Eat the Recommended Amount of Fruits and Vegetables

OVERVIEW

1

In an article published in 2014 in Critical Reviews in Food Science and Nutrition, a researcher from Madrid, Spain wrote that the association between diet and overall health has been recognized since ancient times. More recently, there have been a host of epidemiological studies that have shown that diets rich in fruits and vegetables lower the risk of chronic illnesses, such as cancer and cardiovascular disease, and they reduce the risk of premature mortality. The researcher concluded that “phytochemicals in fruits and vegetables might be a promising tool for the prevention and/or amelioration of a wide range of diseases.” 2

Meanwhile, in a 2012 article in Advances in Nutrition, researchers from Valhalla, New York, noted that diets high in fruits and vegetables are “widely recommended for their health promoting properties.” Fruits and vegetables have been valued for high amounts of vitamins, minerals, electrolytes, and fiber. Their high amounts of phytochemicals “function as antioxidants, phytoestrogens, and anti-inflammatory agents.” On average, half of a typical meal should consist of fruits and vegetables; most people in the United States don’t even come close to eating this amount. 3 In “Youth Risk Behavior Surveillance—United States, 2013,” a survey completed by the Centers for Disease Control and Prevention and reported in the June 13, 2014, issue of Morbidity and Mortality Weekly Report, researchers noted that during the seven days before their survey, “5.0% of the high school students had not eaten fruit or drunk 100% fruit juices and 6.6% had not eaten vegetables.” 4 Moreover, there may be disagreements between government officials and nutritionists on what constitutes a serving. “Published studies on 3 methods for counting fruits and vegetables in 4th grade students found that different counting methods yielded significantly different tallies of fruit and vegetable intake.” 5

WHAT THE EXPERTS SAY

Consumption of Fruits and Vegetables Appears to Extend the Lifespan 6

Fruit and Vegetable Consumption Appears to Reduce the Rate of All Types of Mortality

In a study published in 2014 in the Journal of Epidemiology & Community Health, researchers based in England wanted to learn if the consumption of fruits and vegetables would reduce the rate of mortality in the general English population. The cohort consisted of 65,226 people, 35 years of age and older, who were included in the 2001 to 2008 Health Surveys for England. Participants in this survey were interviewed in person; the initial interview was followed by a second visit with a nurse who took measurements, such as waist circumference and blood pressure, and collected biological samples, such as blood. During the median follow-up of 7.7 years, 4,399 deaths were recorded. The researchers found a strong association between consumption of fruits and vegetables and mortality. Those who ate seven or more portions per day of fruits and vegetables had the lowest risk of mortality from any cause. Moreover, these researchers found that vegetables appeared to have a greater effect per portion than fruit. The researchers concluded that “a robust association exists between fruit and vegetable consumption and mortality.” 7

Fruits and Vegetables May Reduce the Risk of Stroke 8

Fruits and Vegetables May Reduce the Incidence of Coronary Heart Disease

In a study published in 2010 in PLoS ONE, researchers from the Netherlands investigated the association between consumption of raw and processed fruits and vegetables and coronary heart disease. The cohort was drawn from two locations in the Netherlands; there were a total of 20,069 men and women between the ages of 20 and 65 years. At baseline, all the participants were free of cardiovascular disease. Information on the consumption of 178 food items was obtained from food frequency questionnaires. During a mean follow-up time of 10.5 years, 245 incident cases of coronary heart disease were documented. Of these, 34 were fatal. The researchers found that the participants with a high intake of raw or processed fruits and vegetables had a 34 percent lower risk of coronary heart disease than the participants with a low intake of these fruits and vegetables. The researchers noted that their findings “suggest that a high consumption [of] fruit and vegetables, whether consumed raw or processed, may protect against CHD [coronary heart disease] incidence.” 9

