoes.
00 [ ] Never
01 [ ] 1-3 times last month
02 [ ] 1-2 times per week
03 [ ] 3-4 times per week
04 [ ] 5-6 times per week
05 [ ] 1 time per day
06 [ ] 2 times per day
07 [ ] 3 times per day
08 [ ] 4 times per day
09 [ ] 5 or more times per day
97 [ ] Refused
99 [ ] Don’t know
6. During the past month . . . How often did you eat COOKED DRIED BEANS, such as refried beans, baked beans, bean soup, and pork and beans? Do NOT include green beans.
00 [ ] Never
01 [ ] 1-3 times last month
02 [ ] 1-2 times per week
03 [ ] 3-4 times per week
04 [ ] 5-6 times per week
05 [ ] 1 time per day
06 [ ] 2 times per day
07 [ ] 3 times per day
08 [ ] 4 times per day
09 [ ] 5 or more times per day
97 [ ] Refused
99 [ ] Don’t know
7. During the past month . . . Not counting what you just told me about (lettuce salads, white potatoes, cooked dried beans), and not counting rice, how often did you eat OTHER VEGETABLES? *Read if necessary: Examples of other vegetables include tomatoes, string beans, carrots, corn, sweet potatoes, cabbage, bean sprouts, collard greens, and broccoli.
00 [ ] Never
01 [ ] 1-3 times last month
02 [ ] 1-2 times per week
03 [ ] 3-4 times per week
04 [ ] 5-6 times per week
05 [ ] 1 time per day
06 [ ] 2 times per day
07 [ ] 3 times per day
08 [ ] 4 times per day
09 [ ] 5 or more times per day
97 [ ] Refused
99 [ ] Don’t know
8. During the past month . . . How often did you have TOMATO SAUCES such as spaghetti sauce or pizza with tomato sauce?
00 [ ] Never
01 [ ] 1-3 times last month
02 [ ] 1-2 times per week
03 [ ] 3-4 times per week
04 [ ] 5-6 times per week
05 [ ] 1 time per day
06 [ ] 2 times per day
07 [ ] 3 times per day
08 [ ] 4 times per day
09 [ ] 5 or more times per day
97 [ ] Refused
99 [ ] Don’t know
9. During the past month . . . How often did you have SALSA?
00 [ ] Never
01 [ ] 1-3 times last month
02 [ ] 1-2 times per week
03 [ ] 3-4 times per week
04 [ ] 5-6 times per week
05 [ ] 1 time per day
06 [ ] 2 times per day
07 [ ] 3 times per day
08 [ ] 4 times per day
09 [ ] 5 or more times per day
97 [ ] Refused
99 [ ] Don’t know
Scoring Procedures
For fruits and vegetables, a Pyramid serving was defined by the U.S. Department of Agriculture (USDA) in the 1992 Dietary Guidelines Food Guide Pyramid as:
Vegetables: 1 cup raw leafy, 1/2 cup of other vegetables, or 3/4 cup vegetable juice; and
Fruits: 1 whole fruit, 1/2 cup of cut-up fruit, or 3/4 cup fruit juice.
More recently, the 2005 Dietary Guidelines measure fruits and vegetables in cup equivalents. Scoring using both metrics is provided.
The following procedures are used to convert an individual’s responses to an estimate of that individual’s daily intake of servings of fruits and vegetables.
1. The frequency reported categorically on the questionnaire is converted to the number of times consumed per day, as shown in Table 1. In general, the midpoint of the frequency range was used.
Table 1. Conversion of Frequency Response to Times per Day | |
Frequency Response | Times per Day |
Never | 0 |
1-3 times per month | 0.067 |
1-2 times per week | 0.214 |
3-4 times per week | 0.5 |
5-6 times per week | 0.786 |
1 time per day | 1 |
2 times per day | 2 |
3 times per day | 3 |
4 times per day | 4 |
5 or more times per day | 5 |
2. The age- and gender-specific portion sizes (see Table 2a and 2b) for each food are multiplied by the frequency calculated in Step 1.
