Public Health Nutrition

Research Article

Fruit and vegetable consumption and self-reported functional health in men and women in the European Prospective Investigation into Cancer–Norfolk (EPIC–Norfolk): a population-based cross-sectional study

Phyo K Myinta1a2 c1, Ailsa A Welcha1, Sheila A Binghama3, Paul G Surteesa1, Nicholas WJ Wainwrighta1, Robert N Lubena1, Nicholas J Warehama4, Richard D Smitha2, Ian M Harveya2, Nicholas E Daya1 and Kay-Tee Khawa1

a1 Department of Public Health and Primary Care, University of Cambridge, UK

a2 School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK

a3 MRC Dunn Human Nutrition Unit, Cambridge, UK

a4 MRC Epidemiology Unit, Cambridge, UK


Objectives To investigate the association between fruit and vegetable consumption and self-reported physical and mental functional health measured by an anglicised short-form 36-item questionnaire (UK SF-36).

Design Population-based cross-sectional study.

Setting General community in Norfolk, UK.

Subjects A total of 16 792 men and women aged 40–79 years recruited from general practice population registers as part of the European Prospective Investigation into Cancer (EPIC)–Norfolk study, who completed food-frequency questionnaires in 1993–1997 and Health and Life Experiences Questionnaires 18 months later, were enrolled in the study.

Results Mean SF-36 physical component summary scores increased significantly with increasing total fruit and vegetable consumption in both men and women (P <  0.0001 for trend). Men and women in the top quartile of consumption compared with the bottom quartile had a significantly higher likelihood of reporting good physical health (defined as a score ≥ 55); odds ratio (OR) 1.30, 95% confidence interval (CI) 1.11–1.53 for men and OR 1.28, 95% CI 1.11–1.48 for women, after controlling for age, body mass index, smoking, education, social class, prevalent illness and total energy intake. Exclusion of current smokers and people with prevalent illness did not alter the associations.

Conclusion Higher fruit and vegetable consumption is associated with better self-reported physical functional health within a general population. Increasing daily intake by two portions of fruit and vegetables was associated with an 11% higher likelihood of good functional health. Since the current average consumption of fruit and vegetables in the UK is about three portions, the recommended ‘five a day’ strategy may have additional benefit for functional as well as other health outcomes in the population.

(Received January 31 2006)

(Accepted August 10 2006)


c1 * Corresponding author: Email