Critical review: vegetables and fruit in the prevention of chronic diseases
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REVIEW
Critical review: vegetables and fruit in the prevention of chronic diseases Heiner Boeing • Angela Bechthold • Achim Bub • Sabine Ellinger • Dirk Haller • Anja Kroke • Eva Leschik-Bonnet • Manfred J. Mu¨ller • Helmut Oberritter • Matthias Schulze • Peter Stehle • Bernhard Watzl
Received: 13 February 2012 / Accepted: 9 May 2012 / Published online: 9 June 2012 Ó The Author(s) 2012. This article is published with open access at Springerlink.com
Abstract Background Vegetables and fruit provide a significant part of human nutrition, as they are important sources of nutrients, dietary fibre, and phytochemicals. However, it is uncertain whether the risk of certain chronic diseases can be reduced by increased consumption of vegetables or fruit by the general public, and what strength of evidence has to be allocated to such an association. Methods Therefore, a comprehensive analysis of the studies available in the literature and the respective study results has been performed and evaluated regarding obesity, type 2 diabetes mellitus, hypertension, coronary heart disease (CHD), stroke, cancer, chronic inflammatory bowel disease (IBD), rheumatoid arthritis (RA), chronic obstructive pulmonary disease (COPD), asthma, osteoporosis, eye diseases, and dementia. For judgement, the strength of evidence for a risk association, the level of evidence, and the number of studies were considered, the quality of the The German Nutrition Society initiated this review and convened the working group. H. Boeing Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbru¨cke, Germany
studies and their estimated relevance based on study design and size. Results For hypertension, CHD, and stroke, there is convincing evidence that increasing the consumption of vegetables and fruit reduces the risk of disease. There is probable evidence that the risk of cancer in general is inversely associated with the consumption of vegetables and fruit. In addition, there is possible evidence that an increased consumption of vegetables and fruit may prevent body weight gain. As overweight is the most important risk factor for type 2 diabetes mellitus, an increased consumption of vegetables and fruit therefore might indirectly reduces the incidence of type 2 diabetes mellitus. Independent of overweight, there is probable evidence that there is no influence of increased consumption on the risk of type 2 diabetes mellitus. There is possible evidence that increasing the consumption of vegetables and fruit lowers the risk of certain eye diseases, dementia and the risk of osteoporosis. Likewise, current data on asthma, COPD, and RA indicate that an increase in vegetable and fruit consumption may contribute to the prevention of these D. Haller Nutrition and Food Research Centre, Chair for the Biofunctionality of Food, Technical University of Munich, Freising-Weihenstephan, Germany
A. Bechthold (&) E. Leschik-Bonnet H. Oberritter Science Department, German Nutrition Society, Bonn, Germany e-mail: [email protected]
A. Kroke Department of
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