Five servings of fruits and vegetables a day can reduce mortality

Two servings of fruit and three servings of vegetables a day may be enough to reduce overall mortality and death from cardiovascular disease, cancer and respiratory disease, according to research published in Circulation.

“While groups like the American Heart Association recommend four to five daily servings of fruits and vegetables, consumers are likely to receive inconsistent messages about what defines the optimal daily intake of fruits and vegetables, such as the recommended amount and what foods include and avoid “. Dong D. Wang, MD, ScD, an epidemiologist, nutritionist and a member of the faculty of medicine at Harvard Medical School and Brigham and Women’s Hospital, said in a press release.

For this analysis, the researchers evaluated 66,719 women from the Nurses’ Health Study (1984-2014) and 42,016 men from the Health Professionals Follow-up Study (1986-2014) with no CVD, cancer, or diabetes at baseline. According to the study, diet was assessed using a semi-quantitative food frequency questionnaire updated from baseline every 2 to 4 years. In addition, the investigators performed a dose-response meta-analysis that included data from the present study and 24 other prospective studies.

Benefits of fruits and vegetables

The researchers observed a non-linear inverse relationship between fruit and vegetable consumption and overall mortality (P <.001); however, compared to two servings per day, intake of more than five servings per day was not associated with any further reduction beyond five servings per day:

• approximately three servings per day (HR = 0.95, 95% CI 0.92-0.99; P <.001);
• approximately four servings per day (HR = 0.89, 95% CI, 0.86-0.92; P <.001);
• approximately five servings per day (HR = 0.88, 95% CI, 0.85–0.91; P <.001); Y
• approximately seven servings per day (HR = 0.89, 95% CI, 0.86-0.93; P <.001), compared to just one serving per day.

Compared with an intake of two servings per day, five servings of fruits and vegetables was associated with lower total mortality (HR = 0.87; 95% CI, 0.85-0.9), lower CVD mortality ( HR = 0.88; 95% CI, 0.83-0.94), lower mortality from cancer (HR = 0.9; 95% CI, 0.86-0.95) and mortality from lower respiratory diseases (HR = 0.65; 95% CI, 0.59-0.72).

Furthermore, total mortality did not decrease beyond approximately two servings of fruit per day compared to 0.5 servings per day (HR = 0.88, 95% CI, 0.86-0.91) and three servings of vegetables per day compared to 1.5 servings per day. (HR = 0.94, 95% CI 0.92-0.97), the researchers wrote.

“This amount probably offers the greatest benefit in terms of preventing major chronic diseases and is a relatively achievable intake for the general public,” Wang said in the statement. “We also found that not all fruits and vegetables offer the same degree of benefit, although current dietary recommendations generally treat all types of fruits and vegetables, including starchy vegetables, fruit juices, and potatoes, equally.”

The association between fruit and vegetable intake and total mortality was consistent in several subgroups, including age, smoking, BMI, hypertension, and hypercholesterolemia (P for all> .05).

In addition, the researchers found similar results after dose-response meta-analysis that included 1,892,885 participants that returned similar results (RR for 5 servings per day vs 2 servings per day = 0.87; 95% CI, 0. 85 to 0.88; nonlinear P <0.001).

“The American Heart Association recommends filling at least half your plate with fruits and vegetables at every meal,” Anne Thorndike, MD, MPH, chairman of the AHA nutrition committee and associate professor of medicine at Harvard Medical School, he said in the statement. “This research provides strong evidence for the lifetime benefits of eating fruits and vegetables and suggests a target amount to consume daily for ideal health. Fruits and vegetables are naturally packaged sources of nutrients that can be included in most meals and snacks and are essential for keeping your heart and body healthy. ”

The unhealthy eating epidemic

In a related editorial to be published in a future print edition of Circulation, Naveed Sattar, MD, PhD, professor of cardiovascular and medical sciences at the University of Glasgow, and Nita Forouhi, Doctor, program leader and MRC researcher in nutritional epidemiology at the University of Cambridge, wrote that health professionals can “help people understand how to implement simple dietary changes. The biggest benefits may come from encouraging those who rarely eat fruits or vegetables, as diets rich in even modestly higher fruit and vegetable consumption are beneficial. Among younger children, the concept of repeated exposure has gained momentum to train the palate to begin to enjoy fruits and vegetables. Adults can take on a similar ‘palate retraining challenge’ to learn to enjoy fruits and vegetables.

“The bottom line is that food is really medicine, and that health professionals and governments would do well to improve their games to improve dietary intake at the individual and population levels,” the editorial authors wrote. “Increasing people’s enjoyment and intake of fruits and vegetables should be a key part of future dietary interventions. In the post-COVID world, where diets and other health behaviors have been negatively affected due to lockdowns, more needs to be done, not less, to address the unhealthy eating epidemic. “

Reference:

• Sattar N, et al. Circulation. To appear in a future print edition. Permission to use quotes granted by the American Heart Association.

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