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PubMed2006

Quantitative analysis of nitrate and nitrite contents in vegetables commonly consumed in Delta State, Nigeria.

Plasma thiocyanate has been reported to be high among cassava-eating populations such as that in Nigeria because of the cyanide content of cassava. Thiocyanate, which is secreted into the stomach contents of animals, has been demonstrated to catalyse the formation of nitrosamines (potent carcinogens) in the stomach from secondary amines and nitrite. The main source of the nitrite precursor in this environment is vegetables, primarily eaten as the chief supplier of proteins. The present study attempts to analyse the levels of nitrate and nitrite in vegetables commonly grown and consumed in Delta State, Nigeria. The nitrate and nitrite contents in green vegetable (Amaranthus spp.), bitter leaf (Vernonia amygdalina), pumpkin (Telfaria occidentalis) and water leaf (Talinum triangulare) grown in different localities of the state were determined by standard analytical procedures. The results show that those vegetables grown in the industrialised urban centres of the state had higher nitrate (223 (SD 71) mg/kg dry weight; P<0.05) and nitrite (12.6 (SD 1.7) mg/kg dry weight; P>0.05) levels when compared with the same species (188 (SD 77) mg nitrate/kg dry weight and 10.9 (SD 1.1) mg nitrite/kg dry weight) cultivated in less industrialised suburbs. We conclude that frequent consumption of such vegetables whose nitrate and nitrite contents are high by cassava-eating individuals might put them at risk of developing stomach cancer and other possible results of nitrate and/or nitrite toxicity. In order to avoid an outbreak in our communities, appropriate agencies should monitor and regulate the release of chemicals into the environment. In the meantime, the cultivation and consumption of vegetables grown in industrialised areas of the state should be discouraged.

Amaranthus↗

PubMed1999

Vegetable and fruit consumption associated with anthropometric, dietary and lifestyle factors in Spain. EPIC Group of Spain. European Prospective Investigation into Cancer.

OBJECTIVE: To evaluate the association of vegetable and fruit intake with several demographic, anthropometric, lifestyle and dietary factors. DESIGN AND SETTING: Cross-sectional analysis. Information on habitual diet was collected by means of the diet history method. Association of vegetable and fruit intakes with other factors was assessed separately by means of multiple lineal regression and the cumulative odds model. SUBJECTS: 39622 healthy subjects aged 29-69 years from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort in Spain. RESULTS: Fruit intake increased with age, education and physical activity and decreased with intake of saturated fatty acids and cholesterol; smoking and alcohol consumption were also negatively associated with fruit, with a very low consumption for current smokers and heavy drinkers. Vegetable intake increased with education and physical activity and with intake of unsaturated fatty acids, mainly monounsaturated. Former smokers consumed more vegetables than never or current smokers and non-consumers of alcohol ate less vegetables than consumers, among whom no differences were observed. All these estimates were adjusted by energy and body mass index (BMI). CONCLUSIONS: When assessing the association of fruit and vegetables with chronic diseases it is important to take into account confounding factors. Furthermore, it would be useful to study dietary patterns including several interrelated factors.

Adult↗

PubMed2002

Antioxidant and antiproliferative activities of common vegetables.

Epidemiological studies have shown that consumption of fruits and vegetables is associated with reduced risk of chronic diseases. Increased consumption of fruits and vegetables containing high levels of phytochemicals has been recommended to prevent chronic diseases related to oxidative stress in the human body. In this study, 10 common vegetables were selected on the basis of consumption per capita data in the United States. A more complete profile of phenolic distributions, including both free and bound phenolics in these vegetables, is reported here using new and modified methods. Broccoli possessed the highest total phenolic content, followed by spinach, yellow onion, red pepper, carrot, cabbage, potato, lettuce, celery, and cucumber. Red pepper had the highest total antioxidant activity, followed by broccoli, carrot, spinach, cabbage, yellow onion, celery, potato, lettuce, and cucumber. The phenolics antioxidant index (PAI) was proposed to evaluate the quality/quantity of phenolic contents in these vegetables and was calculated from the corrected total antioxidant activities by eliminating vitamin C contributions. Antiproliferative activities were also studied in vitro using HepG(2) human liver cancer cells. Spinach showed the highest inhibitory effect, followed by cabbage, red pepper, onion, and broccoli. On the basis of these results, the bioactivity index (BI) for dietary cancer prevention is proposed to provide a simple reference for consumers to choose vegetables in accordance with their beneficial activities. The BI could be a new alternative biomarker for future epidemiological studies in dietary cancer prevention and health promotion.

