Critical review: vegetables and fruit in the prevention of chronic diseases

By H. Boeing, A. Bechthold, A. Bub, S. Ellinger, D. Haller, A. Kroke, E. Leschik-Bonnet, M. Müller, H. Oberritter, M. Schulze and 2 more. European Journal of Nutrition, 2012

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BackgroundVegetables and fruit provide a significant part of human nutrition, as they are important sources of nutrients, dietary fibre, and phytochemicals. However, it is uncertain whether the risk of certain chronic diseases can be reduced by increased consumption of vegetables or fruit by the general public, and what strength of evidence has to be allocated to such an association.MethodsTherefore, a comprehensive analysis of the studies available in the literature and the respective study results has been performed and evaluated regarding obesity, type 2 diabetes mellitus, hypertension, coronary heart disease (CHD), stroke, cancer, chronic inflammatory bowel disease (IBD), rheumatoid arthritis (RA), chronic obstructive pulmonary disease (COPD), asthma, osteoporosis, eye diseases, and dementia. For judgement, the strength of evidence for a risk association, the level of evidence, and the number of studies were considered, the quality of the studies and their estimated relevance based on study design and size.ResultsFor hypertension, CHD, and stroke, there is convincing evidence that increasing the consumption of vegetables and fruit reduces the risk of disease. There is probable evidence that the risk of cancer in general is inversely associated with the consumption of vegetables and fruit. In addition, there is possible evidence that an increased consumption of vegetables and fruit may prevent body weight gain. As overweight is the most important risk factor for type 2 diabetes mellitus, an increased consumption of vegetables and fruit therefore might indirectly reduces the incidence of type 2 diabetes mellitus. Independent of overweight, there is probable evidence that there is no influence of increased consumption on the risk of type 2 diabetes mellitus. There is possible evidence that increasing the consumption of vegetables and fruit lowers the risk of certain eye diseases, dementia and the risk of osteoporosis. Likewise, current data on asthma, COPD, and RA indicate that an increase in vegetable and fruit consumption may contribute to the prevention of these diseases. For IBD, glaucoma, and diabetic retinopathy, there was insufficient evidence regarding an association with the consumption of vegetables and fruit.ConclusionsThis critical review on the associations between the intake of vegetables and fruit and the risk of several chronic diseases shows that a high daily intake of these foods promotes health. Therefore, from a scientific point of view, national campaigns to increase vegetable and fruit consumption are justified. The promotion of vegetable and fruit consumption by nutrition and health policies is a preferable strategy to decrease the burden of several chronic diseases in Western societies.

Subfields: Biochemistry, Genetics, Public Health, Environmental and Occupational Health

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Citations in the corpus

Flavonoid Bioavailability and Attempts for Bioavailability Enhancement (2013, background): “reduce the risk of numerous chronic diseases [1].”
Improving diets with wild and cultivated biodiversity from across the landscape (2015, methodology): “Intake of under-consumed, nutritionally-important food groups such as fruits and vegetables (Hall et al. 2009; Boeing et al. 2012; WHO and FAO 2004; Siegel et al. 2014) and animal source foods (ASFs) (Murphy and Allen 2003) was also commonly used by studies identified in this review.”
Obesity, Oxidative Stress, Adipose Tissue Dysfunction, and the Associated Health Risks: Causes and Therapeutic Strategies (2015, background): “Dietary consumption of more fruits and vegetables is also associated with a decrease in the prevalence of obesity.(377) The role of an increased consumption of fruits and vegetables in the prevention of overweight and obesity is linked to several features: high water content, relatively low-energy d”
Food groups and risk of type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies (2017, background): “With our results we can back the five a day campaign which will have manifold impact on disease occurrence [51] but could not strengthen suggestions for diets going beyond this recommendation.”
Achieving the Balance between ROS and Antioxidants: When to Use the Synthetic Antioxidants (2013, background): “On the other hand, increased or prolonged free radical action can overwhelm ROS defense mechanisms, contributing to development of diseases and aging.”
Potential Nutritional Benefits of Current Citrus Consumption (2013, background): “Diets rich in fruits and vegetables have been strongly associated with numerous health benefits and lower risk of disease [3,4].”
Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies (2019, positive): “…processes, but also cellular redox processes as well as endothelial and metabolic processes; it is assumed that these mechanisms are primarily responsible for the risk-reducing association between vegetable and fruit consumption and risk of cardiovascular and other diseases (Boeing et al. 2012).”