Health effects related to fruit and vegetables intake | Knowledge for policy

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Health effects related to fruit and vegetables intake as described by food and health-related organisations

Effect of fruit and vegetable intake on cardiovascular health
WHO/FAO 2003 'Convincing associations for reduced risk of CVD include consumption of fruits (including berries) and vegetables…' 'Numerous ecological and prospective studies have reported a significant protective association for coronary heart disease and stroke with consumption of fruits and vegetables'.
DGE 2012, DGE 2016 'Strong and consistent evidence demonstrates that dietary patterns associated with decreased risk of CVD are characterized by higher consumption of vegetables, fruits, whole grains, low-fat dairy, and seafood, and lower consumption of red and processed meat, and lower intakes of refined grains, and sugar-sweetened foods and beverages relative to less healthy patterns'. 'Regular consumption of nuts and legumes and moderate consumption of alcohol also are shown to be components of a beneficial dietary pattern in most studies. Randomized dietary intervention studies have demonstrated that healthy dietary patterns exert clinically meaningful impact on cardiovascular risk factors, including blood lipids and blood pressure'. 'Additionally, research that includes specific nutrients in their description of dietary patterns indicate that patterns that are lower in saturated fat, cholesterol, and sodium and richer in fibre, potassium, and unsaturated fats are beneficial for reducing cardiovascular disease risk'.
DGAC 2015 'Strong and consistent evidence demonstrates that dietary patterns associated with decreased risk of CVD are characterized by higher consumption of vegetables, fruits, whole grains, low-fat dairy, and seafood, and lower consumption of red and processed meat, and lower intakes of refined grains, and sugar-sweetened foods and beverages relative to less healthy patterns'. 'Regular consumption of nuts and legumes and moderate consumption of alcohol also are shown to be components of a beneficial dietary pattern in most studies. Randomized dietary intervention studies have demonstrated that healthy dietary patterns exert clinically meaningful impact on cardiovascular risk factors, including blood lipids and blood pressure'. 'Additionally, research that includes specific nutrients in their description of dietary patterns indicate that patterns that are lower in saturated fat, cholesterol, and sodium and richer in fibre, potassium, and unsaturated fats are beneficial for reducing cardiovascular disease risk'.

Effect of fruit and vegetable intake on type 2 diabetes mellitus
DGE 2016 'Increased vegetable intake reduces the risk of type 2 diabetes with probable evidence. This particularly applies to the group of cruciferous vegetables (cabbage etc.)'. 'Possible evidence that fruit reduces risk for type 2 diabetes'.
DGAC 2015 'Moderate evidence indicates that healthy dietary pattern high in vegetables, fruits and whole grains and lower in red and processed meats, high-fat dairy products, refined grains, and sweets/sugar-sweetened beverages reduces the risk of developing type 2 diabetes'.

