• EBM

5 a day - is that enough fruits and veggies?

We’re all familiar with the old saying of 5 a day, but many of us aren’t aware of why we’re encouraged to follow this, what constitutes 1 portion and whether there is anything to gain from eating more than this. To kick it off I’ve got some powerhouse facts for you as we all love a good stat: 1.7 million deaths worldwide are attributable to low fruit and vegetable consumption (1). insufficient intake of fruit and vegetables is estimated to cause around 14% of gastrointestinal cancer deaths, about 11% of ischaemic heart disease deaths and about 9% of stroke deaths globally (1). With stroke, heart disease and cancer contributing to the highest proportion of death and disability in the world (2) it is clear how much of an impact the fruit and veg we munch, or avoid, is having on our health. Fruits and vegetables help prevent these diseases as they contain minerals such as potassion, high levels of fibre as well as phytonutrients such as anti-oxidants, all of which reduce the risk of coronary heart disease, stroke and high blood pressure (3). 400g This is the number - the amount of fruit vegetables where you see a significant impact on disease prevention and the magic amount of fruit and veggies (4), as this is the level at which the ‘reduction in risk was steepest’ (5). So why 5 a day, well 80g is a portion size - take 400 and divide by 80 and you get our 5 portions a day. Bear in mind that this doesn’t include potatoes and other starchy tubers so those chippy chips and crunchy crisps aren’t contributing to the big 5 I’m afraid. For a better understanding of what a portion looks like have a gander at this info from the British Dietetic Association (6): Fruit one banana, orange, pear or apple or a similar-sized fruit two satsumas, plums or similar sized fruit two handfuls of blueberries or raspberries one heaped tablespoon of dried fruit, such as sultanas, currants or cranberries, Vegetables three heaped tablespoons of vegetables (raw, cooked, frozen or tinned) three heaped tablespoons of any ‘pulse’ – beans, peas or lentils one cereal bowl of lettuce, watercress or spinach. But is munching more than 5 going to help me lead an even healthier life? The evidence (7) shows that for each 200g of fruit and veggies consumed there was a: 8–16% reduction in risk of coronary heart disease risk 13–18% reduction in risk of stroke 8–13% reduction in risk of cardiovascular disease 3–4% reduction in the risk of total cancer 10–15% reduction in the risk of all-cause mortality For cancer, 600g proved to be associated with the lowest overall risk and for cardiovascular disease and total mortality, 800g is the sweet spot (7). So 10 servings. So basing your diet around whole plant foods seems to promote health the most, and the more the merrier. Things like cauliflower rice, squash carrot and pumpkin mash or courgette spaghetti are a few ideas of getting more veggies in our lives. What other ways can you think of introducing more fruits and veggies into your daily food routine? The evidence 1) https://www.who.int/dietphysicalactivity/fruit/en/ (accessed 19.07.2019) 2) Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2017 (GBD 2017) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2018. 3) World Health Organization, 2003. Diet, nutrition, and the prevention of chronic diseases: report of a Joint WHO/FAO expert consultation (Vol. 916). World Health Organization. 4) Diet, nutrition and the prevention of chronic diseases. Report of a Joint FAO/WHO Expert Consultation. Geneva, World Health Organization, 2003 (WHO Technical Report Series, No. 916). 5) https://academic.oup.com/ije/article/46/3/1029/3039477#112546313 (accessed 19.07.2019) 6) https://www.bda.uk.com/foodfacts/FruitVeg.pdf (accessed on 19.07.2019) 7) Aune, D., Giovannucci, E., Boffetta, P., Fadnes, L.T., Keum, N., Norat, T., Greenwood, D.C., Riboli, E., Vatten, L.J. and Tonstad, S., 2017. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality—a systematic review and dose-response meta-analysis of prospective studies. International journal of epidemiology, 46(3), pp.1029-1056.