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5 A DAY health benefits

  • Last modified date:
    5 February 2010
Capsicum photo

The health benefits of fruits and vegetables.

What is 5 A DAY?

The 5 A DAY message – to eat at least 5 portions (400g) of a variety of fruit and vegetables each day - was developed based on a recommendation from the World Health Organization (WHO), following evidence that populations consuming at least 400g of fruit and vegetables per day can reduce the risk of deaths from chronic diseases such as heart disease, stroke, and some cancers (World Health Organization, 1990).

Fruit and vegetable consumption in England is currently lower than recommended, although available trends data suggests there is an overall upward trend in consumption. Most recent trends data from the Health Survey for England show that the average number of portions consumed in adults is 3.5 portions for men and 3.8 portions for women (Aresu et al, 2009).

Burden of disease

Chronic diseases, particularly cardiovascular disease (CVD) and  cancer are a major cause of death in the UK (accounting for 1.9 and 1.1 million deaths each year) - they are a huge public health challenge. Moreover, they are one of the main causes of disability arising from ill health (Peterson et al., 2005).

In Europe, the burden of disease attributable to low fruit and vegetable intake has been estimated to be between 19 and 35% for heart disease, 12 and 23% for stroke, 13 and 24% for stomach and oesophageal cancers, 8 and 16% for lung cancer, and 1 and 3% for colorectal cancer (Pomerleau et al, 2005).

Why fruit and vegetables?

Fruit and vegetables are good sources of many vitamins and minerals. In addition, fruit and vegetables contain a range of other compounds called phytochemicals, including flavonoids, glucosiniolates and phyto-oestrogens. These have a range of beneficial effects on the body. They act as antioxidants which can help prevent damage to tissues that is associated with the development of cardiovascular disease and some cancers. Furthermore, it is thought that nutrients and phytochemicals act in concert to influence the risk of certain chronic diseases.

Dietary supplements containing isolated vitamins or minerals do not appear to have the same beneficial effects as fruit and vegetables themselves. Indeed, in some studies, supplements caused more harm than good (Department of Health, 1998).

What are the health benefits of 5 A DAY?

Increasing consumption of fruit and vegetables can significantly reduce the risk of many chronic diseases (Department of Health 1994, Department of Health 1998, WHO 2000). It has previously been estimated that eating at least 5 portions of a variety of fruit and vegetables a day could reduce the risk of death from chronic diseases such as heart disease, stroke, and cancer by up to 20% (Department of Health, 2000)
It has also been estimated that diet might contribute to the development of one-third of all cancers, and that increasing fruit and vegetable consumption is the second most important cancer prevention strategy, after reducing smoking (Department of Health 1994).

Cardiovascular disease

In 1994, the Committee on Medical Aspects of Food and Nutrition Policy’s (COMA) cardiovascular review group reviewed the evidence with regard to fruit and vegetable consumption and recommended that the population mean intake of fruit and vegetables should increase by at least 50% (Department of Health, 1994).

More recently, a meta-analysis of 13 cohort studies found that intakes of more than 5 portions of fruit and vegetables a day were associated with a 17% reduction in coronary heart disease (CHD) risk, and intakes of 3-5 portions per day were associated with a more modest decrease in CHD risk (7% reduction) (He et al, 2007). 

According to another study in Europe, the burden of ischaemic heart disease and stroke could be reduced by up to 17% and 10% respectively, with an increase in fruit and vegetables consumption to 600g per day (Pomerleau et al, 2005).

Cancer

In 1998, COMA reviewed the evidence on the nutritional aspects of the development of cancer and concluded that higher vegetable consumption would reduce the risk of colorectal cancer and gastric cancer (Department of Health, 1998).

More recently, the World Cancer Research Fund (WCRF), together with the American Institute for Cancer Research (AICR), published a rigorous review and evaluation of 7,000 studies on food, nutrition, physical activity and body composition in relation to cancer (WCRF & AICR, 2007). Among other findings, the Expert Group concluded that the evidence shows vegetables, fruits and other foods containing dietary fibre (such as whole-grains and pulses) may protect against a range of cancers including mouth, stomach and bowel cancer. WCRF subsequently recommended, 'Eat at least five portions/servings (at least 400g) of a variety of non-starchy vegetables and of fruits every day'.

More specifically, they concluded that non-starchy vegetables ‘probably’ have a protective role against cancers of the mouth, pharynx, and larynx as well as those of the oesophagus and stomach. In addition, there is evidence that certain fruits protect against mouth, pharynx, larynx, oesophagus, lung and stomach cancer (WCRF & AICR, 2007).

Other health benefits

Eating more fruit and vegetables will also help to increase intake of dietary fibre. It may also help to reduce total energy and fat intake, if eating more fruit and vegetables replaces consumption of energy dense foods. It has been suggested that increasing fruit and vegetable consumption may help to reduce the energy density of meals (Dauchet, 2009).

Long-term studies examining the effects of various dietary interventions suggest a positive role for fruit and vegetables in weight management, where increased consumption of fruits and vegetables may enhance satiety and help to avoid hunger (Rolls et al, 2004).

References

 

  1. Aresu M, Bécares L, Brage S, Chaudhury M, Doyle-Francis M, Esliger D, Fuller E, Gunning N, Hall J, Hirani V, Jotangia D, Mindell J, Moody A, Ogunbadejo T, Pickup D, Reilly N, Robinson C, Roth M, Wardle H (2009) Health Survey for England 2008: Physical activity and fitness. The NHS Information Centre for Health and Social Care
  2. Dauchet L, Amouyel P, Dallongeville J  (2009) Fruits, vegetables and coronary heart disease Nat Rev Cardiol 6(9):599-608
  3. Department of Health (1994) Nutritional Aspects of Cardiovascular Disease. London: HMSO
  4. Department of Health (1998) Nutritional Aspects of the Development of Cancer. London: The Stationery Office.
  5. He FJ, Nowson CA, Lucas M, MacGregor GA (2007) Increased consumption of fruit and vegetables is related to reduced risk of coronary heart disease: meta-analysis of cohort studies Journal of Human Hypertension 21: 717-728
  6. Peterson S, Rayner M, Leal J, Luengo-Fernandez R, Gray A (2005) European Cardiovascualr Disease Statistics. 2005 ed Oxford: British Heart Foundation, 2005
  7. Pomerleau J, Lock K, McKee M (2005) The burden of cardiovascular disease and cancer attributable to low fruit and vegetable intake in the European Union: differences between old and new Member States  Public Health Nutrition 9 (5): 575-583
  8. Rolls BJ, Ello-Martin JA, Tohill BC (2004) What can intervention studies tell us about the relationship between fruit and vegetable consumption and weight management? Nutr Rev 62(1):1-17
  9. World Cancer Research Fund/American Institute for Cancer Research (2007) Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Prospective. Washington DC: AICR
  10. World Health Organization (1990) Diet, Nutrition, and the Prevention of Chronic Diseases. Geneva: World Health Organization (Technical report series 797)

Additional links

5 A DAY (opens new window)

The 5 A DAY website encourages people to eat more fruit and vegetables.

Ordering 5 A DAY resources (opens new window)

Phone: 0300 123 1002 OR order from prolog online and search '5 A DAY'

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