Fruit and vegetable consumption and all-cause, cancer and CVD mortality: analysis of Health Survey for England data

Oyebode, Oyinlola; Gordon-Dseagu, Vanessa; Walker, A.; Mindell, Jennifer S.

doi:10.1136/jech-2013-203500

Cited by 392 publications

(314 citation statements)

References 23 publications

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“…In line with evidence that suggests that eating habits are established in childhood (78,79) , our results indicate that in Scotland nutritional disparities with England begin in the early years and persist. The impact of nutritional deficiencies, such as lower fruit and vegetable consumption, was highlighted by Oyebode et al (80) in an analysis of Health Survey for England data. Higher fruit and vegetable consumption was associated with lower likelihood of all-cause, cancer and cardiovascular mortality.…”

Section: Discussionmentioning

confidence: 99%

Identifying dietary differences between Scotland and England: a rapid review of the literature

Chambers

Barton

Albani

et al. 2017

Public Health Nutr.

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Objective: Rates of premature mortality have been higher in Scotland than in England since the 1970s. Given the known association of diet with chronic disease, the study objective was to identify and synthesise evidence on current and historical differences in food and nutrient intakes in Scotland and England. Design: A rapid review of the peer-reviewed and grey literature was carried out. After an initial scoping search, Medline, CINAHL, Embase and Web of Science were searched. Relevant grey literature was also included. Inclusion criteria were: any date; measures of dietary intake; representative populations; cross-sectional or observational cohort studies; and English-language publications. Study quality was assessed using the Quality Assessment Tool for Observational Cohort and Crosssectional Studies. A narrative synthesis of extracted information was conducted. Results: Fifty publications and reports were included in the review. Results indicated that children and adults in Scotland had lower intakes of vegetables and vitamins compared with those living in England. Higher intakes of salt in Scotland were also identified. Data were limited by small Scottish samples, difficulty in finding Englandlevel data, lack of statistical testing and adjustment for key confounders. Conclusions: Further investigation of adequately powered and analysed surveys is required to examine more fully dietary differences between Scotland and England. This would provide greater insight into potential causes of excess mortality in Scotland compared with England and suitable policy recommendations to address these inequalities.

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Section: Discussionmentioning

confidence: 99%

Identifying dietary differences between Scotland and England: a rapid review of the literature

Chambers

Barton

Albani

et al. 2017

Public Health Nutr.

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“…Recent evidence suggests that a higher number of servings might increase health benefits even further (11) . Increasing individual F&V consumption to up to 600 g/d could reduce the global burden of disease by 1·8 % (12) .…”

Section: Fruit and Vegetable Intake And Supplymentioning

confidence: 99%

Increasing fruit and vegetable intake: where are we at and how do we reach recommendations?

Vandevijvere¹,

Knai²

2015

Public Health Nutr.

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EditorialIncreasing fruit and vegetable intake: where are we at and how do we reach recommendations?As rich sources of micronutrients, dietary fibre and other favourable substances, such as antioxidants, fruit and vegetables (F&V) are important elements of a healthy and balanced diet. However, population consumption of F&V remains inadequate (1) , independently increasing the risk of non-communicable diseases such as cardiovascular diseases (CVD), diabetes and several cancers (2)(3)(4)(5)(6)(7)(8) . Low F&V consumption is among the top contributors to global death and disability, and estimated to be responsible for approximately 6.7 million deaths worldwide in 2010, compared with 5.1 million in 1990 (9) . Fruit and vegetable intake and supplyAs part of a healthy diet, the WHO suggests consuming a minimum of 400 g or five servings of F&V per day to improve overall health and reduce the risk of certain noncommunicable diseases (10) . Recent evidence suggests that a higher number of servings might increase health benefits even further (11) . Increasing individual F&V consumption to up to 600 g/d could reduce the global burden of disease by 1·8 % (12) . The majority of adults globally would have to at least double their current F&V consumption to meet the WHO's minimum recommendation (13) . A study using data from 2003 showed that 77·6 % of men and 78·4 % of women from fifty-two mainly low-and middle-income countries consumed less than the minimum recommended five daily servings of F&V (1) . The determinants of low F&V intake vary and include a strong social gradient (14) and local access and availability (14) . Wolnicka et al. (15) show in this issue that factors within the family environment such as parents' dietary habits and F&V availability have a great influence on children's F&V consumption.A study using data from 2009 found that the global supply of F&V falls, on average, 22 % (34 % when considering food wastage) short of population needs, and this varies from 58 % to 13 % across low-and upper-middle-income countries. High-income countries appear to have sufficient F&V supply (16) . These large differences between countries may be due to a range of factors, such as producer-end subsidies for other crops, adequacy of distribution systems (increasing F&V wastage), increasing population size, international trade, and the exclusion of subsistence farming and food production from the aforementioned figures.An estimated F&V supply gap of 34 % and 43 % has been projected for years 2025 and 2050, respectively, with widening gaps between high-/middle-income and low-income countries, if current production levels remain constant (16) .

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“…Consumption of fruit and fruit products has been associated with a reduced risk of overall mortality and some non-communicable diseases, leading to intake recommendations of least 3 to 4 portions of fruit a day for the general population [1,2]. The protective effect is reduced, but not eliminated, when the fruit is in the juice form, indicating that cellular structure may be important for health beneficial effects.…”

Section: Introductionmentioning

confidence: 99%

Fibrous Cellular Structures are Found in a Commercial Fruit Smoothie and Remain Intact during Simulated Digestion

Chu¹,

Igbetar²,

Orfila³

2017

J Nutr Food Sci

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The intactness of cell wall structures in foods has important repercussions for nutrient digestion and availability. In this study, we show the presence of intact cell wall structures in a commercial fruit smoothie (blend of banana, mango, orange and apple) and fruit purée (banana, mango), but not in fruit juices (apple or orange). Small clusters of cells were observed in fresh crushed fruit (banana, mango, and apple), the size of the cluster dependent on the type of fruit. When the smoothie was subjected to simulated gastro-intestinal digestion, cell wall structures were found abundantly even after 16 hrs of agitated incubation with digestive enzymes (protease, amylase and amyloglucosidase). Total dietary fibre (TDF) content of the smoothie was measured using the AOAC (991.43) and integrated fibre (IF) analysis methods. TDF-AOAC value was significantly lower (1.61%) than the TDF-IF (2.22%), but the ratio of insoluble to soluble dietary fibre (IDF: SDF) was consistently 1:3. Disruption of the cell wall structures in the smoothie by high shear homogenisation led to a 68% reduction in viscosity, 30% reduction in TDF content and a 10% increase in SDF. These experiments suggest that cell wall structures similar to those observed in crushed fruit are preserved during commercial smoothie manufacture and are retained during digestion. Their presence may have implications for fibre quantification and fibre functionality in the gut. We discuss the need to consider fibre structure, as well as content, when evaluating the nutritional properties of fruit and their products.

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Fruit and vegetable consumption and all-cause, cancer and CVD mortality: analysis of Health Survey for England data

Cited by 392 publications

References 23 publications

Identifying dietary differences between Scotland and England: a rapid review of the literature

Identifying dietary differences between Scotland and England: a rapid review of the literature

Increasing fruit and vegetable intake: where are we at and how do we reach recommendations?

Fibrous Cellular Structures are Found in a Commercial Fruit Smoothie and Remain Intact during Simulated Digestion

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