BARRIERS AND PROBLEMS

Healthier Foods, Such as Fruits and Vegetables, Tend to Be More Expensive

It is very clear that large numbers of people have a diet that includes few fruits and vegetables. While they are probably aware that they should be eating more fruits and vegetables, to them, it is easier and more convenient to consume prepared or processed foods. And, fruits and vegetables may well be pricey. According to an article published in 2014 in PLoS ONE, there are ever-increasing price gaps between more healthful and less healthful foods. Researchers from the United Kingdom used data from the U.K. Department of Health National Diet and Nutrition Survey to trace the price trends of more and less healthful foods from 2002 to 2012. Each of the 94 foods studied was placed in one of five groups; one of these groups was fruits and vegetables. All the foods were classified as either “more healthy” or “less healthy.” Though healthier foods and drinks have always been more expensive than less healthy alternatives, the researchers found that over the 10-year period of the study, the size of the price gap had increased 28.6 percent. Thus, the healthier foods were even less affordable than they had previously been, making it more likely that people will eat the less healthy foods. The researchers noted that their findings “suggest that we should consider not only the issue of people being able to afford to eat enough food to avoid hunger but also being able to eat enough food which is healthy.” 10

Teens May Not Have the Healthiest Habits

In a cross-sectional study published in 2014 in Przegl Epidemiol, researchers based in Poland wanted to estimate the prevalence of healthy behaviors, such as eating fruits and vegetables, among adolescents. Their cohort consisted of 574 teens who were 13 years old. In two separate questions, the teens were asked how many times per week they ate fruits and vegetables. Almost half of the teens reported eating fruits and vegetables at least once per day; there was no significant difference between the male and female teens. 11 Still, that intake is significantly lower than the WHO recommendations mentioned early in this entry.

NOTES

1. World Health Organization, www.who.int.

2. Arantxa Rodriguez-Casado, “The Health Potential of Fruits and Vegetables Phytochemicals: Notable Examples,” Critical Reviews in Food Science and Nutrition (2014).

3. Joanne L. Slavin and Beate Lloyd, “Health Benefits of Fruits and Vegetables,” Advances in Nutrition 3 (2012): 506-16.

4. Centers for Disease Control and Prevention, “Youth Risk Behavior Surveillance—United States, 2013,” Morbidity and Mortality Weekly Report 63, no. 4 (2014). http://www.cdc.gov/mmwr/pdf/ss/ss6304.pdf.

5. Slavin and Lloyd, “Health Benefits.”

6. Anette Hjartåker, Markus Dines Knudsen, Steinar Tretli, and Elisabete Weiderpass, “Consumption of Berries, Fruits and Vegetables and Mortality Among 10,000 Norwegian Men Followed for Four Decades,” European Journal of Nutrition 54 (2015): 599-608.

7. Oyinlola Oyebode, Vanessa Gordon-Dseagu, Alice Walker, and Jennifer S. Mindell, “Fruit and Vegetable Consumption and All-Cause, Cancer and CVD Mortality: Analysis of Health Survey for England Data,” Journal of Epidemiology & Community Health 68 (2014): 856-62.

8. Susanna C. Larsson, Jarmo Virtamo, and Alicja Wolk, “Total and Specific Fruit and Vegetable Consumption and Risk of Stroke: A Prospective Study,” Atherosclerosis 227 (2013): 147-52.

9. Linda M. Oude Griep, Johanna M. Geleijnse, Daan Kromhout et al., “Raw and Processed Fruit and Vegetable Consumption and 10-Year Coronary Heart Disease Incidence in a Population-Based Cohort Study in the Netherlands,” PLoS ONE 5, no. 10 (2010): e13609.

10. Nicholas R. V. Jones, Annalijn I. Conklin, Marc Suhrcke, and Pablo Monsivais, “The Growing Price Gap Between More and Less Healthy Foods: Analysis of a Novel Longitudinal UK Dataset,” PLoS ONE 9, no. 10 (2014): e109343.

11. Maria Jodkowska, Anna Oblacińska, and Izabela Tabak, “How Well Do Polish Teenagers Meet Health Behaviour Guidelines?” Przegl Epidemiol 68 (2014): 65-70.

