“Finish your vegetables, they’re good for you,” is an oft-repeated phrase. The list of exactly why they are good for us can seem almost endless – among other things, they prevent cancer and protect from heart disease. Time and time again, research has also shown the multiple health benefits that fruit and vegetables offer us. They are allegedly so good for us that governments around the world have invested in campaigns to promote eating five a day.
Where did the whole five-a-day drive come from? And if they are really that good for us, should we actually be aiming to eat more than the recommended five a day? Surely every extra portion provides added protection and benefits?
Origins of the Five-a-Day Claim
The advice to eat five a day came from the World Health Organization (WHO). In 1991, WHO published a report highlighting that eating a minimum of 400g of fruit and vegetables a day lowers the risk of chronic health diseases such as heart disease, stroke, type 2 diabetes and obesity. One portion of fruit and vegetables is 80g, so in the recommended 400g, you have five portions.1
In the UK, a national diet and nutrition survey in 2003 on behalf of the Department of Health revealed that the average fruit and vegetable consumption among adults (19 to 64 years) was fewer than three portions a day. Only 13% of men and 15% of women were found to consume five or more portions of fruit and vegetables a day. This survey, together with the WHO recommendations and previous work carried out by the Scientific Advisory Committee on Nutrition (a committee that advises the UK Government), resulted in the Department of Health's five-a-day drive in 2001.2
What Counts as Fruit and Vegetables?
- Fresh fruit and vegetables
- Frozen fruit and vegetables
- Tinned or canned fruit and vegetables in natural juice or water with no added sugar or salt
- Dried fruit
- 150ml unsweetened 100% fruit and vegetable juice
- Beans and pulses (legumes)
Note: Only those foods that contain no added sugar, fat or salt can count.
According to information released by the UK's Department of Health in 20033, 80g of fruit and vegetables (one portion) is equal to:
| Fruit |
Dried Fruit |
Vegetables |
Juice |
Beans and Legumes |
| One medium banana |
Three dried apricots |
One tablespoon of peas |
One glass of 100% fruit or vegetable juice* |
Three heaped tablespoons of baked beans, kidney beans, etc.* |
| Three tablespoons of fruit salad |
One tablespoon of raisin |
Two spears of broccoli |
TIP: * You can only count one portion of these a day no matter how many servings you eat or drink |
| Two satsumas (small oranges) |
Two dried figs |
One cereal bowl of lettuce |
| ½ large grapefruit |
Four dried apple rings |
Seven cherry tomatoes |
How Important is it that a Large Variety of Fruit and Vegetables is Consumed?
To get the most benefit out of eating five a day, your five portions should include a variety of fruit and vegetables. This is because different fruit and vegetables contain different combinations of fiber, vitamins, minerals and other nutrients. For example, oranges are packed with vitamin C, carrots are high in vitamin A, leafy green vegetables contain iron and bananas provide potassium.
What Does the Scientific Evidence Say?
There have been reports that the UK Government was originally going to call it the "5-8" a day campaign, but this was shelved as it was feared this figure wasn’t attainable, it would put people off and it was decided that five was an easier figure to market. Several national newspaper articles have screamed about the need to eat eight portions a day4 and claimed that eating five portions leads to a 22% lower risk of ischemic heart disease. But what does the science really say?
The eight-a-day speculations are derived from a large observational study, looking into the health and diet of 300,000 people in eight countries over an eight-year period. Results from this study suggest that a higher intake of fruit and vegetables is associated with a reduced risk of ischemic heart disease (IHD) mortality. Participants consuming at least eight portions (80g) each of fruit and vegetables were reported to have a 22% lower risk of fatal IHD compared to those consuming fewer than three portions a day (the UK average).
One portion increment in fruit and vegetables intake was associated with a 4% lower risk of fatal IHD.5,6 However, it would be bad science to leap from association to risk. The research does show an association between fruit and vegetable intake and heart disease; however the underlying thing to remember is that the correlation observed in this study is very small and by no means enough to claim for a direct cause and effect relationship. What’s more, being an observational study, there are other factors such as lifestyle that would have played significant roles in preventing heart disease.7 The people eating eight a day are more likely to have been generally healthier – shunning processed foods in favor of fresh, keeping active, not smoking and managing stress levels. In essence, what this study tells us is that, overall, healthy people will have a lower rate of heart disease than people who have less healthy lifestyles.
Pulling It Together
The guideline encourages us to aim for a minimum of five a day for good health. Considering the majority of us eat less than three each day, five is a good starting point. Fruit and vegetables are a good source of vitamins and minerals but don’t provide all the micronutrients needed, so focus must be kept to ensure the diet is balanced.
When advising our clients, we need to keep a number of things in mind. First, what are their goals? Second, remember that you need to distinguish between fruit and vegetables. Fruit contains fructose (fruit sugar) and therefore, in general, contains more calories than vegetables. Within fruits, you have some that are lower in glycemix index (Gl) (i.e., berries) and some that are higher in GI (i.e., grapes). Thirdly, what are your clients eating during the hours they are not with you?
For example, weight-loss clients won’t be doing themselves any favors by consuming eight portions of grapes or dried fruit a day. A better recommendation would be to eat a higher proportion of vegetables than fruit, as vegetables are lower in calories and GI, and higher in fiber, which is important for satiety. On the other end of the spectrum, endurance athletes such as triathletes training for a long, hard race, burning large amounts of calories, may be better off eating a higher proportion of high-GI fruit (dried fruit, tropical fruit) than vegetables as they need to get those calories in.
The take-home message? Yes, eating more vegetables and fruit is one important aspect of being healthy and more could be better – but it goes further than that. For optimal health, your clients need to get their hearts pumping and maintain balance in their whole diet.
References
1European agency for safety and health at work website: http://osha.europa.eu/en/publications/reports/TERO09009ENC.
2US Department of Health and Human Services website: http://www.ahrq.gov/research/mar11/0311RA31.htm.
3Nadler, S, Weingand, K. & Kruse, R. (2004). The physiologic basis and clinical applications of cryotherapy and thermotherapy for the pain practitioner. Pain Physician, 7:395-399.
4Khamis, V. & Yizhar, Z. (2007). Effect of feet hyperpronation on pelvic alignment in a standing position, Gait & Posture, 25:127-134.
5Rothbart, B. (2006). Relationship of functional leg-length discrepancy to abnormal pronation. Journal of the American Podiatric Medical Association, 96(6).
6Gorassini, M., Yang, J., Siu, M. & Bennett, D. (2002). Intrinsic activation of human motoneurons: Reduction of motor unit recruitment thresholds by repeated contractions. Journal of Neurophysiology, 87(4): 1859-1866.
7Biering-Sorensen, F. (1984). Physical measurements as risk indicators for low back trouble over a one-year period. Spine, 9:106-119.
Source: Fitpro Network