Antineoplastic Agents↗

PubMed2000

Content of glucosinolates in cruciferous vegetables grown at the same site for two years under different climatic conditions.

Individual glucosinolates (GLS) were determined in vegetables of three Cruciferae species: Brassica oleracea L. (white cabbage, red cabbage, Savoy cabbage, Brussels sprouts, cauliflower, kale, kohlrabi), Brassica rapa L. (turnip), and Raphanus sativus L. (red radish, black radish, and white radish) produced in two years. The cultivars were compared for the contents of total-, indole-, and aliphatic GLS. In both years, the total content of GLS was highest in black radish, and all examined R. sativus vegetables contained the greatest amount of aliphatic GLS. Neither the level nor the identity of GLS differentiated among the vegetables of the other cultivars grown in the same year. Comparison of the GLS contents of the same cultivar in two production years, which differed in temperature and rainfall rate, showed that low average 10-day rainfall and high average temperature during the vegetation period significantly increased the GLS content of vegetables. This suggests that the year x cultivar interaction modified the GLS content of vegetables.

Climate↗

PubMed1998

Measuring stage of change for fruit and vegetable consumption in 9- to 12-year-old girls.

This paper presents results of the pilot-testing of a stage of change measure for eating fruit and vegetables (F & V) in 9- to 12-year-old girls. During troop meetings, 259 girls from 22 troops completed a 1-day food recognition form, a brief stage of change algorithm for fruit and for vegetables, and a questionnaire measuring psychosocial variables associated with F & V consumption. Stages for F & V consumption were different and MANOVAs revealed overall significant differences across stages for each variable. F & V intake increased with higher stages, as did preferences, self-efficacy for selecting, preparing, and eating F & V, subjective norms, and F & V preparation skills; reported barriers decreased. Stepwise discriminant analyses between Precontemplation and Contemplation stages identified fruit preferences and barriers differentiating the two stages for fruit consumption and subjective norms and self-efficacy differentiating the two stages for vegetable consumption. Barriers and F & V preparation responsibilities/skills were significant between the Contemplation and the Action stages for both fruit and vegetable consumption, with the additional variable of subjective norms for fruit stage and vegetable preferences for vegetable stage. Findings support the use of this measure to identify stage for children's adoption of F & V consumption behavior and as a guide for intervention development.

Child↗

PubMed2004

Vegetables, fruit consumption and risk of lung cancer among middle-aged Japanese men and women: JPHC study.

OBJECTIVE: To investigate the association between vegetable and fruit consumption and incidence of lung cancer. METHODS: Self-administered questionnaires were used to assess diet in two large population-based cohorts with 42,224 and 51,114 subjects in 1990 and 1993, respectively. After ten and seven years of follow-up, we ascertained 428 newly diagnosed case of lung cancer. Relative risk (RR) estimates were calculated using the Cox proportional hazards model with pooling of estimates from the two cohorts. RESULTS: Total vegetable and fruit intake was not associated with lowered risk of lung cancer, with RR approximating unity. The null relation between vegetable and fruit consumption and lung cancer incidence was consistent across strata of smoking status (never or ever smokers). When dividing lung cancers into adenocarcinoma and non-adenocarcinoma, risk for middle and high intakes of vegetables only, fruit only, and vegetables and fruit combined were all below one for non-adenocarcinoma and above one for adenocarcinoma, although no statistically significant differences were noted. Similar patterns of results were found when the two cohorts were analyzed separately. CONCLUSIONS: Contrary to popular belief, our results suggest that vegetables and fruit do not appear to confer protection from lung cancer.

Aged↗

PubMed2003

Vegetable and fruit: the evidence in their favour and the public health perspective.

