Title: Promoting fruit and veg consumption to improve health
Key words: cardiovascular disease, cancer, public health, interventions, dyslipidaemia, obesity, diet, lifestyle, polyunsaturates, fruit, vegetables, Mediterranean diet, antioxidant, cardioprotection, colorectal cancer, fibre,
Date: Sept 2006
Category: Special diets, Macronutrients
Author: Morgan, G
Promoting fruit and vegetable consumption to improve health
Cardiovascular disease and cancer remain the two largest causes of mortality in developed countries. Public health measures to combat this epidemic have recognised the multi-factorial nature of the problem and have sought through a combination of health intervention programmes, education and improved health delivery to improve the situation. The following facts relate to the dietary aspects of the problem.
Increasing obesity in developed countries has helped to focus research on the role of dyslipidaemia in the aetiology of heart disease. The beneficial role of increased polyunsaturated fatty acid intake confirmed in many studies (e.g. the Dart and Reinfarction Trial 1989). Combined approaches addressing obesity, diet and lifestyle factors have been shown to reduce cardiovascular morbidity significantly (see Truswell 1994 for a meta-analysis review of such trials).
Nevertheless, policies to increase the amount of polyunsaturates
in the diet have not led to a reduction in cardiovascular morbidity over the
last 30 years. Improvements in survival due to increased polyunsaturated intake
and acute medical care have been largely swallowed up by obesity related
factors (Stephen & Wald 1990, Rosenman
1993). In the
Marked regional and temporal variations and the difficulties of conducting large prospective studies have handicapped research in this area. Many surveys have shown associations between cancer rates and diet, following the initial report of Armstrong & Doll (1978). Colorectal cancers have shown the strongest association, studies suggesting that 25-35% of such cancers could be prevented by high intakes of vegetables and fibre ( see Bingham 2001 for a review of this and other research findings).
Present recommendations are to increase the consumption of fruit and vegetables to 400 grams/day in order to curtail the epidemic of these two diseases. Average intakes presently stand at around 250 grams/day (National Heart Forum 1997) and one survey (Block 1991) showed that, amongst 12000 adults on one day, only 40% consumed any fruit or vegetable at all. Amongst children, the lower socio-economic classes, the elderly and infirm, the figures are even worse. Much therefore remains to be done. A concerted effort from government agencies down is called for to help redress the balance and needs and requires action from:
Effective national and local policies to raise awareness and provide
solutions to the problem must also take account of the conservative nature of
the groups most at risk and the fact that fruit and vegetables are an expensive
food item and one that is frequently inconvenient to procure and prepare.
Innovative ways of making these foods affordable and attractive to these target
groups should be looked at. A coordinated effort by all the groups concerned is
called for if the encouraging results of the
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