5 a day or 10 a day? Just eat more!

Today’s headlines induced guilt for the 73% of UK adults that fail to consume 5 portions of fruit and vegetables a day (NDNS data, 2016).  A new study suggests that while getting your 5 a day is good, eating 10 portions a day offers the most protection against chronic diseases like cancer and cardiovascular disease.  Given that most of us struggle to achieve just 5 portions, is the reporting of these health messages doing more harm than good?

We all know that fruit and vegetables are good for us.  Many studies have shown that those who eat diets rich in fruit and veg have a lower risk of obesity, type 2 diabetes, cancer and cardiovascular disease.  The World Health Organisation recommends consuming around 400g of a variety of fruit and vegetables a day.  That equates to roughly 5 portions of 80g each of vegetables or fruits and it’s important to eat a wide variety to reap the most health benefits.  The more variety, particularly when it comes to the colour of fruit and veg, the wider the range of nutrients you consume, hence the ‘eat a rainbow’ message.

Over the years, many studies have identified different recommendations for the ideal number of portions, portion size and the balance of fruit to vegetables.  Hence, governments around the world differ in the public health advice that they provide: Australia recommends 2+5 portions a day, which equates to 5 75g portions of vegetables and 2 150g portions of fruit – far more than the UK recommendations and a lot more detail.  However, most Australians also fall short of this target.

This recent review analysed 95 separate epidemiological studies on fruit and vegetable intake and disease risk.  In these type of studies, large numbers of people fill in food diaries and have their health status checked and they are then monitored for many years to track their health.  This review of evidence found that the greatest benefit in terms of disease risk reduction was found with a consumption of 800g or 10 80g portions of fruit and vegetables a day.

However, it’s important to remember is that eating ANY fruit and veg is better than eating none.  The review found that even eating 200g a day was linked to a 16% reduced risk of cardiovascular disease, an 18% reduced risk of stroke and a 4% reduced risk of cancer compared to eating none.  Eating 5 a day (400g) is linked to even bigger risk reductions but the team of researchers lead by Dr Dagfinn Aune at Imperial College London suggested that around 7.8 million premature deaths could be potentially prevented globally every year if people ate 10 portions of fruit and veg a day.

Now it’s notoriously difficult to be specific when it comes to risk reduction and prevention of premature death.  People have a habit of over-reporting their intake of healthy foods and under-reporting that of less healthy foods, diet and lifestyle change over the long study times and behaviours are linked which can then confuse the overall picture (i.e. someone who eats few vegetables, is less likely to exercise and more likely to drink alcohol and smoke) so it’s very hard to draw clear conclusions.  In addition, these studies can only ever imply correlation between diet and disease risk, not causation.

The bottom line is that fruit and vegetables are undeniably good for us and we should aim to eat more.  The absolute numbers are less important, particularly when we eat so few as a nation, so aiming to increase our intake by a portion a day on a gradual basis is a pretty good idea.  Public health policy should always be realistic and not put people off by setting unachievable targets, so the 5 a day recommendation is still relevant.  Including a wide variety of fruits and vegetables is a great way to get the best range of nutrients so aim for a rainbow of colours over the course of a week too.  For advice on helping babies and toddlers to love veg, have a read of my blog here.

There is a perception that fruit and vegetables are expensive.  That doesn’t have to be the case.  There are affordable frozen vegetables widely available and the freezer aisles of supermarkets are stocked with not just peas but green beans, soy beans, spinach, mushrooms and even butternut squash (the latter having saved me hours of chopping time!)  If you buy in season, buy odd shaped fruit and veg, include canned fruit or veg in juice or water, with no added sugar or salt, you can get cheaper options too.

Top tips for 5+ a day

• Pimp your breakfast by adding frozen berries to overnight oats or top your cereal and porridge with sliced fruit; you can even put sliced fruit like apple or banana on your toast and peanut butter!
• Add a glass of fruit juice at breakfast but keep serve sizes to no more than 150ml
• Snack on chopped up fruit, veg sticks with hummus or smashed berries mixed with yoghurt
• Have homemade soup for lunch made with plenty of veg and added pulses for protein
• If you’re having a sandwich or wrap, pack in some salad with your filling or have some cherry tomatoes and sticks of celery to munch on, as a side dish
• At dinner, if you’re making a tomato sauce for a Bolognese, chilli or other one pot dish, add onion, leeks or even celery.
• Add carrots, squash and other root veg to winter lamb and beef stews and roast peppers, courgettes, red onions and aubergine for colourful summer dishes.

I literally pack my one pot dishes with veg.  For me, a pimped out Bolognese sauce usually incorporates onions, leeks, mushrooms, courgettes and aubergine alongside the canned tomatoes and I usually throw in some lentils to make the beef go further.  It may not be Bolognese as we know it but it gets a lot of veg in!

To summarise, aim to eat at least some fruit and vegetables every day.  More is better but don’t beat yourself up if you don’t always get to 5 (or 10!)  Set yourself manageable goals to eat more and share your tips for fruit and veg hacks with friends so it becomes a fun way to eat healthier.