Research Article| Volume 100, ISSUE 12, P1511-1521, December 2000

Overview of the Health Benefits of Fruit and Vegetable Consumption for the Dietetics Professional

Selected Literature


      Epidemiologic evidence of a protective role for fruits and vegetables in cancer prevention is substantial. The strength of this scientific base guides US national policymaking in diet and health issues and facilitates community and local programs that address national dietary goals to increase fruit and vegetable consumption. Current scientific evidence also suggests a protective role for fruits and vegetables in prevention of coronary heart disease, and evidence is accumulating for a protective role in stroke. In addition, a new scientific base is emerging to support a protective role for fruits and vegetables in prevention of cataract formation, chronic obstructive pulmonary disease, diverticulosis, and possibly, hypertension. This article provides an overview of the health benefits associated with fruit and vegetable consumption for each of these conditions, including brief discussions of underlying protective mechanisms, identifies key scientific findings regarding the health benefits of fruit and vegetable consumption, and outlines applications of these findings for dietetics professionals. The evidence reviewed provides additional support for increased consumption of a wide variety of vegetables, in particular, dark-green leafy, cruciferous, and deep-yellow-orange ones, and a wide variety of fruits, in particular, citrus and deep-yellow-orange ones. Continued attention to increasing fruit and vegetable consumption is a practical and important way to optimize nutrition to reduce disease risk and maximize good health. J Am Diet Assoc. 2000; 100:1511-1521.
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        • World Cancer Research Fund, American Institute for Cancer Research.
        Food, Nutrition and the Prevention of Cancer. American Institute for Cancer Research, Washington DC1997
        • Ries L.A.G
        • Eisner M.P
        • Kosary C.L
        • Hanlcey B.F
        • Miller B.A
        • Clegg L.X
        • Edwards B.K
        Seer Cancer Statistics Review 1973-1997. National Cancer Institute, Bethesda, MD2000 (NIH Pub. No.00-2789)
      1. Committee on Medical Aspects of Food, Nutrition Policy Epidemiology of diet in relation to specific cancers. In: Department of Health Report on Health and Social Subjects No.48 Nutritional Aspects of the Development of Cancer. London, England: Stationery Office; 1998. 80-153.

      2. Ten Leading Causes of Death in the U.S. Hyattsville, Md: National Center for Health Statistics. 1997. 46:32-33.

        • Klerk M
        • Jansen M.C.J.F
        • Van’t Veer P
        • Kok F.J
        Fruits and Vegetables in Chronic Disease Prevention. Grafisch Bedrijf Ponsen & Looijen BV, Wageningen, The Netherlands1998
        • Ness A.R
        • Powles J.W
        Fruit and vegetables and cardiovascular disease.
        Int J Epidemiol. 1997; 26: 1-13
        • Knekt P
        • Reunanen A
        • Jarvinen R
        • Seppanen R
        • Heliovaara M
        • Aromaa A
        Antioxidant vitamin intake and coronary mortality in a longitudinal population study.
        Am J Epidemiol. 1994; 139: 1180-1189
        • Key T.J.A
        • Thorogood M
        • Appleby P.N
        • Burr M.L
        Dietary habits and mortality in 11,000 vegetarians and health conscious people.
        BMJ. 1996; 313: 775-779
        • Rimm E.B
        • Ascherio A
        • Giovannucci E
        • Spiegelman D
        • Stampfer M.J
        • Willett W.C
        Vegetable, fruit, and cereal fiber intake and risk of coronary heart disease among men.
        JAMA. 1996; 275: 447-451
        • La Vecchia C
        • Decarli A
        • Pagano R
        Vegetable consumption and risk of chronic disease.
        Epidemiology. 1998; 9: 208-210
        • Ornish D
        • Scherwitz L.W
        • Billings J.H
        • Gould K.L
        • Merritt T.A
        • Sparler S
        • Armstrong W.T
        • Ports T.A
        • Kirkeeide R.L
        • Hogeboom C
        • Brand R.J
        Intensive lifestyle changes for reversal of coronary heart disease.
        JAMA. 1998; 280: 2001-2007
        • Joshipura K.J
        • Ascherio A
        • Manson J.E
        • Stampfer M.J
        • Rimm E.B
        • Speizer F.E
        • Hennekens C.H
        • Spiegelman D
        • Willett W.C
        Fruit and vegetable intake in relation to risk of ischemic stroke.
        JAMA. 1999; 282: 1233-1239
      3. The American Cancer Society 1996 Advisory Committee on Diet, Nutrition, and Prevention. Guidelines on diet, nutrition and cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. Cancer J Clin. 1996;46:325-341.

