EU Science Hub

Fruit and Vegetables

Table of Contents

1. Defining fruit and vegetables

Botanical definitions of vegetables, and fruit as a subgategory, refer to any kind of plant, without consideration for edibility. For nutrition purposes however, the term vegetable in general refers to a plant cultivated for its edible part(s), or refers to the edible parts of a plant (IARC Handbook); these include the stems and stalks, roots, tubers, bulbs, leaves, flowers and fruits. Fruit are, by this definition, a subgroup of vegetables consisting of the seeds and surrounding pulpy tissues. What constitutes a fruit or a vegetable varies, depending on their traditional uses in different countries and cultural practices (IARC Handbook). Reference to fruit and vegetables (F&V) often excludes cereal grains, nuts, seeds, tea leaves, coffee beans, cacao beans, herbs and spices. Table 1 provides examples of fruit and vegetable-related definitions.

2. Nutritional value of fruit and vegetables

The macronutrient composition of F&V differs substantially. Even within the same fruit or vegetable it can vary according to many factors, such as the type of cultivar, the plant growing conditions (e.g. soil composition, climate, fertilizer use), post-harvest handling, distribution and storage conditions as well as the ripeness of the final produce. In general, F&V have a high fibre and water content and they are a good source of micronutrients such as vitamins (in particular vitamins C and E, provitamin A and folate) and minerals (e.g. potassium, magnesium, phosphorus and calcium). Legumes, roots and tubers have a higher energy density in comparison to fruit and leafy vegetables. Legumes also have high protein content and are a good source of iron. Nuts have high energy density due to their high fat content, mainly in the form of unsaturated fatty acids (WCRF/AICR 2007). F&V also contain a variety of phytochemicals, as reported in Table 2.

Food processing – such as juicing, canning, freezing or cooking – can have an impact on F&V nutritional value. Commercial canning and freezing appear to have little effect but may result in minimal losses of some micronutrients (e.g. vitamin C and folic acid); often F&V cultivars used for canning are different from those sold fresh and this may be reflected in their composition too (e.g. higher levels of carotenoids in canned vs fresh tomatoes) (Rickman JC, et al). Other food processing techniques such as juicing result in changes to the energy density and loss of dietary fibre; drying of F&V removes water and also results in an increase in energy density (IARC Handbook)

3. Fruit and vegetables intake: effects on health

According to major food and health-related organizations – and as described in Table 3 - F&V intake is associated with a reduction in the risk of non-communicable diseases like cardiovascular disease (CVD), Type 2 diabetes mellitus (T2DM) and some types of cancer as well as improved bone health and reduced likelihood of unhealthy weight gain.

4. Recommended intake of fruit and vegetables

Table 4 showcases recommendations for F&V intake across Europe and beyond.

5. Fruit and vegetable intake across European countries

Average F&V intake data for different age groups in 17 EU countries plus Norway are presented in Table 5.  The intake data -unless differently specified- has been extracted from the European Food Safety Authority (EFSA) Comprehensive Food Consumption database (EFSA database) . According to EFSA – and as reported in the 2009 European Nutrition and Health Report (ENHR 2009) – daily intake of F&V varies broadly across different EU countries and between population groups. Despite the different methodologies used for the assessment of food intake in the surveys, it is possible to conclude that, with few exceptions, EU citizens fail to consume the recommended 400 grams a day of F&V.

The European Health Interview Survey (EHIS) (Eurostat 2016) reports that, on average, more than a third of the EU adults (defined as older than 15 years) does not consume any F&V on a daily basis whereas 51.4% consume between 1 and 4 portions of F&V per day; only 14.1% of the EU adults consume 5 portions (equivalent to 400g) of F&V per day as recommended by most food based dietary guidelines from EU Member States (JRC Report - unpublished).

Data from a 2013-2014 European children  survey (WHO 2016b) suggest that, on average, less than half of the children ate fruit on a daily basis, with even less frequent intakes observed in the age groups of 13- and 15-year olds. Data for vegetable consumption patterns are similar to those for fruit.

6. Disease burden related to low intake of fruits and vegetables

The Global Burden of Disease study (GBD Study 2017) estimated that in EU28, diets low in fruit and vegetables (including legumes) were among the leading dietary risk factors, being accountable for approx. 172000 and 118000 deaths respectively (GBD Tool 2017). According to the same data, in 2017, diets low in fruit were accountable for approx. 3.4 million disability adjusted life years (DALYs), while diets low in vegetables accounted for 1.8 million DALYs (GBD Tool 2017). Values for individual EU Member States can be seen in the map below. In the GBD study, diets low in fruits are defined as average daily consumption of less than 250 grams per day of fruits (fresh, frozen, cooked, canned, or dried, excluding fruit juices and salted or pickled fruits), whereas diets low in vegetables were defined as average daily consumption of less than 360 grams per day of vegetables (fresh, frozen, cooked, canned or dried vegetables excluding legumes and salted or pickled vegetables, juices, nuts and seeds, and starchy vegetables such as potatoes or corn). Finally, diet low in legumes is defined as average daily consumption of less than 60 grams per day of legumes.

Fruit map
 

Disease burden related to diet low in fruit in EU Member States (2017). Click to expand map.

Vegetables map

 

Disease burden related to diet low in vegetables in EU Member States (2017). Click to expand map.



These data are confirmed by other studies; a recent meta-analysis (Wang X., et al 2014) of observational studies conducted in Europe, North America and Asia found that higher consumption of F&V is associated with a reduced risk of mortality from all causes, and from CVD in particular. All-cause mortality decreased by 5% for each additional serving a day of F&V (6% for fruit and 5% for vegetables) with a threshold of around five servings a day, after which the risk of death did not decrease further. Similarly, the European Prospective Investigation into Cancer and Nutrition (EPIC) study reported that participants consuming more than 569 g per day of fruit and vegetables had respectively 15%, 27% and 40% lower risk of circulatory, respiratory and digestive system mortality when compared with participants consuming less than 249 g per day (Leenders M.,et al 2014).

 

6.1. Inequalities and fruits and vegetables intake

There is evidence to suggest that those with lower income and education levels consume less F&V (Eurostat 2016, GBD Study 2016, WHO 2014b) . A more detailed discussion on fruit and vegetables consumption and inequalities can be found in the Inequalities in Diet and Physical Activity Patterns in this series.

 

7. Policy recommendations for the promotion of fruit and vegetable intake

Two recent nutrition-related European action plans, the EU Action Plan on Childhood Obesity 2014-2020 (EU 2014) and the WHO European Food and Nutrition Action Plan 2015–2020 (WHO 2015) offer, among others, detailed recommendations regarding specific policy actions to increase availability and intake of F&V in Europe. These are summarised in Table 6. In both documents (but in particular in the EU Action Plan on Childhood Obesity), special attention has been given to school children. In addition, both documents highlight the need to focus on low socio-economic and other vulnerable population groups.

The European Commission has also compiled series of effective school-based interventions to increase F&V intake consumption in children. These school-based actions, separated into education, environment and parental are tried and tested interventions that have shown to increase F&V consumption in children and are described in 'How to promote fruit and vegetable consumption in schools: a toolkit' (JRC 2016) .

8. Implemented policies for the promotion of fruit and vegetable intake

Several European countries have implemented policies to increase fruit and vegetable consumption in children as well as adults. Examples of such policies are detailed in table 7.


References


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