Although "an apple a day keeps the doctor away" and "eat your veggies" may sound like folklore, it turns out that these maxims may have scientific backing. The only catch is that just one apple or one vegetable serving a day isn't enough. In fact, to maximize your health, you need a combination of at least five a day.
The underlying causes of deaths from heart disease and cancer include behaviors that, unlike genetic factors, can be prevented or changed. For example, better dietary and exercise patterns can contribute significantly to a reduced risk for
, and could prevent 300,000 deaths annually.
A recent scientific literature review ascertained that approximately 35% of all cancer deaths in the United States are related to poor dietary habits. Research also points to high intakes of fruits and vegetables as the most consistent factor associated with decreased cancer risk.
For years, epidemiologic studies have shown lower rates of chronic diseases in countries that have high per capita intakes of fruits and vegetables. Although this may sound compelling, the information is too isolated to prove a cause and effect relationship in and of itself.
However, recent studies have strengthened the argument for fruit and vegetable consumption. In these studies, people who ate large amounts of fruits and vegetables had lower rates of cancer compared to people who ate one or fewer servings a day. Five servings a day is the minimum number demonstrated to reap health benefits.
Despite such strong evidence, many Americans still don't realize the importance of fruits and vegetables in the diet. According to baseline data used to set the
Healthy People 2000 National Health Promotion and Disease Prevention Objectives
, average fruit and vegetable intake was approximately four servings per day. In fact, only 32% of US adults met the recommended five a day.
A 1991 survey revealed that only 8% of American adults knew how many fruits and vegetables to eat. In response to this lack of knowledge, the National Cancer Institute (NCI) in cooperation with the Produce for Better Health Foundation launched the 5 A Day—for Better Health program.
What Is The 5 A Day Program?
The 5 A Day program seeks to increase the number of fruits and vegetables consumed by Americans. The program's goal is to inform Americans that fruits and vegetables can easily become a part of the daily diet, improve health, and may reduce the risk of cancer and other chronic diseases.
Peter Greenwald, MD, Director of NCI's Division of Cancer Prevention and Control, summed up the situation by saying, "In the last several years, consumers have been bombarded with food and nutrition messages—many of which have been confusing and sometimes frightening. The 5 A Day message is simple and positive: Eat more of something that tastes great and improves your overall health."
Fruits and vegetables readily fit the bill; they provide fiber, beneficial vitamins such as
, minerals, and other compounds that may help to fight cancer. While single-dose nutrients receive much press, it appears that the combination of nutrients in fruits and vegetables probably holds the key to disease prevention. A bonus for the weight conscious is that most fruits and vegetables (except avocados and olives) are naturally low in fat and calories, have no cholesterol, and taste delicious.
This simple, straightforward message—eat five a day—has successfully increased public awareness of the dietary guidelines. The actual number of people meeting the goal is unknown at this time, but awareness is a good predictor of consumption.
Where Do You and Your Family Fit in?
Children mimic the dietary habits of adults. Only 20% of American children consume the recommended five a day. Though children are not concerned with developing diseases such as cancer, they need healthful diets to promote growth and development. And dietary habits formed in childhood usually last a lifetime. Conversely, older Americans who have developed healthful eating patterns consume the most fruits and vegetables, while women manage to eat more fruits and vegetables than do men.
What Can Be Done?
To help motivate people to eat more fruits and vegetables, the NCI urges Americans to take the "5 A Day Challenge." The challenge encourages people to engage in a healthy competition that will prove easier than the Olympic games and allows more people to feel like winners. Ultimately, fruits and vegetables can become part of a health routine that can make everyone feel good.
Start Your Own 5 A Day Challenge
To start your own 5 A Day Challenge, begin at home by striving to eat five servings of fruits and vegetables today. Continue your success each day, each week, and soon you will have a more healthful diet.
Take your challenge into the streets by organizing a friendly competition among neighbors. End the week with a potluck and ask everyone to bring his/her favorite fruit or vegetable dish.
Take the opportunity to beat the boss and suggest a 5 A Day Challenge at work. Teams can offer the best support as you share ideas in the lunch room. If your workplace has a cafeteria, invite the food service manager to help the challenge by offering daily specials on fruits and vegetable dishes.
Eating five a day is easier than most people think. A serving is:
1 medium piece of fruit
½ cup cooked or raw fruit or vegetable
¾ cup (6 ounces) juice
1 cup leafy greens
¼ cup dried fruit
½ cup cooked beans or peas (such as lentils, pinto beans, kidney beans)
Eat five a day
At breakfast, enjoy a six ounce glass of 100% fruit juice and a medium piece of fruit. Two servings already!
At lunch, bring along some carrot or celery sticks; five sticks is a vegetable serving.
For dinner, try a salad with dark, leafy greens and tomato, and a medium baked potato with your meal for two more vegetable servings.
Voila! Not counting any fruit or vegetable snacks, you've already made your 5 A Day goal.
Buy five a day
In the grocery store, buy fresh fruits and vegetables that are in season. Locally grown produce is usually less expensive than produce that has been shipped, and it is fresher.
Softer fruits and vegetables, such as peaches and berries, or tomatoes and mushrooms, don't last as long as harder fruits and vegetables, such as apples and oranges, or carrots and potatoes.
Canned and frozen fruits and vegetables are good to have on hand so that you never run out.
Find five a day on the road
Most fast food chains serve 100% fruit juice, and convenience stores stock both juice and fresh fruit.
Enjoy a breakfast waffle or pancake with strawberries instead of syrup, or have an omelet stuffed with tomatoes, mushrooms, peppers, and onions.
Bring along dried fruit or raisin packs for a transportable snack.
At the deli, take advantage of vegetable sandwich toppings and try a bowl of vegetable soup on the side.
For your evening meal, include the vegetable side choices, or try a vegetarian-based meal such as chili. Don't forget that a tomato pizza also counts towards your vegetable intake!
Don't stop at five a day!
While we would see real health benefits if all Americans increased their intake of fruits and vegetables to five a day, this target is only a first or baseline level. More recent recommendations suggest that women should aim for seven servings, and men for nine. Five is great, but more is better!
Krebs-Smith SM, Cook A, Subar AF, Cleveland L, Friday J. US adult's fruit and vegetable intakes, 1989 to 1991: A revised baseline for the Healthy People 2000 Objective.
Am J Public Health.
Krebs-Smith SM, Cook A, Subar AF, Cleveland L, Friday J, Kahle LL. Fruit and vegetable intakes of children and adolescents in the United States.
Pediatr Adolesc Med.
National Research Council, US Committee on Diet and Health.
Diet and Health: Implications for Reducing Chronic Disease Risk.
Washington, DC: National Academy Press. 1989.
Steinmetz KA. Vegetables, fruit, and cancer, I: epidemiology.
Cancer Causes Control.
US Department of Agriculture, US Department of Health and Human Services.
Nutrition and Your Health: Dietary Guidelines for Americans.
Washington, DC: US Government Printing Office; 1995.
US Department of Health and Human Services.
Healthy People 20000: National Health Promotion and Disease Prevention Objectives.
Washington, DC: US Government Printing Office; 1990.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a