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The potential contribution of increased vegetable and fruit consumption to health gain in the European Union

Published online by Cambridge University Press:  02 January 2007

Michael Joffe  and
Aileen Robertson
Michael Joffe*
Affiliation:
Department of Epidemiology & Public Health, Imperial College School of Medicine, St Mary's Campus, Norfolk Place, London W2 1PG, UK:
Aileen Robertson
Affiliation:
Acting Regional Adviser for Nutrition, WHO Regional Office for Europe, Copenhagen, Denmark
*
*Corresponding author: Email [email protected]
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Abstract

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Background:

The risk of many important diseases can be reduced by consuming a diet rich in vegetables and fruit. For this reason the World Health Organization (WHO) recommends a daily intake of more than 400 g person−1. The pattern of both the supply and intake of vegetables and fruit and the potential health gain achieved by increasing intake in the European Union (EU) and three accession countries are presented in this paper.

Methods:

Patterns of supply and dietary intake were assessed using (1) FAO food balance sheets, which allow comparison between the levels of supply in countries but do not reflect actual intake; and (2) survey data reflecting dietary intake. Using WHO mortality data for coronary heart and cerebrovascular disease and major cancers up to age 65 years, the number of preventable deaths is estimated, assuming vegetable and fruit consumption were levelled up to that of the highest consuming group, and assuming relative risks of 0.5, 0.7 or 0.9.

Results:

Vegetable and fruit consumption varies considerably between EU Member States. The populations of about half (seven) of the EU Member States have a mean daily intake of less than 275 g. Using the best current estimates of relative risk, over 26,000 deaths before the age of 65 years would be prevented annually in the EU if intake was levelled up to the highest consumption levels (and about double this number of deaths before the age of 75 years).

Conclusion:

Increasing the intake of vegetables and fruit is feasible and could result in considerable improvements in public health within the EU. Priority should be given to developing methods that demonstrate the burden of disease caused by too low intakes of vegetables and fruit. This would enable the appropriate social, cultural and economic policies to be developed within the EU.

Keywords

Health gainEuropeVegetablesFruitNutrition policy
Type
Research Article
Information
Public Health Nutrition , Volume 4 , Issue 4 , August 2001 , pp. 893 - 901
Copyright
Copyright © CABI Publishing 2001