There is strong evidence that the intake of vegetables and fruits reduces the risk of cardiovascular disease (CVD) and is inversely associated with several forms of cancer. In contrast, information concerning specific macro- or micronutrients in relation to chronic diseases is limited and largely inconclusive. The beneficial role of vegetable and fruit consumption can also be inferred by considering the health effects of two dietary patterns, the Mediterranean and Japanese ones, in both of which the consumption of plant foods holds a prominent position. Time-trend data, retrieved from the DAFNE databank on the vegetable and fruit availability in four European countries (Greece, Ireland, Italy and Norway) indicate that, during the last decade, fruit availability decreased in Greece and Italy and increased in Ireland and Norway, whereas vegetable availability decreased only in Italy. In Greece, Italy and Norway, the daily fruit availability was higher than that of vegetables, a dietary pattern not in accordance to recommendations for higher vegetable consumption. This information, which is crucial for nutrition policies and health education, also demonstrates the value of the DAFNE surveillance system.

Cardiovascular Diseases↗

PubMed2002

Intakes of fruits and vegetables, carotenoids and vitamins A, E, C in relation to the risk of bladder cancer in the ATBC cohort study.

We examined the relation between dietary fruit and vegetables, carotenoids and vitamin intakes and the risk of bladder cancer among male smokers in a prospective cohort study. Over a median of 11 years, we followed 27 111 male smokers aged 50-69 years who were initially enrolled in the Alpha-Tocopherol Beta-Carotene Cancer Prevention Study. During this period, 344 men developed bladder cancer. All of these men had completed a 276-food item dietary questionnaire at baseline. Cox proportional hazards models were used to estimate the relative risks and 95% confidence intervals and to simultaneously adjust for age, smoking history, energy intake and intervention group. Consumption of fruits and vegetables was not associated with the risk of bladder cancer (relative risk=1.28; 95% confidence intervals CI: 0.89-1.84, for highest vs lowest quintile). Similarly, no associations were observed for groups of fruits or vegetables (berries and cruciferous vegetables), or for specific fruits and vegetables. Dietary intakes of alpha-carotene, beta-carotene, lycopene, lutein/zeaxanthin, beta-cryptoxanthin, vitamins A, E, and C, and folate were not related to the risk of bladder cancer. These findings suggest that fruit and vegetable intakes are not likely to be associated with bladder cancer risk. However, these results may not be generalisable to non-smokers.

Aged↗

PubMed2003

Vegetables and fruit intake and cancer mortality in the Hiroshima/Nagasaki Life Span Study.

The association between green-yellow vegetables and fruit consumption and risk of cancer death was investigated in a prospective study of 38 540 men and women who were atomic-bomb survivors in Hiroshima and Nagasaki, Japan. Study participants completed a dietary questionnaire in 1980-1981 and were followed-up for cancer deaths until March 1998, during which time 3136 cancer deaths were identified. Daily or almost daily fruit consumption was associated with a significant 12% reduction in total cancer mortality (RR=0.88; 95% CI, 0.80-0.96 for daily intake compared with intake once per week or less). Daily or almost daily green-yellow vegetables consumption was associated with a marginally significant 8% reduction in total cancer mortality (0.92; 0.94-1.01). Green-yellow vegetables consumption was associated with a significant reduction in liver cancer mortality (0.75; 0.60-0.95). Fruit consumption was associated with a significantly reduced risk of stomach cancer and lung cancer mortality (0.80; 0.65-0.98). Green-yellow vegetables and fruit consumption was associated with a reduction in oesophageal cancer, but these associations were not statistically significant. Neither green-yellow vegetables nor fruit consumption was associated with colorectal cancer or breast cancer mortality. These results support the evidence that daily consumption of fruit and vegetables reduces the risk of total cancer, and specifically cancers of the stomach, liver, and lung.

Cohort Studies↗

PubMed2003

Effects of enhanced consumption of fruit and vegetables on plasma antioxidant status and oxidative resistance of LDL in smokers supplemented with fish oil.

