Is ‘five-a-day’ an effective way of increasing fruit and vegetable intakes?

OBJECTIVES: To assess whether the amount of fruits and vegetables consumed depends on the serving size or on how often fruits and vegetables are eaten. DESIGN: Estimation of the weight of serving sizes and the number of fruits and vegetables eaten daily, using a validated food diary method. SETTING: Free-living men and women participating in the Norfolk arm of the European Prospective Investigation into Cancer and Nutrition (EPIC). SUBJECTS: Two hundred and sixty-nine men and women sampled from EPIC-Norfolk to participate in a study of simple methods of assessing fruit and vegetable intakes. RESULTS: The average portion of all fruits and vegetables measured was 87 g, close to the standard portion size of 80 g used as the basis of ‘5-a-day’ recommendations. There was a wide variation; the average portion size for baked beans was 147 g while for lettuce it was 26 g. The 20th and 80th percentiles also showed a large range, e.g. 39-72 g for carrots and 60-150 g for strawberries. Women ate more fruit than did men but fewer vegetables, so the total amount of fruit and vegetables eaten by men and women was the same. High consumers of fruits and vegetables (> or =400 g day(-1)) ate them approximately 5 times a day whilst low consumers (<400 g day(-1)) ate them less often (approximately 3 servings per day, P<0.01). Portion size differed little between high and low consumers. CONCLUSIONS: Frequency of intake is more important than portion size when distinguishing between high and low consumption of fruits and vegetables. Therefore, to increase intakes, low consumers should eat fruits and vegetables more often. This endorses the '5-a-day' healthy eating message.