Hawaiʻi Health Data Warehouse


Our health is profoundly impacted by the foods and beverages that we consume. Good nutrition is essential across the lifespan: from infancy, childhood, and adolescence to adulthood and older adulthood.1 Breastfeeding supports infant health and growth, and protects against childhood illnesses. Healthy dietary practices contribute to good health and the reduction and/or management of chronic diseases such as cardiovascular disease, obesity, and type 2 diabetes.2

Why It’s Important

Poor diet quality is a leading risk factor associated with death and disability in the United States (US). Eating a diet rich in fruits and vegetables as part of an overall healthy diet can help protect against a number of serious and costly chronic diseases.3 Healthy eating patterns are important across the lifespan:1

  • From birth through 23 months to lower the risk of overweight, type 1 diabetes, iron deficiency, peanut allergy, and asthma.
  • Women who are pregnant or lactating to promote child cognitive development and favorable folate status for the mother.
  • Children and adolescents to lower the risk of overweight and obesity and lower LDL cholesterol.
  • Adults and older adults to lower the risk of all-cause mortality, chronic disease, and certain cancers.

In addition to health impacts, healthy eating has a significant effect on the economy. Low breastfeeding rates contribute to over $3 billion a year in medical costs in the US.2

What Is Known

The American Academy of Pediatrics (AAP) recommends that mothers exclusively breastfeed their baby for the first six months. After six months, breastfeeding should continue alongside nutritious complementary foods.4 Although most infants in the US are breastfed, most are not exclusively breastfed or are not breastfed as long as recommended. Nationally 83.9% of babies are ever breastfed, 56.7% are still breastfeeding at six months of age and only 35.0% are still breastfeeding at one year (NIS 2018).

In terms of exclusive breastfeeding, 46.3% of babies are breastfed exclusively through three months and only 25.8% are breastfed exclusively through six months (NIS 2018). Rates of breastfeeding are higher in Hawaiʻi than in the US with 94.6% of women initiating breastfeeding, and 75.1% who still breastfed at six months (PRAMS 2019). 59.2% of babies were exclusively breastfed through three months, and 36.6% were exclusively breastfed through six months (NIS 2018).

Nationally, less than one in 10 children and adults eat the recommended daily amount of vegetables. In Hawai‘i, 40.3% of adults eat less than one serving of fruit per day and 22.0% eat less than one serving of vegetables per day (BRFSS 2019). Among teens, only 13.9% ate fruits and vegetables five or more times per day (YRBS 2019).

Nationally in 2019, 15.1% of teens drank a can, bottle or glass of sugary soda at least once per day, compared to 10.6% in Hawai‘i in 2019 (YRBS). In 2020, 11.5% of adults in Hawai‘i drank a sugary soda at least once per day (BRFSS).

Who Is at Risk

About 60% of mothers do not breastfeed as long as they intend to. How long a mother breastfeeds her baby is influenced by many factors including, but not limited to:5

  • Lactation and latching issues
  • Unsupportive work policies and lack of parental leave
  • Cultural norms and/or lack of family support
  • Lack of community resources to support breastfeeding

Certain communities have more difficulty accessing healthy foods. These include:6

  • Low income neighborhoods
  • Rural communities
  • Individuals without access to a vehicle or public transportation
  • Minority communities

While there is evidence that sugary soda consumption is decreasing, teen boys are more likely to report daily soda consumption than girls, and Other Pacific Islanders report more soda consumption than other race/ethnicity groups.7

How To Reduce Risk

The USDA 2020-2025 Dietary Guidelines for Americans recommends to:1

  • Follow a healthy dietary pattern at every life stage
  • Customize healthy food and beverage choices to reflect personal, cultural, and budgetary preferences
  • Focus on nutrient-dense foods and beverages, and keep mindful of calorie limits
  • Limit foods and beverages with added sugars, saturated fats and sodium

States and communities can help citizens consume more fruits and vegetables by making them convenient and affordable in the places where children and adults live, work, learn, and play. This is particularly important for individuals and families that face food insecurity or lack access to stores selling quality produce at reasonable prices.

Page last updated July 29, 2022.

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1 US Department of Agriculture and US Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf Accessed July 21, 2022.
2 Why it Matters. Centers for Disease Control and Prevention. https://www.cdc.gov/nutrition/about-nutrition/why-it-matters.html Updated January 25, 2021. Accessed July 21, 2022.
3 Vegetables and Fruits. Harvard TH Chan School of Public Health. https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vegetables-and-fruits/ Accessed July 21, 2022.
4 American Academy of Pediatrics Calls for More Support for Breastfeeding Mothers Within Updated Policy Recommendations. American Academy of Pediatrics. https://www.aap.org/en/news-room/news-releases/aap/2022/american-academy-of-pediatrics-calls-for-more-support-for-breastfeeding-mothers-within-updated-policy-recommendations/ Published June 27, 2022. Accessed July 21, 2022.
5 Breastfeeding Data & Statistics. Centers for Disease Control and Prevention. https://www.cdc.gov/breastfeeding/data/facts.html Updated August 24, 2021. Accessed July 21, 2022.
6 Access to Foods that Support Healthy Eating Patterns. Healthy People. https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/access-to-foods-that-support-healthy-eating-patterns Updated February 6, 2022. Accessed July 21, 2022.
7 Get the Facts: Sugar-Sweetened Beverages and Consumption. Centers for Disease Control and Prevention. https://www.cdc.gov/nutrition/data-statistics/sugar-sweetened-beverages-intake.html Updated April 11, 2022. Accessed July 21, 2022.