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Seven or more portions of fruit and vegetables daily offers best protection against dying prematurely

People who eat seven or more portions of fruit and vegetables a day are less likely to die from any cause than people who eat fewer portions, researchers report in the Journal of Epidemiology and Community Health (online, 31 March 2014).

Analysis of more than 65,000 participants in the Health Survey for England (HSE) indicates that increased consumption of vegetables and salad afforded the greatest protection whereas frozen and canned fruit seemed to increase the risk of death.


Oyinlola Oyebode, from University College London, and team, analysed dietary data on 65,226 people aged 35 years and over who had taken part in the HSE annual surveys between 2001 and 2008. During a median follow-up of 92 months, 4,399 participants (6.7 per cent) died.

Fruit and vegetable consumption was associated with a lower risk of death from any cause in a dose-dependent manner, with a 37 per cent lower risk for seven or more portions per day compared with less than one portion per day (adjusted hazard ratio [HR] 0.67, 95 per cent confidence interval 0.58–0.78). Excluding deaths within a year of baseline strengthened the association, giving a 42 per cent lower risk of death (0.58, CI 0.46–0.71).

Fruit and vegetable consumption was also associated with a lower risk of death from cancer and cardiovascular disease. The risk of dying from cancer was 25 per cent lower (0.75, CI 0.62–0.91) with consumption of between five and less than seven portions per day compared with less than one portion per day, with no further benefit of eating seven or more portions. The risk of cardiovascular death was 31 per cent lower (0.69, CI 0.53–0.88) for seven or more portions per day.

The relative benefit on mortality appeared to be greater for vegetables and salad than for fresh or dried fruit. Meanwhile, consumption of frozen or canned fruit was associated with increased risk of death from any cause (HR per portion 1.17, CI 1.07–1.28), which the researchers describe as “an unexpected finding”. They suggest that further analysis is needed to determine the relative contributions of frozen and canned fruit, and the overall dietary patterns and other characteristics of those who eat these products.

Noting that only 25 per cent of the UK population currently meets the “five-a-day” target, and that fruit and vegetable consumption is inversely related to household income, the authors write: “With increasing evidence of their health benefits, policy-makers may need to consider broader initiatives to promote fruit and vegetable consumption, particularly vegetables and salad.”

The authors of an accompanying commentary suggest that it may be time for the UK to update its “five-a-day” message to “10-a-day”, not including fruit juice.

Citation: The Pharmaceutical JournalURI: 11136777

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