Barriers to produce intake


While many caregivers want to increase their child’s fruit and vegetable intake, barriers keep them from receiving fresh produce.

There are multiple barriers keeping children from receiving produce despite the wishes of caregivers, according to a recent study.

The fruits and vegetables (FV) intake is insufficient among a majority of children in the United States, with only 40% of children aged 1 to 18 years from 2007 to 2010 meeting the recommended daily fruit intake from the US Department of Agriculture, and only 7% meeting the recommended daily vegetable intake.

Eating patterns from childhood often impact eating patterns in adulthood, showcasing the importance of healthy eating behaviors at an early age. Food insecurity (FI) is one source of low FV intake, with a disproportionate number of African Americans and Hispanic individuals affected. This leads to increased obesity and chronic disease among these populations.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), along with other programs, work to improve food security in low-income populations. However, in 2017, it was reported that only 51% of eligible United States households participated in WIC. This rate has lowered since the onset of COVID-19.

To determine barriers of FV intake among WIC-eligible families, investigators conducted a qualitative study. Children were recruited from a primary care clinic in West Philadelphia. Eighty-eight percent of clinic patients were African American, 4% Latino, and 3% non-English speaking. Recruitment occurred from December 2019 to February 2020.

Inclusion criteria for caregivers included being aged over 18 years, residing in Philadelphia, speaking English, and having a WIC-eligible child aged under 5 years. Data was collected through telephone interviews with questions grouped into general categories.

Categories includedfamily’s current and ideal produce intake, use of food benefits and local food programs, facilitators and barriers to produce access, and perceived characteristics of an ideal program to increase produce access. Demographic data gathered included sex, age, race and ethnicity, body mass index, and insurance coverage.

Positive FI screening was reported in 57% of participants. A commonly reported barrier to FV intake was limited produce options in neighborhoods. Higher costs of produce and time constraints were also barriers to FV intake. COVID-19 worsened barriers because of increased food prices, produce shortages, decreased income sources, and childcare center closures.

WIC enrollment increased produce access, but barriers to WIC were present as well. Transitioning to electronic benefit transfer cards during the COVID-19 pandemic led to challenges such as fear of misplacing card and unfamiliarity with the process. The closure of WIC offices during the pandemic also created barriers to receiving benefits.

Most caregivers reported a desire for their child to have an increased FV intake. An ideal food program was described as delivery-based, free or covered by benefits, and containing a wide variety of FV.


Joshi P, Van Remortel BJ, Cullen DL. Perspectives from urban WIC-eligible caregivers to improve produceaccess. Pediatrics. 2023;151(2). doi:10.1542/peds.2022-058536

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