Just three or four servings of fruit and veg a day reduce heart disease risk

By Dr. Ananya Mandal, MDAug 30 2017

It takes just three to four portions of fruits and vegetables a day to reduce the risk of heart disease and death. This was found in a new study and researchers believe that these findings may have a significant impact on persons on low income around the world.

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At present the World Health Organisation – WHO, recommends that all persons require at least 400g of fruit, vegetables and lentils such as beans, peas etc. every day. Studies have shown that as much as 800g of these healthy portions of diet is needed to reduce risk of death from heart disease or stroke and early death. This new study shows that as little as 375g of fruits, vegetables and legumes are enough to keep diseases at bay and reduce risk of death. According to the US Department of Agriculture each portion is around 125g and according to WHO, each portion is around 80g.

This latest study termed Prospective Urban Rural Epidemiology [PURE] study included data from 135,335 participants globally from 613 communities in 18 low-income, middle-income, and high-income countries. Seven geographical regions covered included North America and Europe, South America, the Middle East, south Asia, China, southeast Asia, and Africa. The study was published in the latest issue of the journal Lancet.

The participants were enrolled in the study for a 10-year period from 2003. At the start of the enrolment the participants did not have heart disease and were aged between 35 and 70 years. The participants were given questionnaires and asked to report about their frequency of intake of various foods. This included the foods specific to their regions as well as quantity of fruits and vegetables and their corresponding nutrients every day. The study team excluded tubers like cassava and potatoes and fruit juices from the fruits and vegetables list that they assessed. The participants were followed for between 5.5 and 9.3 years and at least once in every three years they underwent a health check-up. Factors such as age and gender of the participants, educational status, smoking status, alcohol intake, health history, and family history of heart disease, usage of medications and levels of exercise were taken into account. During the period of follow up 4784 major heart disease events, 1649 heart disease deaths, and 5796 total deaths were found.

Results from this study showed that eating a combination of fruit, vegetables and legumes by making them a part of daily diet does help in reducing the risk of heart disease, stroke, cancers and death. Fruit consumption alone is associated with a lower risk of death due to heart disease. Considering vegetables along, raw vegetable intake was strongly associated with a lower risk of total death risk, whereas cooked vegetable intake showed a modest benefit against death.

The greatest impact however was for those who regularly ate between 375g and 500g per day of these healthy foods. They saw a reduction of overall risk of death by 22 percent compared to those who ate less than 125g of fruits and vegetables per day. Higher amounts of fruits and vegetables did not show a further reduction in death risk.

The study researchers believe that this study would mean that low or middle-income countries where fruits and vegetables are expensive, can now meet the daily requirements without burning a hole in their pockets. Victoria Miller, first author of the research from McMaster University in Canada quantified the difference saying that this 25g difference from earlier recommendation is around 2 percent of the total household income in the low income countries and that is significant. She added that this was the minimum requirement, and striving for a diet that contained more fruits and vegetables should always be the goal. For example, she said, those in North America and Europe who are already eating more fruit that these recommendations need not cut down on them. More of these in a diet certainly provides more benefits she explained.

According to an accompanying editorial with this article, Estefania Toledo and Miguel Ángel Martínez-González from the University of Navarra, this was an encouraging study with greater implications. However fruits and vegetables need to be considered as a part of a wider variety of diet they wrote. Adding these to diet should mean reducing on bad food items such as processed and red meats, sugar sweetened beverages, trans and saturated fats and refined sugars etc. Adding fruits and vegetables to diets rich in these unhealthy foods is not sufficient to reduce risk of death they write.

Source: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32253-5/fulltext?elsca1=tlpr