12 January - 20 June 2016

How much fruit and veg do we need?

9 Apr 14

In 1990, the WHO issued recommendations for a minimum daily intake of 400g fruit and vegetables as a protective measure against cardiovascular disease (CVD) and some cancers. In 2003, the '5-a-day' campaign in UK was launched; however, the USA in 2007 moved from a similar '5-a-day' message to a more general 'Fruit and Veggies - More Matters' campaign recommending varying amounts of fruit and vegetables depending on individual calorie needs. Since 2005, meanwhile, the Australian government has recommended consuming two portions of fruit and five of vegetables a day (equivalent to 8.5 UK portions altogether) as part of the 'Go for 2+5 campaign'. But how much fruit and veg must really be consumed for beneficial effects on health, and what is the optimum intake?

The authors of a recently published article in the Journal of Epidemiology and Community Health argue that many of the previous studies demonstrating that fruits and vegetable intake decrease the risk of CVD, some cancers and all-cause mortality use data that is non-representative of general populations, comprising a particularly health-conscious subgroup. They conducted a study to analyse the daily consumption of fruits and vegetables among a representative, non-institutionalised population in England (65,226 people).

The study shows that those eating 1-3 portions of fruits and vegetables a day had significantly greater survival than those eating less than one portion a day, and that those who ate 7+ portions had the lowest all-cause mortality. Moreover, the researchers observed an inverse relationship between total portions of fruit and vegetables and cancer and CVD mortality (5-7 portions for cancer and more than 7 for CVD prevention).

Interestingly, vegetables showed greater beneficial effects than fruits, with 2-3 portions of vegetables a day compared to 3-4 portions of fruit being linked with reduced all-cause mortality. The researchers also demonstrated that the impact on all-cause mortality was dependent on the specific types of fruit and vegetable. Consumption of vegetables, salad, fresh fruit and dried fruit was associated with a significantly lower risk of all-cause mortality, but frozen and canned fruit with a higher risk.

The authors emphasise that the study demonstrates strong associations but not necessarily a cause and effect relationship, because certain confounders (for example total energy or salt consumption) were not included in the analyses. Oyebode et al. also note that WHO-recommended fruit and vegetable intake recommendations are not based on any specific evidence as to the necessary level of intake, and that the upper limit of intake for maximum protective effect is unknown. The current study demonstrates that 7 or more portions is associated with the lowest risk of all-cause mortality.[Eurekalert]

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