1.2.5. Healthy Eating: Outcomes

The Whole Nutrient Package Versus Disease

A healthy diet incorporating seven or more servings of fruits and vegetables has been shown in many scientific studies to reduce cardiovascular disease and overall deaths attributable to cancer. The World Health Organization (WHO) states that insufficient fruit and vegetable intake is linked to approximately 14 percent of gastrointestinal cancer deaths, about 11 percent of heart attack deaths, and 9 percent of stroke deaths globally [1].

The WHO estimates that, overall, 2.7 million deaths could be avoided annually by increasing fruit and vegetable intake. These preventable deaths place an economic, social, and mental burden on society. This is why, in 2003, the WHO and the Food and Agricultural Organization of the United Nations launched a campaign to promote fruit and vegetable intake worldwide.

Antioxidant Variety in Food Provides Health Benefits

Not only has the several-billion-dollar supplement industry inundated us with FDA-unapproved health claims, but science is continuously advancing and providing us with a multitude of promising health benefits from particular fruits, vegetables, teas, herbs, and spices. For instance, blueberries protect against cardiovascular disease, an apple or pear a day reduces stroke risk by over 52 percent, eating more carrots significantly reduces the risk of bladder cancer, drinking tea reduces cholesterol and helps glucose homeostasis, and cinnamon blocks infection and reduces the risk of some cancers. However, recall that science also tells us that no one nutrient alone is shown to provide these effects.

What micronutrient and phytochemical sources are best at protecting against chronic disease? All of them, together. Just as there is no wonder supplement or drug, there is no superior fruit, vegetable, spice, herb, or tea that protects against all diseases. A review in the July–August 2010 issue of Oxidative Medicine and Cellular Longevity concludes that the plant-food benefits to health are attributed to two main factors—that nutrients and phytochemicals are present at low concentrations in general, and that the complex mixtures of nutrients and phytochemicals provides additive and synergistic effects. [2] In short, don’t overdo it with supplements and make sure you incorporate a wide variety of nutrients in your diet.

Eating a variety of fruits and vegetables rich in antioxidants and phytochemicals promotes health. Consider these diets:

  • mediterranean diet: Fresh fruit and vegetables are abundant in this diet, and the cultural identity of the diet involves multiple herbs and spices. Moreover, olive oil is the main source of fat. Fish and poultry are consumed in low amounts and red meat is consumed in very low amounts. An analysis of twelve studies involving over one million subjects published in the September 2008 issue of the British Medical Journal reports that people who followed the Mediterranean diet had a 9 percent decrease in overall deaths, a 9 percent decrease in cardiovascular death, a 6 percent decrease in cancer deaths, and a 13 percent reduced incidence of Parkinson’s disease and Alzheimer’s disease. [3] The authors of this study concluded that the Mediterranean diet is useful as a primary prevention against some major chronic diseases.
  • dietary approaches to stop hypertension (DASH diet): The DASH diet is an eating plan that is low in saturated fat, cholesterol, and total fat. Fruits, vegetables, low-fat dairy foods, whole-grain foods, fish, poultry, and nuts are emphasized while red meats, sweets, and sugar-containing beverages are mostly avoided. Results from a follow-up study published in the December 2009 issue of the Journal of Human Hypertension suggest the low-sodium DASH diet reduces oxidative stress, which may have contributed to the improved blood vessel function observed in salt-sensitive people (between 10 to 20 percent of the population). [4]
  • diets high in fruits and vegetables: An analysis of The Nurses’ Health Study and the Health Professionals’ Follow-up Study reported that for every increased serving of fruits or vegetables per day, especially green leafy vegetables and vitamin C-rich fruits, there was a 4 percent lower risk for heart disease. [5]

Canadians and Americans Typically Eat Fewer Than the Recommended Servings of High Quality Food-Group Foods

An article in the January 2009 issue of the Medscape Journal of Medicine reports that fewer than one in ten Americans consumes the recommended amount of fruits and vegetables, which is between five and thirteen servings per day. [6] According to this study, the largest single contributor to fruit intake was orange juice, and potatoes were the dominant vegetable.

