The 10 a Day report – What the Media doesn’t mention

When I heard the news that we now have to eat 10 portions of fruit and vegetables a day, I wanted to read the original report for myself, as the media always leave crucial information out when they make these things headline news.
I’m not sure what Fruit and Vegetables we should be eating according to the research.  Apart from carrots (which have cancer causing properties), I think all root vegetables are OK. Read On.

I’m not a doctor or expert in these things, so I confess the report is heavy reading for me, as a  layman who doesn’t speak scientese. But I wanted to point out the paragraphs that points to the fact that there are downsides to this report.

They took their evidence from 95 previous studies (142 publications) from 1947 to September 2016.

In the Key Messages section below, which is at the top of the report, I have highlighted the negatives and put notes of my own in italic to help explain.

Please Note: Inverse or Inversely means Contrary or Opposite. Meaning these fruit and vegetables are no help or may actually cause Heart Disease, Cancer or Stroke and there’s a lot of them.

Title of the Research:
Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality–a systematic review and dose-response meta-analysis of prospective studies

Key Messages

  •  Although a high fruit and vegetable intake has been recommended for prevention of cardiovascular disease and some cancers, questions remain with regard to the amounts and types of fruits and vegetables that are most strongly associated with a reduced risk of cardiovascular disease, total cancer or all-cause mortality (this means there isn’t definitive evidence about what types and amounts of fruit and vegetables will help with Heart Disease, Cancer or other types of Death) and with regard to the burden of disease and mortality that may be attributed to a low fruit and vegetable intake.
  • In this meta-analysis of 95 studies (142 publications), reductions in risk of cardiovascular disease and all-cause mortality were observed up to an intake of 800 g/day of fruit and vegetables combined, whereas for total cancer no further reductions in risk were observed above 600g/day. (To help prevent cancer there’s no point in taking more than 600g of fruit and veg a day)
  • Inverse (Contrary)associations were observed between intake of apples/pears, citrus fruits, green leafy vegetables/salads and cruciferous (members of the Brassica family – Broccoli, Cabbage etc. A full list is shown below) vegetables and cardiovascular disease (heart disease) and mortality, and between green-yellow vegetables and cruciferous vegetables and total cancer risk (another huge group of vegetables with no use in preventing cancer)
  • An estimated 5.6 and 7.8 million premature deaths worldwide in 2013 may be attributable to a fruit and vegetable intake below 500 and 800 g/day, respectively, if the observed associations are causal (assuming eating 800g per day of fruit and vegetables prevents these diseases)
Apples, pears, citrus fruits, fruit juices, green leafy vegetables, beta-carotene-rich fruits and vegetables and vitamin C-rich fruits and vegetables showed inverse associations with coronary heart disease in the high vs low analysis
And in addition:
Tomatoes were inversely associated with coronary heart disease in the dose response analysis
Which basically means, none of the above help prevent Heart Disease

This is a section from a previous study which is one of many included in the above report. Basically the summary is stating that increasing fruit and vegetable servings from below 3 to more than 5 provides a 17% reduced risk of Heart Disease but eating any more than that makes little or no difference.

Increased consumption of fruit and vegetables is related to a reduced risk of coronary heart disease: meta-analysis of cohort studies.

Our meta-analysis of prospective cohort studies demonstrates that increased consumption of fruit and vegetables from less than 3 to more than 5 servings/day is related to a 17% reduction in CHD risk, whereas increased intake to 3-5 servings/day is associated with a smaller and borderline significant reduction in CHD risk. These results provide strong support for the recommendations to consume more than 5 servings/day of fruit and vegetables.
Back to the main report.
We calculated the fraction of deaths attributable worldwide due to low fruit and vegetable intake, assuming a causal relationship – There seems to be a lot of assuming of causes in this report.

Fruits & Vegetables that have no beneficial effects in risk of stroke and may make it worse:

Of specific types of fruit and vegetables high intakes of apples/pears, citrus fruits, fruit juice, green leafy vegetables and pickled vegetables were inversely associated with total stroke risk, whereas intake of grapes was also inversely associated with total stroke in the dose-response analysis

For ischaemic stroke there was evidence that intake of citrus fruits, citrus fruit juices, green leafy vegetables, and vitamin C-rich fruits and vegetables were inversely associated with risk (but not inversely associated with haemorrhagic stroke)

Fruits & Vegetables that have no beneficial effects in risk of Heart Disease and may make it worse:

Of specific types of fruits and vegetables there was evidence that high vs low intake of apples/pears, citrus fruits, carrots and noncruciferous vegetables were inversely associated, and tinned fruits were positively associated with cardiovascular disease risk, and in the nonlinear dose-response analysis there was evidence that cruciferous vegetables, green leafy vegetables, and tomatoes were inversely associated with risk, although few studies were included in these analyses

Fruits & Vegetables that have no beneficial effects in risk of Cancer and may make it worse:

