5-a-Day ‘Not Enough’ Fruits and Vegetables

New Research Finds 8-a-Day May Be Needed to Cut the Risk of Dying From Heart Disease

Medically Reviewed by Keith Barnard, MD on January 18, 2011

Jan. 18, 2011 -- We’re all urged to eat five servings of fruits and vegetables a day, but new research finds eight servings may be needed to cut the risk of dying from heart disease.

The diet and lifestyles of more than 300,000 people across eight countries in Europe found that people who ate at least eight portions of fruits and vegetables a day had a 22% lower risk of dying from heart disease than those who ate three portions a day.

Each additional portion in fruits and vegetables was linked to a 4% lower risk of death.

One portion counted as 80 grams, such as a small banana, a medium apple, or a small carrot.

Heart disease is the leading cause of death in the U.S. and around the world, accounting for more than one in every four deaths in the United States, according to the CDC.

Average Intake of Fruits and Vegetables

The average intake of fruits and vegetables in the various countries was five servings a day.

Spain, Greece, and Italy were the leaders in fruit and vegetable eating. Italian men enjoyed 7.5 portions a day, and Spanish women 6.7 portions.

Healthy eating tailed off the further north the researchers looked in Europe.

U.K. men managed 4.1 portions a day, and women 4.8 portions.

Swedish men and women were the worst, with only 3.5 and 2.9 portions a day.

The researchers say factors like cost and availability of fruit and vegetables are likely to account for differences in intake.

Data came from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study.

Every Portion Counts

Study researcher Francesca Crowe, MD, of the Cancer Epidemiology Unit at the University of Oxford in England, tells WebMD by email, “We do need to be cautious in our interpretation of these findings as participants with a higher intake of fruits and vegetables tended to be slightly healthier overall. So we are unable to say whether the association between fruits and vegetables and heart disease is causal.”

In other words, did the fruits and vegetables make people healthier, or are people who eat better also more likely to have healthier lifestyles?

Crowe says healthy eating also needs to be added to healthy lifestyle behaviors as well as other recommendations “such as not smoking, not having high blood pressure or high blood lipids [cholesterol] and being in a healthy weight range.”

Stepping up from five servings to eight servings a day might be hard, but Crowe says, “It may be a more manageable public health guideline to recommend that everyone increases their intake by one portion per day.

“This is a much more modest effect for an individual but if everyone could achieve this then at a population level the impact would be quite large.”

5-a-Day ‘Minimum’

In a statement, Victoria Taylor, senior dietitian at the British Heart Foundation, says, “The take-home message is still that eating fruit and vegetables is healthy for your heart. We need to remember to make five portions our minimum as the more fruit and vegetables people ate the lower their risk of dying from heart disease became.”

Recent research from the British Heart Foundation and the University of Oxford suggested that 15,000 lives a year could be saved if everyone ate five servings a day.

Taylor continues: “We still don’t know exactly why we see this relationship between fruit and vegetables and heart disease. It may be something in the fruit and vegetables itself, but equally it could be something in the lifestyles of people who tend to eat more fruit and vegetables. There’s still work to be done by researchers to answer these questions.”

Show Sources


News release, European Heart Journal.

Francesca Crowe, MD, Cancer Epidemiology Unit, University of Oxford, England.

British Heart Foundation.

NHS Choices: "Cardiovascular disease."


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