Presented on June 8, 2019, at the American Society for Nutrition annual meeting in Baltimore, preliminary results from the study indicate that low fruit and vegetable consumption may be responsible for millions of deaths from heart disease and stroke each year worldwide. In fact, the study estimates that 1 in 7 cardiovascular deaths are caused by not eating enough fruit, while 1 in 12 are caused by not eating enough vegetables. And these numbers only account for deaths caused by deficient diets — not the wider toll that heart disease and stroke can exact by causing poor health, including pain and disability.
Looking at Diets Worldwide
For the study, researchers at the Friedman School of Nutrition Science and Policy at Tufts University in Boston estimated national averages of fruit and vegetable intake for 113 countries based on surveys and food availability data. Together, these countries represent 82 percent of the world’s population. By combining this data with statistics on causes of death in each country, as well as data from separate studies on the cardiovascular risks and benefits of different levels of fruit and vegetable intake, the researchers came up with a model to calculate how many deaths were caused by less-than-optimal intake. The researchers defined optimal intake of fruit as at least 300 grams per day, and optimal intake of vegetables as at least 400 grams per day. These numbers were based on dietary guidelines and studies of cardiovascular risk factors. Based on these numbers, the researchers calculated that low fruit intake was responsible for 1.8 million deaths from cardiovascular disease in 2010. About 1.3 million of these deaths were from stroke, and about 500,000 were caused by coronary artery disease. Low vegetable intake caused about 1 million deaths — about 200,000 from stroke, and about 800,000 from coronary artery disease. Not surprisingly, these deaths were greatest in countries with the lowest overall intake of fruits and vegetables. Countries in South Asia, East Asia, and sub-Saharan Africa tended to have low fruit intake and higher rates of death from stroke, while countries in Central Asia and Oceania had low vegetable intake and higher rates of coronary artery disease. In the United States — where cardiovascular disease is the leading cause of death, as it is worldwide — low fruit and vegetable intake caused about 140,000 cardiovascular deaths in 2010. Younger people and men were more likely to see their risk of death raised by low fruit and vegetable intake.
Huge Opportunity to Reduce Cardiovascular Deaths
The good news in this study is that fruit and vegetable intake is “a modifiable component of diet that can reduce the risk of cardiovascular deaths,” according to Victoria Miller, PhD, the study’s lead author and a postdoctoral research fellow at Tufts. Dr. Miller notes that fruits and vegetables are good sources of fiber, potassium, magnesium, antioxidants, and other beneficial components, and that people who eat them are less likely to be overweight or obese — all of which may contribute to their cardiovascular benefits. Minimally processed foods, including fruits and vegetables, also support the health and diversity of “good” bacteria in the digestive tract, says Miller — an area of ongoing interest to researchers in cardiovascular health and other fields. When it comes to public health efforts in the United States and around the world, the implications of this study are clear, according to Miller. “These findings indicate a need to expand population-based efforts to increase the availability and consumption of protective foods like fruits and vegetables,” she says. “Eating more fruits and vegetables is a relatively accessible and affordable strategy to reduce the risk of cardiovascular disease.” In addition, “fruits and vegetables offer a range of other health benefits — including protecting against the risk of certain cancers and micronutrient deficiencies, and promoting a healthy digestive tract,” says Miller.
