Produce for Better Health Foundation (PBH) periodically conducts a review of the literature on a variety of topics relating to fruits and vegetables (FV) to aid practitioners, policy makers, and other researchers in our collective effort to increase FV consumption. Three recent reviews were conducted and are outlined in this newsletter.

The first was a review on how FV impact disease risk. The number of studies suggesting an association between fruit and vegetable intake and reduced risk of major chronic diseases has continued to grow over time. These studies have demonstrated that several nutrients and other components in FV are associated with beneficial outcomes related to disease. There is also a growing body of basic research suggesting that fruit and vegetable intake may reduce oxidation, inflammation, cell proliferation, and other important disease-related processes. A comprehensive and critical analysis of mechanistic experimental studies was beyond the scope of this review, but the evidence from mechanistic studies found during this review suggests that FV may have an even greater role to play in human health than the already positive results from observational studies outlined in this report. The body of literature is so great that additional reviews should be done by disease state, including more of the mechanistic studies.

The second review looked at human intervention trials in the US related to FV intake and behavioral approaches. The review suggests that statistically significant increases in fruit and vegetable intake are demonstrated when behavior-based interventions are employed. However, these increases in fruit and vegetable intake are small compared to that necessary to achieve recommended intake levels. Among the most supported are interventions applying Motivational Interviewing or Stages of Change at the individual level and Social Ecological or Social Contextual Theories at the group (e.g., worksite, church) level. Only with a multifaceted approach that integrates individual, group, governmental, industry, and social involvement and includes all ages, including early life exposure, is it expected that substantial and clinically relevant improvements in fruit and vegetable intake will be achieved. Achieving and sustaining fruit and vegetable intake at currently recommended levels across the population also will require stronger interventions that are strategically combined with other approaches, including efforts to address taste, convenience, availability and access, and competitive foods, as well as enhance the perceived value of habitually adopting this behavior.

The third review was an effort to determine if the US government was financially supporting FV to their level of importance as outlined in the US Dietary Guidelines. The review found that FV remain a low US federal spending priority. This low-priority status is inconsistent with the large fruit and vegetable consumption gap, the enormous economic costs and substantial health risks associated with that gap, and statements of high-level federal officials warning that the impact of diet-related diseases has reached a crisis in this country. The report has been used to help justify federal allocation or reallocation of funding to better support FV consumption. A similar analysis could be done by other countries.

For all reports go to http://www.pbhfoundation.org/about/res/pbh_res/

See next article