Table 2a. Median Portion Size (Pk) in Pyramid Servings* per Mention by Gender and Age for Fruits and Vegetables | |||||||
Food Group | Age Group | ||||||
18-27 | 28-37 | 38-47 | 48-57 | 58-67 | 68-77 | 78-99 | |
Men | |||||||
100% fruit juice (P1) | 2.000000 | 1.667500 | 1.335000 | 1.335000 | 1.334000 | 1.001000 | 1.001000 |
Fruit (P2) | 1.301000 | 1.301000 | 1.229571 | 1.227333 | 1.168000 | 1.168000 | 1.052333 |
Salad (P3) | 0.545000 | 0.708000 | 0.754500 | 0.750000 | 0.833500 | 0.750000 | 0.822500 |
Fried potatoes (P4) | 2.000000 | 2.000000 | 1.773000 | 1.710000 | 1.400000 | 1.250000 | 1.250000 |
Other potatoes (P5) | 2.000000 | 2.000000 | 1.999000 | 1.999000 | 1.914000 | 1.544000 | 1.508000 |
Dried beans (P6) | 1.374000 | 1.047000 | 1.065000 | 1.227000 | 1.000000 | 1.000000 | 1.114000 |
Other Vegetables (P7) | 0.750000 | 0.906000 | 0.974500 | 1.000000 | 1.000000 | 0.880000 | 0.833333 |
Tomato sauce (P8) | 0.500000 | 0.541000 | 0.541000 | 0.812000 | 0.541000 | 0.541000 | 0.541000 |
Salsa (P9) | 0.533000 | 0.533000 | 0.421500 | 0.386500 | 0.137000 | 0.266000 | 0.266000 |
Women | |||||||
100% fruit juice (P1) | 1.500500 | 1.334000 | 1.334000 | 1.251250 | 1.019500 | 1.000500 | 1.000500 |
Fruit (P2) | 1.168000 | 1.168000 | 1.168000 | 1.168000 | 1.150500 | 1.083833 | 1.000000 |
Salad (P3) | 0.613500 | 0.572500 | 0.833333 | 1.000000 | 0.795500 | 0.625000 | 0.750000 |
Fried potatoes (P4) | 1.481000 | 1.365500 | 1.272000 | 1.400000 | 1.000000 | 1.026000 | 1.000000 |
Other white potatoes (P5) | 1.544000 | 1.544000 | 1.528000 | 1.544000 | 1.499000 | 1.516000 | 1.272000 |
Dried beans (P6) | 0.964000 | 0.684000 | 0.800000 | 0.687000 | 0.822000 | 0.807000 | 1.000000 |
Other Vegetables (P7) | 0.702200 | 0.779333 | 0.792500 | 0.788500 | 0.774000 | 0.833000 | 0.856750 |
Tomato sauce (P8) | 0.541000 | 0.541000 | 0.273000 | 0.541000 | 0.500000 | 0.500000 | 0.500000 |
Salsa (P9) | 0.274000 | 0.266000 | 0.322500 | 0.238250 | 0.266000 | 0.137000 | 0.137000 |
Table 2b. Median Portion Size (Pk) in Cup Servings** per Mention by Gender and Age for Fruits and Vegetables | ||||||||||||||
Food Group | Age Group | |||||||||||||
18-27 | 28-37 | 38-47 | 48-57 | 58-67 | 68-77 | 78-99 | ||||||||
Men | ||||||||||||||
100% fruit juice (P1) | 1.499160 | 1.250580 | 1.000980 | 1.000980 | 1.000176 | 0.750735 | 0.750735 | |||||||
Fruit (P2) | 0.999580 | 0.933450 | 0.867300 | 0.867300 | 0.867300 | 0.774916 | 0.657060 | |||||||
Salad (P3) | 0.272700 | 0.353970 | 0.377235 | 0.374963 | 0.416640 | 0.375000 | 0.411323 | |||||||
Fried potatoes (P4) | 0.721125 | 0.727700 | 0.641000 | 0.641000 | 0.548055 | 0.480750 | 0.499980 | |||||||
Other potatoes (P5) | 1.000400 | 1.140030 | 0.999600 | 0.999600 | 0.999490 | 0.833175 | 0.754400 | |||||||
Dried beans (P6) | 0.717550 | 0.551540 | 0.566720 | 0.612360 | 0.500250 | 0.502285 | 0.575360 | |||||||
Other Vegetables (P7) | 0.387675 | 0.473920 | 0.499840 | 0.500240 | 0.499905 | 0.460585 | 0.416899 | |||||||
Tomato sauce (P8) | 0.249900 | 0.271250 | 0.271250 | 0.406875 | 0.271250 | 0.271250 | 0.271250 | |||||||
Salsa (P9) | 0.266430 | 0.266430 | 0.210897 | 0.195683 | 0.068480 | 0.133236 | 0.133236 | |||||||
Women | ||||||||||||||
100% fruit juice (P1) | 1.124370 | 1.000960 | 1.000176 | 0.938130 | 0.764776 | 0.750728 | 0.750434 | |||||||
Fruit (P2) | 0.749235 | 0.867300 | 0.844838 | 0.789970 | 0.742350 | 0.712640 | 0.620475 | |||||||
Salad (P3) | 0.306788 | 0.286335 | 0.416625 | 0.499950 | 0.397688 | 0.312469 | 0.374963 | |||||||
Fried potatoes (P4) | 0.509595 | 0.455110 | 0.448700 | 0.448700 | 0.394856 | 0.444260 | 0.444260 | |||||||
Other white potatoes (P5) | 0.782020 | 0.876945 | 0.771260 | 0.771260 | 0.749700 | 0.771260 | 0.644235 | |||||||
Dried beans (P6) | 0.492150 | 0.341550 | 0.430530 | 0.345763 | 0.430685 | 0.430530 | 0.500400 | |||||||
Other Vegetables (P7) | 0.364468 | 0.395882 | 0.404303 | 0.408330 | 0.416913 | 0.436560 | 0.452214 | |||||||
Tomato sauce (P8) | 0.271250 | 0.271250 | 0.136710 | 0.271250 | 0.249900 | 0.249900 | 0.249900 | |||||||
Salsa (P9) | 0.136960 | 0.133236 | 0.163080 | 0.119187 | 0.133236 | 0.068480 | 0.068480 |
3. For Pyramid servings of fruits and vegetables, including and excluding French fries, for each gender, the estimated regression coefficients are listed in Table 3a.