OBJECTIVE: To determine whether consumption of five portions of fruit and vegetables per day reduces the enhancement of oxidative stress induced by consumption of fish oil. SUBJECTS: A total of 18 free-living healthy smoking volunteers, aged 18-63 y, were recruited by posters and e-mail in The University of Reading, and by leaflets in local shops. DESIGN: A prospective study. SETTING: Hugh Sinclair Unit of Human Nutrition, School of Food Biosciences, The University of Reading, Whiteknights PO Box 226, Reading RG6 6AP, UK. INTERVENTION: All subjects consumed a daily supplement of 4 x 1 g fish oil capsules for 9 weeks. After 3 weeks, they consumed an additional five portions of fruits and vegetables per day, and then they returned to their normal diet for the last 3 weeks of the study. Fasting blood samples were taken at the ends of weeks 0, 3, 6 and 9. RESULTS: The plasma concentrations of ascorbic acid, lutein, beta-cryptoxanthin, alpha-carotene and beta-carotene all significantly increased when fruit and vegetable intake was enhanced (P<0.05). Plasma concentrations of alpha-tocopherol, retinol and uric acid did not change significantly during the period of increased fruit and vegetable consumption. Plasma oxidative stability, assessed by the oxygen radical absorbance capacity (ORAC) assay, also increased from weeks 3-6 (P<0.001) but not in association with increases in measured antioxidants. Lag phase before oxidation of low-density lipoprotein (LDL) significantly decreased in the first 3 weeks of the study, reflecting the incorporation of EPA and DHA into LDL (P<0.0001). Subsequent enhanced fruit and vegetable consumption significantly reduced the susceptibility of LDL to oxidation (P<0.005). CONCLUSION: Fish oil reduced the oxidative stability of plasma and LDL, but the effects were partially offset by the increased consumption of fruit and vegetables.

Adolescent↗

PubMed2004

Increasing children's fruit and vegetable consumption: a peer-modelling and rewards-based intervention.

OBJECTIVE: To evaluate a peer-modelling and rewards-based intervention designed to increase children's fruit and vegetable consumption. DESIGN: Over a 5-month period, children in an experimental and a control school were presented with fruit and vegetables at lunchtime. Children aged 5-7 y also received fruit at snacktime (mid-morning). The intervention was implemented in the experimental school and levels of fruit and vegetable consumption were measured at baseline, intervention and at 4-month follow-up. SETTING: Two inner-city London primary schools. SUBJECTS: In total, 749 children aged 5-11 y. INTERVENTION: Over 16 days children watched video adventures featuring heroic peers (the Food Dudes) who enjoy eating fruit and vegetables, and received small rewards for eating these foods themselves. After 16 days there were no videos and the rewards became more intermittent. MAIN OUTCOME MEASURES: Consumption was measured (i) at lunchtime using a five-point observation scale; (ii) at snacktime using a weighed measure; (iii) at home using parental recall. RESULTS: Compared to the control school, lunchtime consumption in the experimental school was substantially higher at intervention and follow-up than baseline (P<0.001), while snacktime consumption was higher at intervention than baseline (P<0.001). The lunchtime data showed particularly large increases among those who initially ate very little. There were also significant increases in fruit and vegetable consumption at home (P<0.05). CONCLUSIONS: The intervention was effective in bringing about substantial increases in children's consumption of fruit and vegetables.

Child↗

PubMed2006

Longitudinal trends in consumption of vegetables and fruit in Finnish children in an atherosclerosis prevention study (STRIP).

