Weight resilience and fruit and vegetable intake among African-American women in an obesogenic environment

Objective: To investigate relationships between weight resilience (maintaining a normal weight in a food desert environment) and fruit and vegetable (F&V) intake, attitudes and barriers. Design: Cross-sectional, in-person surveys collected May-December 2011, including self-reported data on F&V-related psychosocial factors, attitudes and barriers. Two 24h dietary recalls were completed; weight and height were measured. Multivariable regression models estimated prevalence ratios (95% CI). Setting: Two low-income, predominantly African-American food deserts in Pittsburgh, Pennsylvania, USA. Subjects: Women aged 18-49 years (n 279) who were the primary food shopper in a household randomly selected for a parent study. Results: Fifteen per cent were weight resilient, 30% were overweight and 55% were obese. Overall, 25% repotted eating >= 5 F&V servings/d. After adjustment for age, education, parity, employment, living alone, physical activity, per capita income and mean daily energy intake, women eating >= 5 F&V servings/d were 94% more likely to be weight resilient compared with those eating < 5 servings/d (1.94; 1.10, 3.43). Across BMI groups, self-efficacy regarding F&V consumption was high and few F&V barriers were reported. The most frequently reported barrier was concern about the cost of F&V (36%). Of the attitudinal F&V-related factors, only concern about wasting food when serving F&V was associated with weight resilience in adjusted models (0.29; 0.09, 0.94). In a model predicting consuming >= 5 F&V servings/d, driving one's own car to the store was the only attitudinal F&V-related factor associated with consumption (1.50; 1.00, 2.24). Conclusions: In this population, weight resilience may be encouraged by improving access to affordable and convenient F&V options and providing education on ways to make them palatable to the entire household, rather than by shifting women's F&V perceptions, which are already positive.