Effect of fruit and vegetable intake on cancer
WCRF/AICR 2007 'Non-starchy vegetables, and fruits, probably protect against some cancers'. 'Non-starchy vegetables probably protect against cancers of the mouth, pharynx, and larynx, and those of the oesophagus and stomach'. For non-starchy vegetables, 'There is limited evidence suggesting that they also protect against cancers of the nasopharynx, lung, colorectum, ovary, and endometrium'. 'Allium vegetables probably protect against stomach cancer. Garlic (an allium vegetable, commonly classed as a herb) probably protects against colorectal cancer. There is limited evidence suggesting that carrots protect against cervical cancer; and that pulses (legumes), including soya and soya products, protect against stomach and prostate cancers'. 'Fruits in general probably protect against cancers of the mouth, pharynx, and larynx, and those of the oesophagus, lung, and stomach'. 'There is limited evidence suggesting that fruits also protect against cancers of the nasopharynx, pancreas, liver, and colorectum'. 'Evidence that vegetables and fruits protect against some cancers is supported by evidence on foods containing various micronutrients, found especially in vegetables, fruits, and pulses (legumes), and nuts and seeds, as well as in cereals, roots, tubers, and other plant foods'. ^a
DGE 2012 'There is probable evidence that the overall risk of cancer is inversely associated with the consumption of vegetables and fruit'. 'There still is probable evidence that the increased intake of vegetables and fruit reduces the risk of malignant tumours in the mouth/pharynx/larynx, of squamous cell carcinomas in the esophagus and of malignant tumours in the colon, and possible evidence of a reduced risk of malignant tumours of the stomach and rectum as well as of adenocarcinomas of the esophagus'. 'There is still possible evidence that increased vegetables and fruit intake reduces the risk of kidney carcinoma.' 'There is probable evidence that increased intake of fruit - and possible evidence that increased intake of vegetables - reduces the risk of malignant tumours of the lung'. 'There is possible evidence that there is no association between the intake of vegetables and fruit and the risk of breast and prostate cancer. The data on the other hormone-dependent types of cancer is considered insufficient'. '…studies on vegetables and fruit intake and the risk of pancreatic cancer do not indicate any risk relationships, so that there is possible evidence that there is no risk relation'. The evidence for an association between the intake of vegetables and fruit and the risk of gallbladder, bladder, and skin cancer is considered insufficient.
WHO/FAO 2003 For colon cancer, 'Probable protective factors are consumption of fruits and vegetables…' For colorectal cancer, 'there is some evidence that risk is […] decreased by high intakes of fruits and vegetables […] but none of these hypotheses has been firmly established' and 'the evidence that is currently available suggests that intake of fruits and vegetables probably reduces the risk for colorectal cancer'. In addition, 'For colorectal cancer, a protective effect of fruit and vegetable intake has been suggested by many case—control studies but this has not been supported by results of several large prospective studies, suggesting that if a benefit does exist it is likely to be modest'. There is probable evidence that high fruit and vegetable intakes decrease risk of development of oral cavity, oesophagus, and stomach cancers. For lung cancer, 'the apparent protective effect of fruits and vegetables may be largely the result of residual confounding by smoking, since smokers generally consume less fruit and vegetables than non-smokers'. For breast cancer, 'The results of studies of other dietary factors including […] fruits and vegetables […] are inconclusive'. For endometrial cancer, 'some case--control studies have suggested that diets high in fruits and vegetables may reduce risk […] but the amount of available data is limited'.

Effect of fruit and vegetable intake on body weight/ energy intake
WHO 2014a 'limited evidence suggests that when consumed as part of a healthy diet low in fat, sugars and salt/sodium, fruits and vegetables may also help to prevent weight gain and reduce the risk of obesity, an independent risk-factor for NCDs'.
WCRF/AICR 2007 Non-starchy vegetables and fruits 'being typically low in energy density, they probably also protect against weight gain'.
DGE 2016 'There is possible evidence that a diet with increased consumption of vegetables and fruit may prevent body weight gain'.
NNR 2012 'Evidence was also limited-suggestive for dietary fibre and fruit intake to protect against larger increases in waist circumference'.
DGAC 2015 'Moderate evidence indicates dietary patterns that are higher in vegetables, fruits, and whole grains; include seafood and legumes; are moderate in dairy products (particularly low and non-fat dairy) and alcohol; lower in meats (including red and processed meats), and low in sugar-sweetened foods and beverages, and refined grains are associated with favourable outcomes related to healthy body weight (including lower BMI, waist circumference, or percent body fat) or risk of obesity'.

Effect of fruit and vegetable intake on bone health
WHO/FAO 2003 Fruit and vegetables consumption could possibly decrease the risk of osteoporotic fractures. In addition, 'several components of fruits and vegetables are associated with a decreased risk at levels of intake within the normal range of consumption (e.g. alkalinity, vitamin K, phytoestrogens, potassium, magnesium, boron)'.
DGAC 2015 'Limited evidence suggests that a dietary pattern higher in vegetables, fruits, grains, nuts and dairy products, and lower in meats and saturated fat, is associated with more favourable bone health outcomes in adults, including decreased risk of fracture and osteoporosis, as well as improved bone mineral density'.

Effect of fruit and vegetable intake on dental health
WHO/FAO 2003 There is insufficient evidence that whole fresh fruit decreases the risk of dental caries. There is insufficient evidence that dried fruit increases the risk of dental caries. There is insufficient evidence that whole fresh fruit increases the risk of dental erosion, while there is probable evidence of no relationship between whole fresh fruit intake and dental erosion.

Other
DGE 2016 'Data on dementia indicate possible evidence for a risk-reducing influence of increased vegetable and fruit consumption'.

^a For a detailed description please refer to the original source

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