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Fruits and vegetables in the prevention of cancer and cardiovascular disease

Published online by Cambridge University Press:  02 January 2007

Pieter van't Veer*
Affiliation:
Division of Human Nutrition and Epidemiology, Wageningen University, PO Box 8129, 6700 EV Wageningen, the Netherlands.
Margje CJF Jansen
Affiliation:
Division of Human Nutrition and Epidemiology, Wageningen University, PO Box 8129, 6700 EV Wageningen, the Netherlands. Department of Chronic Diseases and Environmental EpidemiologyNational Institute of Public Health and the Environment, 6700 EV Wageningen, Bilthoven, the Netherlands.
Mariska Klerk
Affiliation:
Division of Human Nutrition and Epidemiology, Wageningen University, PO Box 8129, 6700 EV Wageningen, the Netherlands.
Frans J Kok
Affiliation:
Division of Human Nutrition and Epidemiology, Wageningen University, PO Box 8129, 6700 EV Wageningen, the Netherlands.
*
*Corresponding author: Email [email protected]
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Abstract

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Objective

We quantified the public health benefit of fruits and vegetables on the prevention of cancer and cardiovascular disease (CVD), using currently available human data.

Design

We reviewed over 250 observational studies on cancer and CVD. Relative risks (RRs) for high versus low intake of fruits and vegetables were obtained. The preventable proportion of chronic diseases, i.e. the per cent of cases attributable to low consumption of fruits and vegetables, was estimated using three scenarios: best guess, optimistic (using stronger RRs) and conservative (using weaker RRs and eliminating the contribution of smoking and/or drinking). The preventable proportion was calculated for increasing average intake from the current 250 g day−1 to the recommended 400 g day among the general Dutch population.

Results

It is estimated that in the Netherlands cancer incidence could be reduced by 19% (12 000 cases annually, best guess), ranging from 6% (conservative) to 28% (optimistic). Cardiovascular deaths could be reduced by 16% (8000 deaths annually, best guess), ranging from 6% to 22%. Evidence is most abundant for gastrointestinal cancers, followed by hormone-related cancers, but limited for other sites and CVD.

Conclusions

Increasing consumption of fruits and vegetables carries a large public health potential. Population trials and biological mechanisms should eventually provide scientific proof of their efficacy. The available evidence is sufficient to justify public health education and promotion aimed at a substantial increase in the consumption of fruits and vegetables.

Type
Research Article
Copyright
Copyright © CABI Publishing 2000

Footnotes

Reprints are not available from the authors. A report, underlying this paper, was produced thanks to two grants (in 1995 and 1998) provided by the Fruits and Vegetables Bureau. As long as available, the original report can be obtained by contacting Mrs M. Slagmoolen-Gijze, Fruits and Vegetables Bureau, PO Box 90403, 2509 LK The Hague, the Netherlands.

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