Lack of Fruit and Vegetable Consumption Responsible for Millions of Cardiovascular Deaths

Could an apple a day keep cardiovascular diseases (CVD) away?

According to the findings of a recent study, many preventable cardiovascular deaths take place each year due to an inadequate consumption of fruits and vegetables. The findings of the study were presented at Nutrition 2019, the American Society for Nutrition annual meeting, in Baltimore.

The research suggested that about 1 in 7 cardiovascular deaths are due to not eating enough fruit—resulting in about 1.8 million deaths—while 1 in 12 can be attributed to not eating enough vegetables—about 1 million deaths.

“Fruits and vegetables are a modifiable component of diet that can impact preventable deaths globally,” lead study author Victoria Miller, a postdoctoral researcher at the Friedman School of Nutrition Science and Policy at Tufts University—who presented the findings—said in a press release. “Our findings indicate the need for population-based efforts to increase fruit and vegetable consumption throughout the world.”

For the study, the researchers used a Bayesian hierarchical model to estimate national fruit and vegetable intakes based on 266 surveys representing 1,630,069 people from 113 countries—82% of the world’s 187 countries. They evaluated how fruit and vegetable intake correlated with CVD, particularly coronary heart disease (CHD) and stroke mortality.

The study authors reported: “In 2010, suboptimal intakes of fruit were estimated to result in 521,395 (95% uncertainty interval [UI] 498,254-542,808) CHD deaths ([proportional attributable fraction] PAF: 7.5%; 7.2-7.8%) and 1,255,978 (1,187,716-1,325,879) stroke deaths (PAF: 21.7%; 20.5-22.9%) globally per year. Suboptimal intakes of vegetables were estimated to result in 809,425 (783,362-836,687) CHD deaths (PAF: 11.6%; 11.3-12.0%) and 210,849 (196,297-226,577) stroke deaths (PAF: 3.6%; 3.4-3.9%).” They observed that death rates were higher among males and younger adults. When evaluating deaths in the 20 most populous countries included in the research, the largest absolute amount of CVD deaths from inadequate fruit intake took place in China (541,564; 482,709-608,314; PAF: 20.3%), and for inadequate vegetable intake, was India (199,364; 176,961-222,688; PAF: 11.6%).

While current recommendations tend to focus on what not to include in a healthy diet, the study suggests that a larger focus should perhaps be placed on what should be included, according to senior study author Dariush Mozaffarian, dean of the Friedman School of Nutrition Science and Policy at Tufts University: “Global nutrition priorities have traditionally focused on providing sufficient calories, vitamin supplementation and reducing additives like salt and sugar. These findings indicate a need to expand the focus to increasing availability and consumption of protective foods like fruits, vegetables and legumes—a positive message with tremendous potential for improving global health.”