Almost 3 million deaths linked to low fruit and vegetable intake, warns study

A meticulous new study reports that almost 3 million people who die from stroke and heart disease do so because of not eating enough fruit and vegetables.

Cardiovascular disease (CVD) causes the greatest number of deaths, both in the US and globally. The current study showed a clear correlation between cardiovascular mortality and fruit/vegetable intake (FVI).

In fact, almost 1.8 million (1 in 7) CVDs are linked to low fruit consumption, that is, an estimated deaths. Meanwhile, another 1 million (1 in 12) CVDs are attributed to not eating enough vegetables. In other words, eating enough fruit and vegetables powerfully reduces the risk of dying from a heart attack or stroke.

Image Credit: Leonori / Shutterstock
Image Credit: Leonori / Shutterstock

How do fruits and vegetable protect cardiovascular health?

Fruits and vegetables contain fiber, as well as ions like potassium and magnesium, and plant antioxidants. These protect against raised blood pressure and cholesterol. They also promote the health of the gut microbiome. Finally, people with a high FVI are less likely to be obese or overweight. All these actions mean that FVI improves cardiovascular health.

Most people think of food only in terms of calories and vitamins, and going easy on the salt and the sugar. Senior author Dariush Mozaffarian comments: “These findings indicate a need to expand the focus to increasing availability and consumption of protective foods like fruits, vegetables and legumes--a positive message with tremendous potential for improving global health.”

Less is more when it comes to FVI and CVD

Countries with the lowest average FVI had the highest CVD rate. Thus, countries in South Asia, East Asia and Sub-Saharan Africa, where little fruit is eaten, showed high rates of stroke mortality. On the other hand, low vegetable consumption in Central Asian and Oceania countries was correlated with high rates of heart disease.

Individually, the largest number of CVD deaths due to low fruit and vegetable intake occur in China and in India, respectively. Coming to the US, the researchers attribute over 80 000 and 57 000 CVD deaths to low vegetable and fruit intake, respectively.

The point is that anyone can eat fruits or vegetables, making this one of the easiest ways to prevent many deaths. Victoria Miller, lead study author, said, “Fruits and vegetables are a modifiable component of diet that can impact preventable deaths globally. Our findings indicate the need for population-based efforts to increase fruit and vegetable consumption throughout the world.”

How much fruit and vegetables is enough?

Surprisingly, you don’t need to stuff yourself with vegetables or fruits to eat a heart-healthy diet. Just about 300 g of fruit (as much as two small apples), and 400 g of vegetables a day (equivalent to 3 cups of raw carrots), are enough to be called optimal intake. Legumes and tubers are also part of the vegetable category, in this study.

Where did this data come from?

Researchers gathered data on diet and food availability from 2010, from about 82% of the world’s people, and 113 of the 187 countries in the world. They also gathered country-wise data on mortality due to coronary heart disease and stroke separately from recent meta-analyses, to derive CVD mortality rates. They also used the latest information on the effect of increased FVI on cardiovascular disease. Putting all this together, they derived the proportion of risk attributable to each cause (low fruit/vegetable intake) and the number of deaths from each disease (stroke/heart disease).

Risk factor Cause of death: stroke Cause of death: heart disease
Low fruit intake 1.3 million 520,000
Low vegetable intake 200,000 800,000

Among different age groups, eating less fruit and vegetables causes the greatest adverse impact in younger adults, especially men. Researchers think this is because women likely eat more fruits and vegetables than men do.

What does this mean?

The take-home is that eating adequate amounts of fruit and vegetables steeply reduces the risk of death from stroke and heart disease. To reduce the number of preventable CVD deaths, public health initiatives should focus on educating and encouraging the public to modify their diet, and making fruits and vegetables affordable and accessible.

The study will be presented at the annual meeting of the American Society for Nutrition, Nutrition 2019, between June 8 and 11, 2019.

Source: Miller, V. FS01-01-19 - Estimated Global, Regional, and National Cardiovascular Disease Burdens Related to Fruit and Vegetable Consumption: An Analysis from the Global Dietary Database.

Dr. Liji Thomas

Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.


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  1. Sally Blessing Sally Blessing United States says:

    Fruits contain SUGAR, the more sugar you consume, the higher rates of cancer and heart disease not to mention diabetes.  Please show me a legitimate study, or any study for that matter from a legitimate source that shows that FIBER is essential.  I bet you will have a problem finding a study like that because FIBER is NOT an essential and SUGAR should not be consumed.  There are a few berries that are not too high on the glycemic index, that are ok to eat, but most fruits will raise our sugar levels too high this causing more disease.

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