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Fruits and Vegetables: How Much Consumption is Enough?

In a large meta-analysis of over 800,000 participants’ dietary habits, researchers concluded….

An international team of researchers from the Harvard School of Public Health and Chinese universities studied the potential dose-response relation between fruit and vegetable consumption and risk of all cause, cardiovascular, and cancer mortality using data from Medline, Embase, and the Cochrane library.

Sixteen prospective cohort studies identified for the meta-analysis. During follow-up periods ranging from 4.6 to 26 years there were 56,423 deaths (11,512 from cardiovascular disease and 16 817 from cancer) among 833,234 participants. Higher consumption of fruit and vegetables was significantly associated with a lower risk of all-cause mortality. Pooled hazard ratios of all-cause mortality were 0.95 (95% confidence interval 0.92 to 0.98) for an increment of one serving a day of fruit and vegetables (P=0.001), 0.94 (0.90 to 0.98) for fruit (P=0.002), and 0.95 (0.92 to 0.99) for vegetables (P=0.006). There was a threshold around five servings of fruit and vegetables a day, after which the risk of all-cause mortality did not reduce further. A significant inverse association was observed for cardiovascular mortality (hazard ratio for each additional serving a day of fruit and vegetables 0.96, 95% confidence interval 0.92 to 0.99), while higher consumption of fruit and vegetables was not appreciably associated with risk of cancer mortality.

The researchers concluded that the meta-analysis provides further evidence that higher consumption of fruit and vegetables is associated with a lower risk of mortality from all causes, particularly from cardiovascular diseases. The results support current recommendations to increase consumption to promote health and overall longevity.

Practice Pearls:

  • Higher consumption of fruit and vegetables is associated with a lower risk of mortality from all causes, particularly from cardiovascular diseases.
  • There was a threshold around five servings of fruit and vegetables a day, after which the risk of all-cause mortality did not reduce further.
  • Higher consumption of fruit and vegetables was not appreciably associated with risk of cancer mortality.

"Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies" BMJ 2014;349:g4490