References

1Block, G, Patterson, B, Subar, A. Fruit, vegetables and cancer prevention: a review of the epidemiological literature. Nutr. Cancer 1992; 18: 1–29.Google Scholar
2Ferro-Luzzi, A, Cialfa, E, Leclerq, C, Toti, E. The Mediterranean diet revisited: focus on fruit and vegetables. Int. J. Food Sci. Nutr. 1994; 45: 291–300.CrossRefGoogle Scholar
3Morris, DM, Kritchevsky, SB, Davis, CE. Serum carotenoids and coronary heart disease: the Lipid Research Clinics Coronary Primary Prevention Trial and follow-up study. JAMA 1994; 274: 1439–41.CrossRefGoogle Scholar
4World Health Organization. Diet, Nutrition and the Prevention of Chronic Diseases: Report of WHO Study Group. WHO Technical Series Report No. 797. Geneva: WHO, 1990.Google Scholar
5Huijbregts, P, Feskens, E, Rasanen, L, et al. Dietary pattern and 20 year mortality in elderly men in Finland, Italy and the Netherlands: longitudinal cohort study. BMJ 1997; 315: 13–7.CrossRefGoogle ScholarPubMed
6Findanza, F. The Mediterranean diet: keys to contemporary thinking. Proc. Nutr. Soc. 1991; 50: 519–26.CrossRefGoogle Scholar
7Keys, A. Seven Countries. A Multivariate Analysis of Death and Coronary Heart Disease. Cambridge, MA: Harvard University Press, 1980.CrossRefGoogle Scholar
8Cannon, G, ed. Food, Nutrition and the Prevention of Cancer: A Global Perspective. Washington, DC: World Cancer Research Fund/American Institute for Cancer Research, 1997.Google Scholar
9Working Group on Diet and Cancer of the Committee on Medical Aspects of Food and Nutrition Policy. Nutritional Aspects of the Development of Cancer. Department of Health: Report on Health and Social Subjects No. 48. London: The Stationery Office, 1998.Google Scholar
10van't Veer, P, Jansen, MCJF, Klerk, M, Kok, FJ. Fruits and vegetables in the prevention of cancer and cardiovascular disease. Public Health Nutr. 2000; 3: 103–7.CrossRefGoogle ScholarPubMed
11Ness, AR, Powles, JW. Fruit and vegetables, and cardiovascular disease: a review. Int. J. Epidemiol. 1997; 26: 1–13.Google Scholar
12Law, MR, Morris, JK. By how much does fruit and vegetable consumption reduce the risk of ischaemic heart disease? Eur. J. Clin. Nutr. 1998; 52: 549–56.Google Scholar
13Parodi, PW. The French paradox unmasked: the role of folate. Med. Hypotheses 1997; 49: 313–8.Google Scholar
14Pietinen, P, Rimm, EB, Korhonen, P, et al. Intake of dietary fiber and risk of coronary heart disease in a cohort of Finnish men. The alpha-tocopherol, beta-carotene cancer prevention study. Circulation 1996; 94: 2720–7.CrossRefGoogle Scholar
15Rimm, EB, Ascherio, A, Giovanucci, E, Spiegelman, D, Stampfer, MJ, Willett, WC. Vegetable, fruit and cereal fiber intake and risk of coronary heart disease among men. JAMA 1996; 275: 447–51.CrossRefGoogle ScholarPubMed
16Hu, FB, Stampfer, MJ, Manson, JE, et al. Frequent nut consumption and risk of coronary heart disease in women: prospective cohort study. BMJ 1998; 317: 1341–5.CrossRefGoogle ScholarPubMed
17Key, TJ, Fraser, GE, Thorogood, M, et al. Mortality in vegetarians and non-vegetarians: a collaborative analysis of 8300 deaths among 76,000 men and women in five prospective studies. Public Health Nutr. 1998; 1: 33–41.Google Scholar
18de Lorgeril, M, Salen, P, Martin, J-L, Monjaud, I, Boucher, P, Mamelle, N. Mediterranean dietary pattern in a randomised trial. Arch. Intern. Med. 1998; 158: 1181–7.Google Scholar
19Schmitt, A, Chambolle, M, Millstone, E, Brunner, E, Lobstein, T. Nutritional Surveillance in Europe. IPTS/ESTO Task C Project No. 10, 1998.Google Scholar
20Trichopoulou, A, and Lagiou, P, eds. Methodology for the Exploitation of HBS Food Data and Results on Food Availability in 5 European Countries. DAFNE Report. Luxemburg: European Communities, 1997.Google Scholar
21Shibata, A, Paganini-Hill, RK, Henderson, R, Henderson, BE. Intake of vegetables, fruit, beta-carotene, vitamin C, supplements and cancer among the elderly: a prospective study. Br. J. Cancer 1992; 66: 673–9.Google Scholar
22Negri, E, La Vecchia, C, Franceschi, S, D'Avanzo, B, Parazzini, F. Vegetable and fruit consumption and cancer risk. Int. J. Cancer 1991; 48: 350–4.Google Scholar
23Trichopoulos, A, Katsouyanni, K, Stuver, S, et al. Consumption of olive oil and specific food groups in relation to breast cancer risk in Greece. J. Natl. Cancer Inst. 1995; 87: 110–6.Google Scholar
24Toniolo, P, Riboli, E, Protta, F, Charrel, M, Cappa, APM. Calorie-providing nutrients and the risk of breast cancer. J. Natl. Cancer Inst. 1989; 81: 278–86.CrossRefGoogle ScholarPubMed
25Thun, MJ, Calle, EE, Namboodiri, MM, et al. Risk factors for fatal colon cancer in a large prospective study. J. Natl. Cancer Inst. 1992; 84: 1491–1500.CrossRefGoogle Scholar
26Kneller, RW, McLaughlin, JK, Bjelke, E, et al. A cohort study of stomach cancer in a high-risk American population. Cancer 1991; 68: 672–8.3.0.CO;2-T>CrossRefGoogle Scholar
27World Health Organization. World Health Statistics Annual 1996. Geneva: WHO, 1998.Google Scholar
28World Health Organization. World Health Statistics Annual 1994. Geneva: WHO, 1995.Google Scholar
29EPIC Group of Spain: Agudo, A, Amiano, P, Barcos, A, et al. Dietary intake of vegetables and fruits among adults in five regions of Spain. Eur. J. Clin. Nutr. 1999; 53: 174–80.CrossRefGoogle ScholarPubMed
30Aranceta, J, Pérez Rodrigo, C, Eguileor, I, Marzana, I, González de Galdeano, L, Saenz de Buruaga, F. Food consumption patterns in the adult population of the Basque country (EINUT-1). Public Health Nutr. 1998; 1: 185–92.CrossRefGoogle Scholar
31Laitenen, S, Rasenen, L, Viikari, J, Akerblom, HK. Diet of Finnish children in relation to the family's socio-economic status; Scand. J. Soc. Med. 1995; 23: 88–94.CrossRefGoogle Scholar
32Bobak, M, Hense, H-W, Kark, J, et al. An ecological study of determinants of coronary heart disease rates: a comparison of Czech, Bavarian and Israeli men. Int. J. Epidemiol. 1999; 28: 437–44.Google Scholar
33Kristenson, M, Zieden, B, Kucinskiene, Z, Elinder, LS, Bergdahl, B, Elwing, B, Abaravicius, A, Razinkoviene, L, Calkauskas, H, Olsson, AG. Antioxidant state and mortality from coronary heart disease in Lithuanian and Swedish men: concomitant cross sectional study of men aged 50. BMJ 1997; 314: 629–33.Google Scholar
34Rose, G. The Strategy of Preventive Medicine. Oxford: Oxford University Press, 1992.Google Scholar
35Murray, CJL, Lopez, A. The Global Burden of Disease. Boston, MA: Harvard University Press, 1996.Google ScholarPubMed
36National Institute of Public Health. Determinants of the Burden of Disease in the EU. Stockholm: National Institute of Public Health, 1997.Google Scholar
37Piettinen, P, Vartiainen, E, Seppanen, R, Aro, A, Puska, P. Changes in diet in Finland from 1972 to 1992: impact on coronary heart disease. Prev. Med. 1996; 25: 243–50.Google Scholar
38Marshall, T. Exploring a fiscal food policy: the case of diet and ischaemic heart disease. BMJ 2000; 320: 301–5.CrossRefGoogle ScholarPubMed
39World Health Organization. Urban Food and Nutrition Action Plan LVNG 030102 [Online]. Available at http://www.who.dk/Nutrition/food.htm. Copenhagen: WHO, October 1999.Google Scholar