REFERENCES AND RESOURCES

Magazines, Journals, and Newspapers

Aune, D., D. S. M. Chan, A. R. Vieira et al. “Fruits, Vegetables and Breast Cancer Risk: A Systematic Review and Meta-Analysis of Prospective Studies.” Breast Cancer Research and Treatment 134 (2012): 479-93.

Fulton, Sharon L., Michelle C. McKinley, Ian S. Young et al. 2014. “The Effect of Increasing Fruit and Vegetable Consumption on Overall Diet: A Systematic Review and Meta-Analysis.” Critical Reviews in Food Science and Nutrition

Gardiner, Breeana, Miranda Blake, Raeleigh Harris et al. “Can Small Stores Have a Big Impact? A Qualitative Evaluation of a Store Fruit and Vegetable Initiative.” Health Promotion Journal of Australia 24 (2013): 192-98.

Hjartåker, Anette, Markus Dines Knudsen, Steinar Tretli, and Elisabete Weiderpass. “Consumption of Berries, Fruits and Vegetables and Mortality Among 10,000 Norwegian Men Followed for Four Decades.” European Journal of Nutrition 54 (2015): 599-608.

Jodkowska, Maria, Anna Oblacińska, and Izabela Tabak. “How Well Do Polish Teenagers Meet Health Behaviour Guidelines?” Przegl Epidemiol 68 (2014): 65-70.

Jones, Nicholas R. V., Annalijn I. Conklin, Marc Suhrcke, and Pablo Monsivais. “The Growing Price Gap Between More and Less Healthy Foods: Analysis of a Novel Longitudinal UK Dataset.” PLoS ONE 9, no. 10 (2014): e109343.

Larsson, Susanna C., Jarmo Virtamo, and Alicja Wolk. “Total and Specific Fruit and Vegetable Consumption and Risk of Stroke: A Prospective Study.” Atherosclerosis 227 (2013): 147-52.

Mytton, O. T., K. Nnoaham, H. Eyles et al. “Systematic Review and Meta-Analysis of the Effect of Increased Vegetable and Fruit Consumption on Body Weight and Energy Intake.” BMC Public Health 14 (2014): 886+.

Oude Griep, Linda M., Johanna M. Geleijnse, Daan Kromhout et al. “Raw and Processed Fruit and Vegetable Consumption and 10-Year Coronary Heart Disease Incidence in a Population-Based Cohort Study in the Netherlands.” PLoS ONE 5, no. 10 (2010): e13609.

Oyebode, Oyinlola, Vanessa Gordon-Dseagu, Alice Walker, and Jennifer S. Mindell. “Fruit and Vegetable Consumption and All-Cause Cancer and CVD Mortality: Analysis of Health Survey for England Data.” Journal of Epidemiology & Community Health 68 (2014): 856-62.

Rodriguez-Casado, Arantxa. “The Health Potential of Fruits and Vegetables Phytochemicals: Notable Examples.” Critical Reviews in Food Sciences and Nutrition 34, no. 7 (May 2016): 1097-1107.

Slavin, Joanne L., and Beate Lloyd. “Health Benefits of Fruits and Vegetables.” Advances in Nutrition 3 (2012): 506-16.

Storey, Maureen, and Patricia Anderson. “Income and Race/Ethnicity Influence Dietary Fiber Intake and Vegetable Consumption.” Nutrition Research 34 (2014): 844-50.

Young, Candace R., Jennifer L. Aquilante, Sara Solomon et al. “Improving Fruit and Vegetable Consumption Among Low-Income Customers at Farmers Markets: Philly Food Bucks, Philadelphia, Pennsylvania, 2011.” Preventing Chronic Disease 10 (2013): E166.

Web Sites

Centers for Disease Control and Prevention. www.cdc.gov .

World Health Organization. www.who.int .

  This information is not a tool for self-diagnosis or a substitute for professional care.