OBJECTIVE: To assess prospectively the consumption of fruit and vegetables and its' correlation to the parental consumption in boys and girls taking part in an atherosclerosis prevention study (Special Turku Coronary Risk Factor Intervention Project for Children (STRIP) study). HYPOTHESIS: Nutrition counselling focused on cardiovascular health effects vegetable and fruit consumption. DESIGN: A prospective, randomised, clinical trial. SUBJECTS: Children were recruited to the STRIP study between 1989 and 1992. At the age of 7 months, children were randomised to the intervention (n = 540) or the control group (n = 522) and were followed up until the age of 11 years. INTERVENTION: Families in the intervention group have, since randomisation, received biannual individualised dietary counselling aimed at reduction of cardiovascular risk factors, especially saturated fat intake. Food records were used to assess fruit and vegetable consumption of children and parents. RESULTS: The percentage of total energy intake provided by fruit and vegetables decreased when the children grew older (P for age <0.001). The 1- to 10-year-old intervention boys consumed more vegetables (mean difference 3.18 g/day; CI 1.48-4.86; P < 0.001) and fruit (mean difference 10.1 g/day; CI 5.28-14.94; P < 0.001) than did the control. Mother's consumption correlated with the consumption of their daughters and sons, whereas father's consumption correlated only with the consumption of their sons. CONCLUSIONS: Finnish children taking part in the atherosclerosis prevention study had a remarkably low fruit and vegetable consumption, which furthermore decreased with age. The children's consumption correlated with the parental consumption, except between boys and mothers. A slight intervention effect was present only among boys.

Atherosclerosis↗

PubMed2002

Fruit and vegetables--attitudes and knowledge of primary school children.

OBJECTIVES: To evaluate whether children, aged 8-11 years could correctly identify commonly available fruit and vegetables; to assess the acceptability of these; and to gain a broad understanding of children's perceptions of 'healthy eating'. METHODS: Fruit and vegetables used were those readily available in retail outlets in the UK. Data were collected from three year-groups (n = 221) using a questionnaire supported by semistructured interviews and discussions. RESULTS: Overall, fruit was more popular than vegetables and recognition of fruit better; melons being the least well identified. Recognition of vegetables increased with age; the least well identified being cabbage which was confused with lettuce by 32, 16 and 17% of pupils in their respective age groups. Most children (75%) were familiar with the term healthy eating, citing school (46%) as the most common source of information. Pupils showed an awareness and understanding of current recommendations for a balanced diet, although the message has become confused. CONCLUSIONS: If fresh fruit and vegetables are to form part of a balanced diet, the 'health message' needs to be clear. Fruit is well liked; vegetables are less acceptable with many being poorly recognized, factors which need to be addressed.

Child↗

PubMed2001

Significance of wild vegetables in micronutrient intakes of women in Vietnam: an analysis of food variety.

The association between food variety and nutrient intake/health status among rural women was tested in two agro-ecological settings in Vietnam. Special emphasis was placed on the significance of wild vegetables 'Rau Dai' in micronutrient supply and on the usefulness of food variety analysis in determining their current role. Data from 7-day food frequency interviews and a nutrition/health survey with 93 and 103 rural women in the Mekong Delta and the Central Highlands, respectively, were used in the analysis. Energy and nutrient intakes in the groups with the highest food variety score (FVS) (high = > or = 21) in the two regions were compared to those with the lowest food variety score (low = < or = 15). The high FVS groups in both regions also had a more diversified diet in terms of food categories. With the exception of low iron and riboflavin intakes in all groups, the high FVS groups had relatively adequate diets. A large variety of vegetables was used and only approximately half of the vegetable species were cultivated. In both regions the high FVS groups used a significantly greater variety of vegetables than the low FVS groups. Wild vegetables contributed significantly to the overall micronutrient intakes, mostly carotene, vitamin C and calcium intakes, but only the contribution to carotene intake was significantly higher in the high FVS group. Overall, we conclude that a food variety analysis is a useful tool in capturing the dietary role of wild vegetables.

Adult↗

PubMed2001

The microbiological examination of ready-to-eat organic vegetables from retail establishments in the United Kingdom.

AIMS: A microbiological study of uncooked ready-to-eat organic vegetables was undertaken to determine the microbiological quality of these vegetables on retail sale in the UK. METHODS AND RESULTS: Organic vegetables were collected and examined according to a standardized protocol. The majority (3185 of 3200; 99.5%) of samples were found to be of satisfactory/acceptable quality whilst only 15 (0.5%) were of unsatisfactory quality. Unsatisfactory results were due to Escherichia coli and Listeria spp. (not L. monocytogenes) levels in excess of 102 cfu g-1. CONCLUSIONS: The absence of pathogens (L. monocytogenes, Salmonella, Campylobacter and E. coli O157) and the low incidence (1.5%) of E. coli and Listeria spp. associated with these organic vegetables indicates that overall agricultural, hygiene, harvesting and production practices were good. SIGNIFICANCE AND IMPACT OF THE STUDY: There has been a significant expansion of the UK organic market since 1998/99. Of the various commodity sectors making up the organic market, fruit and vegetables is the largest sector and this has been reflected in an increased interest in their microbiological safety. This is the first study to provide information on the microbiological quality of organic vegetables.

