Global study finds fruit and vegetable consumption cuts disease risk—why aren't we eating enough?

New research underscores fruits and vegetables as essential for health and sustainability—but will water-use concerns slow global adoption?

Study: Diet, fruit and vegetables and One Health: benefits for health, environment, society and the consumer—proceedings of the 9th edition of EGEA conference. Image Credit: Oksana Mizina / Shutterstock

In a recent perspective article published in the European Journal of Nutrition, researchers collated and synthesized the proceeds of the 9th edition of the EGEA Conference held in Barcelona, Spain, between September 20th and 22nd, 2023. This article focuses on current knowledge surrounding fruit and vegetables (FV) and their implications for human and planetary health.

Discussions between almost 150 scientists and stakeholders reveal that FVs are protective against type 2 diabetes (T2D), cardiovascular disease (CVDs), and certain cancers, though additional research is required to clarify the mechanisms involved in cancer prevention, aside from the known link between dietary fiber and colorectal cancer. FVs also have a significantly smaller carbon footprint than most other food groups, highlighting their environmental sustainability. However, significant water consumption associated with FV production remains a key environmental challenge, requiring sustainable management practices. Unfortunately, their global adoption leaves scope for improvement. Enhancing FV consumption monitoring may help promote a healthier, more sustainable tomorrow.

Background

‘Food systems’ is an umbrella term referring to all activities associated with food production and consumption and their impacts on economic, health, and environmental outcomes. Given the unprecedented growth of human populations globally, food systems face the unique challenge of meeting humanity’s growing nutritional needs while balancing their ecological and environmental costs.

“It is estimated that the current food systems are responsible for 20 to 35% of greenhouse gas emissions and are a major driver in land conversion, deforestation, and biodiversity loss. At the same time, nearly 690 million people worldwide suffer from hunger, representing 8.9% of the world population, and nearly one in ten people report suffering from severe food insecurity worldwide, while 3 billion people cannot afford a healthy diet.”

Recent research highlights the importance of fruits and vegetables (FVs) in meeting these food systems requirements—providing nutritious and potentially cost-effective food sources at a substantially lower cost to the environment than meats and other food groups. The United Nations Food and Agriculture Organization (FAO) has emphasized FV’s importance by stating that their adoption can contribute to human (individual) and planetary health improvements.

One Health

Unfortunately, FVs continue to be an underused resource, particularly in Western nations. Various complex factors, including public knowledge gaps, taste preferences, marketing strategies, social influences, availability, accessibility, and at times, high economic costs, prevent their widespread adoption. To combat this, the One Health system aims to mobilize interdisciplinary experts and stakeholders to engage in data sharing and discourse to develop solutions promoting long-term, sustainable planetary health. One Health is an integrated, unifying scientific research stream that aims to sustainably balance and optimize the health of people, animals, and ecosystems.

EGEA Conference

The EGEA conference is an international conference that provides a platform for scientists and stakeholders to derive evidence-backed policy recommendations for promoting FV in nutritious and sustainable diets. It was created in 2003, and its most recent (9th) edition was hosted by Aprifel in Barcelona, Spain, between 20 and 22 September 2023.

The main topic for the 9th edition of the EGEA Conference was “Diet, Fruit and Vegetables and One Health: What Contributions?” The themes included 1. FVs’ role in preventing chronic diseases, 2. Sustainability and planetary health, 3. Consumer choice determinants, and 4. Suggestions to place FVs at the center of future One Health discussions and research.

Conference outcomes

The present article synthesizes four primary conference outcomes: 1. FV’s contributions to One Health, backed by scientific evidence; 2. Present knowledge gaps; 3. Uncertain topics; and 4. Recommendations for future research and policy.

Several scientific studies highlight the health benefits of FV consumption, particularly in preventing non-communicable diseases (NCDs), the leading cause of human mortality worldwide. Approximately 400g of FVs daily have been shown to substantially reduce the risk of cardiovascular diseases (CVDs) and type 2 diabetes (T2D), primarily due to their high concentrations of fibers, vitamins, potassium, and other antioxidant and anti-inflammatory bioactive compounds. Notably, these associations have been shown to be dose-dependent, with higher quantities of daily dietary FVs (up to 800g/day) enhancing beneficial outcomes.

Emerging research also indicates additional benefits of FV consumption, including modulation of gut microbiota and potential protective effects on mental and brain health. Furthermore, studies distinguish between the health impacts of healthy versus unhealthy plant-based diets, emphasizing the importance of nutritional quality.

From the sustainability perspective, FVs have been proven to ensure territorial cohesion and reduce conflict between adjoining political entities. They are one of the richest sources of nutrition while exhibiting a significantly lower carbon footprint than other food groups such as meats. However, current production methods often lead to high water consumption, which can potentially be mitigated through precision irrigation, deficit irrigation, organic mulching, and other sustainable agronomic techniques. Overdependence on synthetic pesticides and fertilizers presents an additional demerit of current FV production chains, but the widespread adoption of biopesticides and agroecological fertilizers can overcome these issues shortly.

Finally, despite overwhelming support in favor of their increased consumption, most nations do not meet FV’s recommended daily intakes, presumably due to a lack of education or economic unaffordability. To address these limitations, the EGEA conference provides seven key policy recommendations:

1. Further adaptation of dietary recommendations to cultural contexts, local traditions, market availability, and hedonic motivations; 2. Accessibility, desirability, and affordability should be prerequisites for educational actions; 3. Actions need to be co-constructed with the users (targets); 4. Monitor dietary consumption; 5. To make FV as attractive and salient as high Fat, Salt, and Sugar (HFSS) products, using effective marketing techniques; 6. Support local market infrastructure and capacities of small-scale business actors to improve the food environment; 7. A systemic and holistic approach is needed to build (cost-)effective policies.