        • Steinmetz K.A
        • Potter J.D
        Vegetables, fruit, and cancer prevention.
        J Am Diet Assoc. 1996; 96: 1027-1039
        • Khaw K.T
        • Barrett-Connor E
        Dietary potassium and stroke-associated mortality.
        N Engl J Med. 1987; 316: 235-240
        • Keli S.O
        • Hertog M.G.L
        • Feskens E.J.M
        • Kromhout D
        Dietary flavonoids, antioxidant vitamins and incidence of stroke.
        Arch Intern Med. 1996; 154: 637-642
        • Hertog M.G.L
        • Feskens E.J.M
        • Hollman P.C.H
        • Katan M.B
        • Kromhout D
        Dietary antioxidant flavonoids and risk of coronary heart disease.
        Lancet. 1993; 342: 1007-1011
        • Taylor A
        • Jacques P.F
        • Epstein E.M
        Relations among aging, antioxidant status, and cataracts.
        Am J Clin Nutr. 1995; 62: 1439S-1447S
      4. Ryan SJ. Congressional testimony, May 5, 1993. Washington, DC: US Government Printing Office.

      5. Jacques PF, Chylack CT, Taylor A. Relationships between natural anti-oxidantsand cataract formation. In: Frei B. Natural Antioxidants in Human Health and Disease. New York, NY: Academic Press; 1994.