Table 3a. Estimated Regression Coefficients for Sum of Foods Predicting Servings of Total Fruits and Vegetables and Fruits and Vegetables Excluding French Fries, by Gender | ||
Parameter | Men | Women |
Summary Variable with French fries | ||
Intercept (b0) | 0.704319 | 0.658819 |
b1 | 0.835532 | 0.796243 |
Summary Variable excluding French fries | ||
Intercept (b0) | 0.729653 | 0.639540 |
b1 | 0.822694 | 0.804796 |
For cups of fruits and vegetables (2005 MyPyramid definition), including and excluding French fries, for each gender, the estimated regression coefficients are listed in Table 3b.
Table 3b. Estimated Regression Coefficients for Sum of Foods Predicting Cups of Total Fruits and Vegetables and Fruits and Vegetables Excluding French Fries, by Gender | ||
Parameter | Men | Women |
Summary Variable with French fries | ||
Intercept (b0) | 0.529258 | 0.502480 |
b1 | 0.839721 | 0.792683 |
Summary Variable excluding French fries | ||
Intercept (b0) | 0.559458 | 0.495205 |
b1 | 0.819797 | 0.794978 |
For both metrics, these regression coefficients are applied according to the following equation:
E (Fruits and Veg1/2) = b0 + b1 (NFG1P1 + NFG2P2 + ... + NFG9P9)1/2
For men: Cube root of daily cup equivalents of fruits and vegetables = 0.529258 + 0.839721 (cube root of (Daily Frequency * Gender/Age Specific Portion Size per Mention for 100% fruit juice + Daily Frequency * Gender/Age Specific Portion Size per Mention for Fruit + ... + Daily Frequency * Gender/Age Specific Portion Size per Mention for salsa))
For women: Cube root of daily cup equivalents of fruits and vegetables = 0.502480 + 0.792683 (cube root of (Daily Frequency * Gender/Age Specific Portion Size per Mention for 100% fruit juice + Daily Frequency * Gender/Age Specific Portion Size per Mention for Fruit + ... + Daily Frequency * Gender/Age Specific Portion Size per Mention for salsa))
*Using 1992 Food Guide Pyramid definitions of servings.
**Using 2005 MyPyramid definitions of cups of fruits and vegetables.
Kool-Aid® is a registered trademark of Kraft Foods Inc.; Hi-C® is a registered trademark of The Coca-Cola Company; Gatorade® is a registered trademark of PepsiCo Inc.; Tampico® is a registered trademark of Tampico Beverages, Inc.; and Sunny Delight® is a registered trademark of Sunny Delight Beverages Co.
Personnel and Training Required
The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews. The interviewer should be trained to prompt respondents further if a "don’t know" response is provided. There are multiple modes to administer this question (e.g., paper-and-pencil and computer-assisted interviews).
Equipment Needs
While the source instrument was developed to be administered by computer, the PhenX Working Group acknowledges these questions can be administered in a non-computerized format (i.e., paper-and-pencil instrument). Computer software is necessary to develop computer-assisted instruments. The interviewer will require a laptop computer/handheld computer to administer a computer-assisted questionnaire.