Colony Count, Microbial↗

PubMed2001

Serum carotenoids as biomarkers of fruit and vegetable consumption in the New York Women's Health Study.

OBJECTIVE: To investigate the usefulness of serum carotenoids as biomarkers of fruit and vegetable consumption. DESIGN: : Reproducibility study on three repeat measurements of serum carotenoids. Correlation analysis of carotenoids and dietary food intake, and regression analysis of potential predictive parameters for serum carotenoid levels. SETTING: New York, USA. SUBJECT: : Women participating in the New York Women's Health Study, a prospective study of sex hormones, diet and breast cancer. Forty-eight women with three repeat blood samples and 302 women having a blood sample and a dietary history questionnaire (including 47 subjects from the reproducibility study). RESULTS: Serum carotenoid concentrations were highly reproducible between one- and two-year repeat samples. Estimated fruit and vegetable consumption was positively correlated with serum carotenoid concentrations but correlation coefficients were low. Consumption of fruit was predictive for serum levels of beta-carotene, alpha-carotene and beta-cryptoxanthin, while vegetable consumption was predictive for serum beta-carotene, lutein, zeaxanthin and lycopene. Serum concentrations of cholesterol and triglycerides were predictive for serum carotenoids but adjustment for their levels had little or no influence on the correlation between fruit and vegetable consumption and serum carotenoid concentrations. CONCLUSIONS: One single serum measurement of alpha-carotene, beta-carotene and lutein can accurately rank subjects according to their usual serum level. Serum concentrations, however, correlate only moderately with estimated dietary intake of fruits or vegetables and should therefore be used with caution as biomarkers of fruit and vegetable intake.

Biomarkers↗

PubMed2001

The potential contribution of increased vegetable and fruit consumption to health gain in the European Union.

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.

Aged↗

PubMed2003

Increased intake of fruit and vegetables: estimation of impact in terms of life expectancy and healthcare costs.

OBJECTIVES: There is strong evidence that a high consumption of fruit and vegetables reduces the risk of developing many cancers. This study examined the economic consequences for the healthcare sector if people followed the recommendations and increased their intake of fruit and vegetables. DESIGN: A life table was used to describe a base case population with respect to life expectancy, cancer incidence and healthcare costs. Relative risks of cancer for a high versus a low intake of fruit and vegetables were obtained from the literature and were used to simulate populations with a higher intake of fruit and vegetables. The empirical data consist of a 20% sample of the Danish population that was followed from 1993 to 1997. Civil registration numbers were used to link various computerised registers, in order to describe each individual in the sample in terms of morbidity, mortality and healthcare costs. RESULTS: The average daily intake of fruit and vegetables was assumed to be approximately 250 g for the general Danish population. Simulated intakes of 400 g and 500 g increased the life expectancy by 0.8 and 1.3 years, respectively. In addition, it was estimated that 19% and 32% of the cancer incidence could be prevented. The aggregate healthcare costs remained stable, as the resources saved due to a lower cancer incidence were offset by healthcare costs imposed by the fact that healthy people live longer and require more healthcare. However, the variations across age groups and health sectors were substantial. DISCUSSION: The study adopted a healthcare sector perspective. Only costs from hospitalisation and primary care were included in the calculations. The costs of changing people's dietary habits, i.e. education, information and promotion as well as other costs that would be relevant from a societal perspective, have not been taken into account. Furthermore, the transition from one level of intake to another is not the focus of the analysis, although it might take decades to observe the full effect of the dietary changes. CONCLUSION: Empirical evidence suggests that a considerable fraction of all cancer incidences can be prevented by a higher intake of fruit and vegetables. That may result in improved public health (gain in life years) at no additional cost to the healthcare sector.

Adolescent↗