Guidelines should be changed to encourage people to eat just three portions of fruit and vegetables a day, a major study suggests.
The NHS for the last 15 years has focused on its ‘five-a-day’ message in a bid to improve people’s health.
But three quarters of people in Britain fail to hit the target. Researchers said it may be more realistic to aim for three a day – but make each portion bigger.
Currently in Britain a ‘portion’ is defined as 80g – meaning five daily portions is 400g.
The scientists said a better option might be to advise people to have a larger 125g portion three times a day – giving a slightly lower total of 375g.
Eating more than this, they found in a huge global study, resulted in no additional health benefit.
They said getting variety in types of fruit and veg is not important – the total you eat is the key thing – so fewer but bigger portions might be more achievable.
The NHS for the last 15 years has focused on its ‘five-a-day’ message in a bid to improve people’s health. But three quarters of people in Britain fail to hit the target
But other experts said people should stop obsessing about guidelines, arguing that the simplest message would be just to make sure you eat some fruit or veg with every meal, and forget about trying to count.
The Canadian-led research team, whose findings are published in the Lancet medical journal, tracked 135,000 people around the world.
Welcomed by the researchers
Researcher Dr Andrew Mente, presenting the study at the European Society of Cardiology congress in Barcelona, said: ‘Our findings indicate that optimal health benefits can be achieved with a more modest level of consumption, an approach that is likely to be much more affordable.
‘This is good news, because it is much more feasible to achieve three to four servings than it is to achieve more than five servings a day.
‘Around three to four servings was the amount associated with the maximum benefit, with little further benefit with higher consumption.
‘Beyond this, the risk of mortality remains constant with no added benefit with higher level of intake.’
Dr Mente, of McMaster University, also said the best gains were associated with eating vegetables raw, rather than cooking them.
How was the study carried out?
The team tracked the eating habits of men and women aged 35 to 70 in 18 countries. The health of participants was then monitored for an average of seven and a half years.
BUT OTHER STUDIES SAY DIFFERENT…
While five portions of fruit and veg a day is good for you, eating 10 is dramatically better, researchers found back in March.
They say a fruit and vegetable intake above five-a-day shows major benefit in reducing the chance of heart attack, stroke, cancer and early death, and could prevent up to 7.8 million premature deaths worldwide every year.
The new research, led by scientists from Imperial College London, analysed 95 studies on fruit and vegetable intake.
The team found that although even the recommended five portions of fruit and vegetables a day reduced disease risk, the greatest benefit came from eating 800g a day, which is roughly equivalent to ten portions.
‘Our results suggest that although five portions of fruit and vegetables is good, ten a day is even better’, said Dr Dagfinn Aune, lead author of the research from the School of Public Health at Imperial.
The study, which was a meta-analysis of all available research in populations worldwide, included up to 2 million people, and assessed up to 43,000 cases of heart disease, 47,000 cases of stroke, 81,000 cases of cardiovascular disease, 112,000 cancer cases and 94,000 deaths.
The researchers found that people who ate three servings a day were 22 per cent less likely to die during the study period than those managing less than one. But eating more than that brought no extra gain.
When participants included raw vegetables in their intake, death rates fell by almost a third.
Dr Mente said the findings were ‘robust, globally applicable and provide evidence to inform nutrition policies’.
The ‘five a day’ campaign
In the UK, the ‘five a day’ campaign recommends portions of at least 80g.
Each is the equivalent of three tablespoons of cooked carrots, two spears of broccoli or a single small apple.
Experts believe eating more of each portion would be very easy to achieve, simply involving increasing a portion to five tablespoons of carrots, three spears of broccoli or a large apple.
Since the ‘five-a-day’ campaign was launched in 2003, consumption has barely changed, with official records showing people eat an average of 3.5 portions, and 74 per cent fail to hit the five-a-day target.
Professor Joep Perk, spokesman for the European Society of Cardiology and cardiologist at Linnaeus University in Sweden, said dietary guidelines around the world were too complicated.
In Australia, the government’s advice is to eat seven a day – two helpings of fruit and five portions of vegetables. And some studies have even suggested that we should eat ten portions a day.
Stop obsessing over guidelines
Professor Perk said this was ‘ridiculous’ and that people should stop obsessing over guidelines and counting portions, and instead just try to eat vegetables with every meal.
‘If you try to make sure you try to have some fruit or vegetables with every meal, three times a day, that is the most important thing. That could be a piece of fruit or a glass of juice at breakfast, and some salad or vegetables with lunch and dinner.’
It is much more feasible to achieve three to four servings than it is to achieve more than five servings a day
Dr Andrew Mente, from McMaster University
Professor Metin Avkiran, associate medical director at the British Heart Foundation, said: ‘The important thing is that not enough people are even managing three portions a day – it’s a bit of a moot point whether the benefits tail off after a certain point.
‘I think the important thing is to get everyone eating at least three portions a day – not enough people are managing that.’
Moderate guidelines relevant for poor countries
Lead author Victoria Miller, also of McMaster University, said more moderate guidelines would be especially relevant in poor countries, where people struggle to afford to eat five a day.
But she said that people who were already eating healthily should not cut back.
‘For people in higher income countries already eating five servings per day, this is not a suggestion to eat less,’ she said.
‘Fruit, vegetable and legume intake should be seen as a part of an overall healthy diet and lifestyle.’
BUT VEGETABLES MAY NOT BE AS BENEFICIAL AS FRUIT…
Eating three portions of fruit and legumes each day particularly lowers the risk of heart disease, the study found.
But the groundbreaking research, from 18 countries of different economic levels, suggested vegetables may not have the same impact.
Researchers made the conclusion after assessing the 1,649 cardiovascular disease (CVD) deaths and 4,784 major events – such as heart attacks.
Dr Mente found greater fruit, vegetable and legume intake was associated with a lower risk of a heart-related death.
There was no extra benefit gained from consuming more than four portions, or from vegetables on their own, Dr Mente concluded.
He said: ‘To our knowledge, this is the first study to report on the associations of fruit, vegetable and legume intake with CVD risk in countries at varying economic levels and from different regions.’