Eat your fruit and vegetables

Abstract

Your parents were smart when they told you to eat all of your vegetables, and encouraged you to eat your fruit, but they probably did not know that eating more fruit and vegetables would lower the risk of stroke. 1 He FJ Nowson CA MacGregor GA Fruit and vegetable consumption and stroke: a meta-analysis of cohort studies. Lancet. 2006; 367: 320-326 Summary Full Text Full Text PDF PubMed Scopus (792) Google Scholar , 2 Ness AR Maynard M Frankel S et al. Diet in childhood and adult cardiovascular and all cause mortality: the Boyd Orr cohort. Heart. 2005; 91: 894-898 Crossref PubMed Scopus (135) Google Scholar Results of epidemiological studies of the relation between intakes of nutrients in fruit and vegetables, such as vitamin C or beta-carotene, and risk of stroke have been inconsistent. 3 Ness AR Powles JW Fruit and vegetables, and cardiovascular disease: a review. Int J Epidemiol. 1997; 26: 1-13 Crossref PubMed Scopus (1083) Google Scholar , 4 Leppala JM Virtamo J Fogelholm R et al. Controlled trial of alpha-tocopherol and beta-carotene supplements on stroke incidence and mortality in male smokers. Arterioscler Thromb Vasc Biol. 2000; 20: 230-235 Crossref PubMed Scopus (158) Google Scholar However, disease prevention might not be attributable to single nutrients, but to the interaction of nutrient and non-nutritive components in whole foods. Fruit and vegetables are rich in many health-promoting nutrients and food compounds, including antioxidants such as vitamin C and folate, potassium, phytochemicals, dietary fibre, and plant proteins that have been inversely related to high blood pressure and stroke. 3 Ness AR Powles JW Fruit and vegetables, and cardiovascular disease: a review. Int J Epidemiol. 1997; 26: 1-13 Crossref PubMed Scopus (1083) Google Scholar , 4 Leppala JM Virtamo J Fogelholm R et al. Controlled trial of alpha-tocopherol and beta-carotene supplements on stroke incidence and mortality in male smokers. Arterioscler Thromb Vasc Biol. 2000; 20: 230-235 Crossref PubMed Scopus (158) Google Scholar , 5 Appel LJ Moore TJ Obarzanek E et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med. 1997; 336: 1117-1124 Crossref PubMed Scopus (4242) Google Scholar , 6 Steffen LM Kroenke CH Yu X et al. Associations of plant foods, dairy products, and meat consumption with fifteen-year incidence of elevated blood pressure in young black and white adults: The CARDIA Study. Am J Clin Nutr. 2005; 82: 1169-1177 PubMed Google Scholar , 7 John JH Ziebland S Yudkin P Roe LS Neil HA for the Oxford Fruit and Vegetable Study GroupEffects of fruit and vegetable consumption on plasma antioxidant concentrations and blood pressure: a randomised controlled trial. Lancet. 2002; 359: 1969-1974 Summary Full Text Full Text PDF PubMed Scopus (405) Google Scholar , 8 Bazzano LA He J Ogden LG et al. Dietary intake of folate and risk of stroke in US men and women: NHANES I epidemiologic follow-up study. National health and nutrition examination survey. Stroke. 2002; 33: 1183-1188 Crossref PubMed Scopus (133) Google Scholar It is likely that the combination of nutrients and compounds in foods has greater health benefits than the individual nutrient alone. 9 Jacobs DR Steffen LM Nutrients, foods, and dietary patterns as exposures in research: a framework for food synergy. Am J Clin Nutr. 2003; 78: 508S-513S PubMed Google Scholar In this week's Lancet, a meta-analysis by Feng He and colleagues provides strong evidence of an inverse relation between fruit and vegetable intake and risk of stroke. 1 He FJ Nowson CA MacGregor GA Fruit and vegetable consumption and stroke: a meta-analysis of cohort studies. Lancet. 2006; 367: 320-326 Summary Full Text Full Text PDF PubMed Scopus (792) Google Scholar Compared with individuals who consumed less than 3 servings of fruit and vegetables per day, those who ate more than 5 daily servings of fruit and vegetables had a 26% lower risk of stroke, while 3–5 servings per day conferred a 9% lower risk. Less than a quarter of adults in the USA eat 5 or more servings of fruit and vegetables per day, and there is therefore a serious need to develop and implement public-health strategies to achieve this dietary goal. Fruit and vegetable consumption and stroke: meta-analysis of cohort studiesIncreased fruit and vegetable intake in the range commonly consumed is associated with a reduced risk of stroke. Our results provide strong support for the recommendations to consume more than five servings of fruit and vegetables per day, which is likely to cause a major reduction in strokes. Full-Text PDF