Canadian Food Guide recommends that you fill half your plate with fruits and vegetables. The number of servings of fruits and vegetables that a person should consume every day is dependent on age, sex, and level of physical activity. For example, a forty-year-old male who exercises for sixty minutes per day should consume 2 cups of fruit and 3½ cups of vegetables, while a fifteen-year-old female who exercises for thirty minutes per day should consume 1½ cups of fruit and 2½ cups of vegetables. (One cup of a fruit or vegetable is equal to one banana, one small apple, twelve baby carrots, one orange, or one large sweet potato.)

Improving Fruit and Vegetable Intake at Home and in Your Community

Eating more fruits and vegetables can make you think better, too. According to a study published in 2009 in the Journal of Alzheimer’s Disease, no matter your age, eating more fruits and vegetables improves your brain function. [7]

The Centre for Disease Control (CDC) has developed seven strategies to increase intake of fruits and vegetables:[8]

  1. Support local and state governments in the implementation of a Food Policy Council, which develops policies and programs that increase the availability of affordable fruits and vegetables.
  2. In the food system, increase the availability and affordability of high-quality fruits and vegetables in underserved populations.
  3. Promote farm-to-where-you-are programs, which is the delivery of regionally grown farm produce to community institutions, farmers markets, and individuals.
  4. Encourage worksites, medical centers, universities, and other community and business establishments to serve more fruits and vegetables in cafeterias and onsite eateries.
  5. Support schools in developing healthy food messages to students by incorporating activities such as gardening into curricula.
  6. Encourage the development and support of community and home gardens.
  7. Have emergency food programs, including food banks and food rescue programs, increase their supply of fruits and vegetables.

The seven strategies developed by the CDC are based on the idea that improving access to and availability of fruits and vegetables will lead to an increase in their consumption.

  1. Global Strategies on Diet, Physical Activity, and Health. World Health Organization. http://www.who.int/dietphysicalactivity/fruit/en/index.html. n.d. Accessed September 30, 2011.
  2. Bouayed, J. and T. Bohn. Exogenous Antioxidants—Double-Edged Swords in Cellular Redox State: Health Beneficial Effects at Physiologic Doses versus Deleterious Effects at High Doses. Oxidative Medicine and Cellular Longevity. 2010; 3(4), 228–37. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2952083/?tool=pubmed. Accessed November 22, 2017.
  3. Sofi F, et al.Adherence to Mediterranean Diet and Health Status: Meta-Analysis. British Medical Journal (Online). 2008; 337, a1344. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2533524/. Accessed November 22, 2017.
  4. Al-Solaiman Y, et al. Low-Sodium DASH Reduces Oxidative Stress and Improves Vascular Function in Salt-Sensitive Humans. J Hum Hypertens. 2009; 12, 826–35. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2783838/?tool=pubmed. Accessed November 22, 2017.
  5. Joshipura KJ, et al. The Effect of Fruit and Vegetable Intake on Risk for Coronary Heart Disease. Ann Intern Med. 2001; 134(12), 1106–14. http://www.ncbi.nlm.nih.gov/pubmed/11412050. Accessed November 12, 2017.
  6. Kimmons J, et al. Fruit and Vegetable Intake among Adolescents and Adults in the United States: Percentage Meeting Individualized Recommendations. Medscape Journal of Medicine. 2009; 11(1), 26. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2654704/?tool=pubmed. Accessed November 22, 2017.
  7. Polidori MC, et al. High Fruit and Vegetable Intake Is Positively Correlated with Antioxidant Status and Cognitive Performance in Healthy Subjects. Journal of Alzheimer’s Disease. 2009; 17(4), 921–7. http://www.ncbi.nlm.nih.gov/pubmed/19542607. Accessed November 22, 2017.
  8. The CDC Guide to Fruit and Vegetable Strategies to Increase Access, Availability, and Consumption. Centers for Disease Control and Prevention. http://www.cdph.ca.gov/SiteCollectionDocuments/StratstoIncreaseFruitVegConsumption.pdf. Updated March 2010. Accessed November 22, 2017.


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Fundamentals of Health and Physical Activity by Kerri Z. Delaney and Leslie Barker is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.