Of specific types of fruits and vegetables there were significant inverse associations between cruciferous vegetables and green-yellow vegetables and total cancer risk

Fruits & Vegetables that have no beneficial effects in risk of Other types of Death and may make it worse:

Of specific types of fruits and vegetables there was evidence that high vs low intake of apples/pears, berries, citrus fruits, fruit juice, cooked vegetables, cruciferous vegetables, potatoes and green leafy vegetables/salads were inversely associated with all-cause mortality and tinned fruits were positively associated with all-cause mortality;

Contrary to above though – Quote: whereas in the dose-response analysis fruit juice, cruciferous vegetables and green leafy vegetables/salads were significantly associated with reduced risk and tinned fruits were associated with increased risk

Summary of Report –

The percentages show the increased protection for increased amounts of daily amounts of Fruit & Vegetables and n = number of people studied

This isn’t the whole table, just the results Globally. You can view the whole report by clicking  HERE

Coronary heart disease


 

Stroke


 

Cardiovascular disease


 

Total cancer


 

All-cause mortality


 

500 g/d


 

800 g/d


 

500 g/d


 

800 g/d


 

500 g/d


 

800 g/d


 

500 g/d


 

800 g/d


 

500 g/d


 

800 g/d


Region % n % n % n % n % n % n % n % n % n % n
Globally 9.3 710356 17.7 1345327 22.9 1468264 41.8 2682358 7.7 1257996 13.8 2267152 6.9 562056 8.1 657923 11.3 5381962 16.3 7791293

There was a 8–16% reduction in the RR of coronary heart disease, 13–18% reduction in the RR of stroke, 8–13% reduction in the RR of cardiovascular disease, 3–4% reduction in the RR of total cancer and 10–15% reduction in the RR of all-cause mortality for each 200 g/day increment in intake of fruit, vegetables, and fruit and vegetables combined. In the nonlinear models, there were 16%, 28%, 22%, 13% and 27% reductions in the RR of coronary heart disease, stroke, cardiovascular disease, total cancer and all-cause mortality, respectively, for an intake of 500 g of fruits and vegetables per day vs 0–40 g/day, whereas an intake of 800 g/day was associated with 24%, 33%, 28%, 14% and 31% reductions in the RR, respectively. Globally an estimated 710 000 coronary heart disease deaths, 1.47 million stroke deaths, 560 000 cancer deaths and 5.4 million premature deaths were attributable to a fruit and vegetable intake below 500 g/day in 2013, and this increased to 1.34 million coronary heart disease deaths, 2.68 million stroke deaths, 660 000 cancer deaths and 7.8 million deaths from all causes when using 800 g/day as the optimal intake. Alternatively, using total cardiovascular disease instead of coronary heart disease and stroke mortality, an estimated 1.25 and 2.26 million cardiovascular disease deaths were attributable to a fruit and vegetable intake below 500 and 800 g/day, respectively.There was evidence of nonlinearity in all analyses of fruits and vegetables combined, apart from one, and in most of the analyses the reduction in risk was steeper at the lower than at the higher range of fruit and vegetable intake. For fruits and vegetables combined the lowest risk was observed at an intake of 550–600 g/day (7–7.5 servings/day) for total cancer, with little evidence of further reductions in risk with higher intakes, whereas for coronary heart disease, stroke, cardiovascular disease and all-cause mortality the lowest risk was observed at 800 g/day (10 servings/day), which was at the high end of the range of intake across studies. Fruit and vegetable intake was only weakly associated with overall cancer risk, particularly cancer incidence, which is consistent with the change in the assessment of the evidence for several individual cancers as well; however, specific fruits and vegetables may be more strongly related to specific cancers. We found that several individual types of fruits and vegetables were inversely associated with coronary heart disease, stroke or cardiovascular disease (apples/pears, citrus fruits, cruciferous vegetables, green leafy vegetables, tomatoes and beta-carotene-rich and vitamin C-rich fruit and vegetables), total cancer (cruciferous vegetables and green-yellow vegetables) and all-cause mortality (apples/pears, berries, citrus fruits, cooked vegetables, cruciferous vegetables, potatoes, and green leafy vegetables/salads). In contrast, intake of tinned fruits was associated with increased risk of cardiovascular disease and all-cause mortality.

However, because of the low number of studies on fruit and vegetable subtypes, the potential for selective reporting and publication of subtypes that are significantly associated with risk, as well as confounding from other types of fruits and vegetables, further studies are needed.

This Report does seem to point to the fact that we all need to eat more fruit and vegetables (if the observed associations are causal) – Their words, not mine.

Also, you have to take into account, the kind of people eating a lot of fruit and vegetables probably live a healthier lifestyle anyway. It’s virtually impossible to prove this science 100% because we can’t survive on Fruit and Veg alone, so there are a lot of other contributing factors.

There is evidence to suggest that Vegetarians have a lower risk of Colon Cancer.

Although, I expect there is other evidence out there to say the contrary.