Abstract
PurposeLow fruit and vegetable consumption is linked with an increased risk of death from vascular disease and cancer. The benefit of eating fruits and vegetables is attributed in part to antioxidants, vitamins and phytochemicals. Whether increasing intake impacts on markers of disease remains to be established. This study investigates whether increasing daily intake of fruits, vegetables and juices from low (approx. 3 portions), to high intakes (approx. 8 portions) impacts on nutritional and clinical biomarkers. Barriers to achieving the recommended fruit and vegetable intakes are also investigated.MethodIn a randomised clinical trial, the participants [19 men and 26 women (39–58 years)] with low reported fruit, juice and vegetable intake (<3 portions/day) were randomised to consume either their usual diet or a diet supplemented with an additional 480 g of fruit and vegetables and fruit juice (300 ml) daily for 12 weeks. Nutritional biomarkers (vitamin C, carotenoids, B vitamins), antioxidant capacity and genomic stability were measured pre-intervention, at 4-, 8- and 12 weeks throughout the intervention. Samples were also taken post-intervention after a 6-week washout period. Glucose, homocysteine, lipids, blood pressure, weight and arterial stiffness were also measured. Intake of fruit, fruit juice and vegetables was reassessed 12 months after conducting the study and a questionnaire was developed to identify barriers to healthy eating.ResultsIntake increased significantly in the intervention group compared to controls, achieving 8.4 portions/day after 12 weeks. Plasma vitamin C (35%), folate (15%) and certain carotenoids [α-carotene (50%) and β-carotene (70%) and lutein/zeaxanthin (70%)] were significantly increased (P < 0.05) in the intervention group. There were no significant changes in antioxidant capacity, DNA damage and markers of vascular health. Barriers to achieving recommended intakes of fruits and vegetables measured 12 months after the intervention period were amount, inconvenience and cost.ConclusionWhile increasing fruit, juice and vegetable consumption increases circulating level of beneficial nutrients in healthy subjects, a 12-week intervention was not associated with effects on antioxidant status or lymphocyte DNA damage.Trial registrationThis trial was registered at Controlled-Trials.com; registration ISRCTN71368072.
Highlights
Low consumption of plant-based foods, including fruits and vegetables, is associated with an increased risk ofEur J Nutr (2018) 57:1855–1872 several human chronic non-communicable diseases including hypertension, cardiovascular disease (CVD), stroke, obesity, diabetes, osteoporosis and certain cancers and with high all-cause mortality [1–5]
Modelling data suggest that 31% of ischemic heart disease, 19% stroke, 20% oesophageal cancer, 19% gastric cancer and 12% lung cancer cases globally could be avoided by increasing the daily intake of fruits and vegetables to at least 400 g per day [7], while 15 000 deaths each year could be avoided if similar dietary guidelines were followed in the UK [8]
77.6% of men and 78.4% of women sampled from 52 low- and middle-income countries reported consuming less than 400 g of fruit and vegetables per day, the minimum recommended by the World Health Organisation (WHO) panel on diet, nutrition and prevention of chronic disease [6]
Summary
Low consumption of plant-based foods, including fruits and vegetables, is associated with an increased risk ofEur J Nutr (2018) 57:1855–1872 several human chronic non-communicable diseases including hypertension, cardiovascular disease (CVD), stroke, obesity, diabetes, osteoporosis and certain cancers and with high all-cause mortality [1–5]. Modelling data suggest that 31% of ischemic heart disease, 19% stroke, 20% oesophageal cancer, 19% gastric cancer and 12% lung cancer cases globally could be avoided by increasing the daily intake of fruits and vegetables to at least 400 g per day [7], while 15 000 deaths each year could be avoided if similar dietary guidelines were followed in the UK [8]. In the recent UK National Diet and Nutrition Survey (NDNS), 70% of all men and women sampled reported eating less than the recommended minimum 5 daily portions (400 g), with 62% of both sexes consuming fewer than 3 portions of fruits and vegetables each day [9]. 77.6% of men and 78.4% of women sampled from 52 low- and middle-income countries reported consuming less than 400 g of fruit and vegetables per day, the minimum recommended by the World Health Organisation (WHO) panel on diet, nutrition and prevention of chronic disease [6]
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