        • Jacques P.F
        • Chylack L.T
        Epidemiologic evidence of a role for the antioxidant vitamins and carotenoids in cataract prevention.
        Am J Clin Nutr. 1991; 53: 352S-355S
        • Mares-Perlman J.A
        • Brady W.E
        • Klein B.E.K
        • Klein R
        • Haus G.J
        • Palta M
        • Ritter L.L
        • Shoff S.M
        Diet and nuclear lens opacities.
        Am J Epidemiol. 1995; 141: 322-334
        • Hankinson S.E
        • Stampfer M.J
        • Seddon J.M
        • Colditz G.A
        • Rosner B
        • Speizer F.E
        • Willett W.C
        Nutrient intake and cataract extraction in women.
        BMJ. 1992; 305: 335-339
        • Brown L
        • Hankinson S.E
        • Seddon J.M
        • Rimm E
        • Willett W.C
        A prospective study of carotenoid intake and cataracts among US men [abstract].
        Am J Epidemiol. 1998; 147: 213
        • Cook D.G
        • Carey I.M
        • Whincup P.H
        • Papacosta O
        • Chirico S
        • Bruckdorfer K.R
        • Walker M
        Effect of fresh fruit consumption on lung function and wheeze in children.
        Thorax. 1997; 52: 628-633
        • Strachan D.P
        • Cox B.D
        • Erzinclioglu S.W
        • Walters D.E
        • Whichelow M.J
        Ventilatory function and winter fresh fruit consumption in a random sample of British adults.
        Thorax. 1991; 46: 624-629
        • Miedema I
        • Feskens E.F
        • Heederik D
        • Kromhout D
        Dietary determinants of long-term incidence of chronic nonspecific lung diseases; the Zutphen Study.
        Am J Epidemiol. 1993; 138: 37-45
        • La Vecchia C
        • Decarli A
        • Pagano R
        Vegetable consumption and risk of chronic disease.
        Epidemiology. 1998; 9: 208-210
        • Tabak C
        • Smit H.A
        • Rasanen L
        • Fidanza F
        • Menotti A
        • Nissinen A
        • Feskens E.M
        • Heederik D
        • Dromhout D
        Dietary factors and pulmonary function.
        Thorax. 1999; 54: 1021-1026
        • Hatch G.E
        Asthma, inhaled oxidants, and dietary antioxidants.
        Am J Clin Nutr. 1995; 61: 625S-630S
        • Roberts P.L
        • Veidenheimn M.C
        Diverticular diseases of the colon.
        in: Bay less T.M Current Therapy in Gasterenterology and Liver Diseases. DC Decker, Toronto, Ontario; Canada1990: 3:416-3419
        • Kennedy M.V
        • Zarling E.J
        Answers to ten key questions on diverticular disease of the colon.
        Compr Ther. 1998; 24: 364-369
        • Painter N.S
        • Burkitt D.P
        Diverticular disease of the colon.
        Clin Gastroenterol. 1975; 4: 3-21
        • Brodribb A.J.M
        • Humphreys D.M
        Diverticular disease: three studies, 1.
        BMJ. 1976; 1: 424-425
        • Fisher N
        • Berry C.S
        • Fearn T
        • Gregory J.A
        • Hardy J
        Cereal dietary fiber consumption and diverticular disease.
        Am J Clin Nutr. 1985; 42: 788-804
        • Aldoori W.H
        • Giovannucci E.L
        • Rockett H.R.H
        • Sampson L
        • Rimm E.B
        • Willett W.C
        A prospective study of dietary fiber types and symptomatic diverticular disease in men.
        J Nutr. 1998; 128: 714-719
        • Aldoori W.H
        • Giovannucci E.L
        • Rimm E.B
        • Wing A.L
        • Trichopoulos D.V
        • Willett W.C
        A prospective study of diet and the risk of symptomatic diverticular disease in men.
        Am J Clin Nutr. 1994; 60: 757-764
        • Marlett J.A
        Content and composition of dietary fiber in 117 frequently consumed foods.
        J Am Diet Assoc. 1992; 92: 175-186
        • Burt V.L
        • Whelton P
        • Roccell E.J
        • Brown C
        • Cutler J.A
        • Higgins M
        • Horan M.J
        • Labarthe D
        Prevalence of hypertension in the US adult population.
        Hypertension. 1995; 25: 305-313
        • Appel L.J
        • Moore T.J
        • Obarzanek E
        • Vollmer W.M
        • Svetkey L.P
        • Sacks F.M
        • Bray G.A
        • Vogt T.M
        • Cutler J.A
        • Wlndhauser M.M
        • Lin P-.H
        • Karanja N
        • for the DASH Collaborative Research Group.
        A clinical trial of the effects of dietary patterns on blood pressure.
        N Engl J Med. 1997; 136: 1117-1124
        • Cronin F.J
        • Shaw A.M
        • Krebs-Smith S.M
        • Marsland P.M
        • Light L
        Developing a food guidance system to implement the dietary guidelines.
        J Nutr Educ. 1987; 19: 281-302
      6. Food Guide Pyramid. US Dept of Agriculture Human Nutrition Information Service, Washington, DC1992 (Home and Garden Bulletin No. 232.)
        • Krebs-Smith S.M
        • Cleveland L.E
        • Ballard-Barbash R
        • Cook D.A
        • Kahle L.L
        Characterizing food intake patterns of American adults.
        Am J Clin Nutr. 1997; 65: 1264S-1268S
        • Heimendinger J
        • Van Duyn M.A
        • Chapelsky D
        • Foerster S
        • Stables G
        The national 5 A Day for Better Health program.
        J Public Health Manage Pract. 1996; 2: 27-35
      7. Healthy People 2010 [conference ed in 2 vol]. US Dept of Health and Human Services, Washington, DC2000
      8. Nutrition and Your Health. 4th ed. US Dept of Agriculture and Health and Human Services, Washington, DC1995 (Home and Garden Bulletin No. 232.)
        • US Departments of Agriculture and Health and Human Services
        Nutrition and Your Health. 5th ed. US Depts of Agriculture and Health and Human Services, Washington, DC2000 (Home and Garden Bulletin No. 232. Report also available from
        • Yaffe S.J
        • Filer Jr, L.J
        Use and abuse of vitamin A.
        Pediatrics. 1971; 48: 655-656
      9. The use and abuse of vitamin A.
        Can Med Assoc J. 1971; 104: 521-522
        • Stein H.B
        • Hasan A
        • Fox I.H
        Ascorbic acid-induced uricosuria.
        Ann Intern Med. 1976; 84: 385-388
        • The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group.
        The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers.
        N Engl J Med. 1994; 330: 1029-1035
        • Omenn G.S
        • Goodman G.E
        • Thornquist M
        • Grizzle J
        • Rosenstock L
        • Barnhart S
        • Balmes J
        • Cherniack M
        • Cullen M
        • Glass A
        • Geogh J
        • Meyskens F
        • Valanis B
        • Williams J
        The beta-Carotene and Retinol Efficacy Trial (CARET) for chemoprevention of lung cancer in high risk populations.
        Cancer Res. 1994; 54: 2038S-2043S
        • Gaziano J.M
        • Henekens C.H
        The role of beta-carotene in the prevention of cardiovascular disease.
        Ann N Y Acad Sci. 1993; 691: 148-155