Examining the Differences in Frequency of Consuming Whole Fruits Versus 100% Fruit Juice on Cardiovascular Disease Indicators in U.S. Adults: Analysis of 2019 BRFSS

Objectives: Consuming fruit helps promote health and prevent disease. The Dietary Guidelines for Americans recommends both whole fruit and 100% fruit juice ("juice") in the fruit group; however, there are compositional differences between whole fruit and juice especially with dietary fiber content. We hypothesized that whole fruit consumption frequency would be lower- but frequency of drinking juice would be higher- in adults with less favorable cardiovascular disease (CVD) risk factors or disease markers. Methods: Data from U.S. adults (n= 371,038) who answered prompts on how often they ate whole fruit or drank juice as part of the 2019 Behavior Risk Factor Surveillance System (BRFSS) was used. Data on cardiovascular risk factors or disease markers was identified from BRFSS participants who answered either "yes" or "no" to questions asking if a healthcare provider had ever informed them that they had high blood pressure, high blood cholesterol, angina/coronary heart disease (CHD), experienced a heart attack, or had a stroke. Linear regression with survey weights was performed on each cardiovascular condition and risk factor to determine whether mean whole fruit consumption and juice consumption frequency differed between groups with and without CVD or CVD risk factors. Results: Mean consumption frequency of juice in the entire study population was 0.30 times per day, and mean consumption frequency of whole fruit was 1.07 times per day. Approximately 34% of the study population had been diagnosed with high blood pressure, 32% with high cholesterol, 4% had experienced a heart attack or been told they had CHD, and 3% had suffered a stroke. As hypothesized, whole fruit consumption frequency was lower in adults who self-reported high blood pressure (p< 0.0001), high cholesterol (p< 0.0001), heart attack (p< 0.0001), CHD (p=0.0004), or stroke (p< 0.0001). Also, juice consumption frequency was higher in adults who self-reported high blood pressure (p< 0.0001), heart attack (p< 0.0001), CHD (p=0.0033), or a stroke (p< 0.0001). Conclusions: Additional research should examine the relationship between fruit form and cardiovascular health to pinpoint potential mechanisms as well as identify strategies to increase whole fruit consumption in the U.S. population. Funding Sources: Brendan Kesler is an employee of Van Drunen Farms and his tuition fees were reimbursed.