Basis of 5 a day
1. Joyce Hughes (2000) The case for increasing the population consumption of
fruit and vegetables and the evidence for the effectiveness of interventions.
“Internationally an intake of at least five portions (400g) of fruit and vegetables
per day has become an established “healthy eating” message.”
“The scientific basis for recommending an increase in fruit and vegetable
consumption is now widely accepted, and there is a broad agreement on the target,
i.e. “at least five portions a day” (or roughly, five 80g portions)”.
2. Williams C. Healthy eating: clarifying advice about fruit and vegetables.
BMJ 1995; 310:1453-1455.
“Before the COMA cardiovascular review group published its report in November
1994 there was no national numerical goals for fruit and vegetable consumption
for England, Wales and Northern Ireland. The Scottish diet report in 1993
recommended that Scotland’s population should eat an average of at least 400g of
fruit and vegetables (excluding potatoes) a day. This is consistent with the lower
limit population goal for fruit and vegetables consumption contained in the WHO
report
Diet, Nutrition and the Prevention of Chronic Disease”. The WHO
recommendation was based upon levels of fruit and vegetable consumption in
Southern Mediterranean countries with low levels of CHD.
3. Balance of Good Health
The 5 a day message also fits into the Balance of Good Health, the food guide
which was developed as a result of the Nutrition Task Force. The quantitative
guidelines for the BoGH are based on COMA 1994, recommending an average
weekly intake of fruit and vegetables of 102.91 oz (equivalent to 425g per day).
The message also contributes to efforts to stem the increase in the prevalence of
obesity and overweight, and other dietary goals such as reduced fat intake,
increased dietary fibre intake.
4. Study by Khaw et al
Studies from the USA suggested that studies attempting to increase fruit and
vegetable intake among the general population are likely to result in a relatively
small increase in intake, at least in the short term. However, small increases may
have significant impacts on health. The recent study by Khaw et al demonstrates
that even a small increase in intake - around 50g, just over half a portion - could
still have significant benefits to health. The main focus of the study by Khaw et al
was relations between plasma ascorbic acid (vitamin C) and mortality. Plasma
ascorbic acid is highly correlated to fruit and vegetable consumption but the
authors would not be able to categorically state the relations with portions or the
“5 a day” message.
5. Joshipura et al
A recent study among US health professionals (Joshipura et al) found that each 1
portion per day increase in fruit and vegetable intake was associated with a 4%
lower risk of CHD and a 6% lower risk of stroke, after controlling for other risk
factors. The authors of this study highlighted that relatively few epidemiologic
studies have examined the relationship between intake of vegetables and fruit and
risk for CHD.
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