a1 Department of Epidemiology & Public Health, Imperial College School of Medicine, St Mary's Campus, Norfolk Place, London W2 1PG, UK:
a2 Acting Regional Adviser for Nutrition, WHO Regional Office for Europe, Copenhagen, Denmark
Background: The risk of many important diseases can be reduced by consuming a diet rich in vegetables and fruit. For this reason the World Health Organization (WHO) recommends a daily intake of more than 400 g person−1. The pattern of both the supply and intake of vegetables and fruit and the potential health gain achieved by increasing intake in the European Union (EU) and three accession countries are presented in this paper.
Methods: Patterns of supply and dietary intake were assessed using (1) FAO food balance sheets, which allow comparison between the levels of supply in countries but do not reflect actual intake; and (2) survey data reflecting dietary intake. Using WHO mortality data for coronary heart and cerebrovascular disease and major cancers up to age 65 years, the number of preventable deaths is estimated, assuming vegetable and fruit consumption were levelled up to that of the highest consuming group, and assuming relative risks of 0.5, 0.7 or 0.9.
Results: Vegetable and fruit consumption varies considerably between EU Member States. The populations of about half (seven) of the EU Member States have a mean daily intake of less than 275 g. Using the best current estimates of relative risk, over 26,000 deaths before the age of 65 years would be prevented annually in the EU if intake was levelled up to the highest consumption levels (and about double this number of deaths before the age of 75 years).
Conclusion: Increasing the intake of vegetables and fruit is feasible and could result in considerable improvements in public health within the EU. Priority should be given to developing methods that demonstrate the burden of disease caused by too low intakes of vegetables and fruit. This would enable the appropriate social, cultural and economic policies to be developed within the EU.
(Received October 27 2000)
(Accepted January 09 2001)