Requirements
Requirement Category | Required |
---|---|
Major equipment | No |
Specialized training | No |
Specialized requirements for biospecimen collection | No |
Average time of greater than 15 minutes in an unaffected individual | No |
Mode of Administration
Interviewer-administered questionnaire
Lifestage
Adult, Senior
Participants
Ages 18 years and older
Selection Rationale
Vetted against several other fruit and vegetable questionnaires, these questions from the National Cancer Institute (NCI) Five-Factor Screener were selected because they are low burden and have been validated against the 24-hour dietary recall.
Language
Chinese, English, Spanish
Standards
Standard | Name | ID | Source |
---|---|---|---|
Logical Observation Identifiers Names and Codes (LOINC) | PhenX - fruits and veg protocol | 62284-5 | LOINC |
caDSR Form | PhenX PX050701 - Fruits And Vegetables Intake | 5850344 | caDSR Form |
Derived Variables
None
Process and Review
The Expert Review Panel #1 reviewed the measures in the Anthropometrics, Diabetes, Physical Activity and Physical Fitness, and Nutrition and Dietary Supplements domains.
Guidance from the ERP includes:
No significant changes to measure
Back-compatible: no changes to Data Dictionary
Previous version in Toolkit archive (link)
Protocol Name from Source
National Health Interview Survey (NHIS) Diet and Nutrition Questionnaire, 2005
Source
Centers for Disease Control and Prevention, National Center for Health Statistics. (2005). National Health Interview Survey (NHIS): Diet and nutrition questionnaire. Questions NAC.040_00.00 (question 1), NAC.070_00.00 (question 2), NAC.090_00.00 (question 3), NAC.100_00.00 (question 4), NAC.110_00.00 (question 5), NAC.120_00.00 (question 6), NAC.130_00.00 (question 7), NAC.131_00.00 (question 8), and NAC.132_00.00 (question 9).
National Cancer Institute. (2005). Five-factor screener: National Health Interview Survey (NHIS) diet and nutrition. NAC.010-NAC.138.
General References
Five-Factor Screener: Validation Results
Protocol ID
50701
Variables
Export VariablesVariable Name | Variable ID | Variable Description | dbGaP Mapping | |
---|---|---|---|---|
PX050701_Bean_Frequency | ||||
PX050701060000 | During the past month... How often did you more | N/A | ||
PX050701_French_Fries_Frequency | ||||
PX050701040000 | During the past month... How often did you more | N/A | ||
PX050701_Fruit_Frequency | ||||
PX050701020000 | During the past month... How often did you more | N/A | ||
PX050701_Fruit_Juice_Frequency | ||||
PX050701010000 | During the past month, how often did you more | N/A | ||
PX050701_Other_Vegetable_Frequency | ||||
PX050701070000 | During the past month... Not counting what more | N/A | ||
PX050701_Salad_Frequency | ||||
PX050701030000 | During the past month, how often did you eat more | N/A | ||
PX050701_Salsa_Frequency | ||||
PX050701090000 | During the past month... How often did you more | Variable Mapping | ||
PX050701_Tomato_Sauce_Frequency | ||||
PX050701080000 | During the past month... How often did you more | Variable Mapping | ||
PX050701_White_Potato_Frequency | ||||
PX050701050000 | During the past month... How often did you more | N/A |
Measure Name
Fruits and Vegetables Intake
Release Date
October 30, 2009
Definition
A measure to estimate an individual’s daily average intake of fruits and vegetables over the last 30 days as measured in cup equivalents.
Purpose
A diet rich in fruits and vegetables has been known to have many health benefits, including lower blood pressure; reduced risk of heart disease, stroke, and probably some cancers; lower risk of eye and digestive problems; and a blunting effect on blood sugar that can help keep appetite in check.
Keywords
Nutrition and Dietary Supplements, obesity, NHIS
Measure Protocols
Protocol ID | Protocol Name |
---|---|
50701 | Fruits and Vegetables Intake |
Publications
Barbirou, M., et al. (2020) Western influenced lifestyle and Kv2.1 association as predicted biomarkers for Tunisian colorectal cancer. BMC Cancer. 2020 November; 20: Article Number: 1086. doi: 10.1186/s12885-020-07605-7
Sapkota, B. R., et al. (2016) Genome-wide association study of 25(OH) Vitamin D concentrations in Punjabi Sikhs: Results of the Asian Indian diabetic heart study. J Steroid Biochem Mol Biol. 2016 April; 158: 149-156. doi: 10.1016/j.jsbmb.2015.12.014
Hitz, M.M., Conway, P.G, Palcher, J.A., McCarty, C.A. (2014) Using PhenX toolkit measures and other tools to assess urban/rural differences in health behaviors: recruitment methods and outcomes. BMC Research Notes. 2014 November; 7(847). doi: 10.1186/1756-0500-7-847