This Facts About reviews fruits and vegetables and gives examples of foods to choose. We provide a guide for selecting an appropriate portion size, and recommendations for incorporating healthy changes into your diet.

What are the recommended servings per day?

• Overall: more than 7 servings
• Vegetables: unlimited (minimum 5 servings)
• Fruits: 2-4 servings

Why should you choose fruits & vegetables?

• Excellent source of fiber
• Rich in vitamins and minerals
• Low in calories and most are fat-free
• Provide a food source of water; fruits and vegetables are made up of more than 50% water
• Abundant in phytochemicals and antioxidants
• High consumption helps reduce risk of various diseases such as cancer, obesity, heart disease, arthritis, asthma, macular degeneration and diverticulosis

What is the threshold effect?

Research supports evidence of an inverse relationship of fruit and vegetable consumption with development of chronic disease. This means that the more fruits and vegetables you eat, the less likely you are to develop a chronic disease. The most significant reductions in risk of illness are seen when individuals consume 7-10 servings of fruits & vegetables per day (the threshold). Therefore, to get the most health benefits we recommend a minimum “threshold” of 7 servings of fruits & vegetables daily.

A limited selection of fruits and vegetables

Selected serving sizes of fruits & vegetables

Specific Considerations

Phytochemicals

• Phytochemicals (‘phyto’means plant) are naturally occurring plant chemicals
• Phytochemicals are not yet classified as nutrients. Nutrients are substances necessary for sustaining life. Phytochemicals’ role in nutrition is still unfolding however, they have been identified as containing properties that aid in disease prevention
• In the human body, some phytochemicals act as antioxidants, some protect and regenerate essential nutrients, while others work to deactivate cancer-causing substances
• Thousands of phytochemicals have been identified in the plant foods we eat
• One serving of fruit or vegetables may contain 100 different phytochemicals.  Some are available when the vegetable is raw, and others when the vegetable is cooked.  It is important to eat a mix of raw and cooked vegetables to gain the most benefit from phytochemicals.
• Cooking method matters; steaming helps retain water soluble vitamins like B vitamins and vitamin C rather than boiling
• High cooking temperature and long cooking times also destroy heat sensitive nutrients such as B vitamins, vitamin C, and folate, so keep cooking times short

Antioxidants

The most well known phytochemicals are the antioxidants

• Antioxidants found in fruits and vegetables protect cells from damage caused by metabolic by-products (free radicals), as well as toxic substances from food and the environment. As our bodies use oxygen to produce energy, these free radicals are formed. They damage cells which may lead to cellular dysfunction and disease
• Colorful plant foods are loaded with antioxidants so eating a variety of fruits and vegetables is a great way to protect the body from oxidation, and therefore reduces the risk of numerous health conditions

Examples of antioxidants:

• Beta carotene - carrots, cantaloupe
• Vitamin C - citrus, cantaloupe, mango, and kiwi
• Vitamin E - dark leafy greens, broccoli
• Selenium – mushrooms, cabbage

Rainbow of Color

Phytochemicals contribute to the pigments of fruits and vegetables:

• Red - lycopene found in tomatoes, watermelon, & pink grapefruit
• Orange - beta carotene found in carrots, mangoes, & cantaloupe
• Yellow - beta cryptothanxin found in pineapple, oranges, & peaches
• Green - indoles found in broccoli, cabbage, & kale
• Purple - anthocyanins found in blueberries, grapes, & eggplant
• White – allicin found in garlic, onions, & chives

Research tells us that the more phytochemical-rich foods eaten, the lower the risk for diseases such as cancer and heart disease. Therefore we recommend eating a rainbow of fruits and vegetables daily.

Pesticide Use

Pesticides are chemicals that are used to control pests that destroy crops. They are used in the production of most crops sold in the United States. These chemicals may increase your risk for cancer or other chronic diseases and should be limited in your diet. To reduce consumption of pesticides, follow these tips:

• Wash all fruits and vegetables with water
• Before eating apples, cucumbers, potatoes or other produce in which the outer skin or peeling is consumed, scrub with a brush
• Throw away the outer leaves of leafy vegetables, such as lettuce and cabbage
• Peel and cook when appropriate, although some nutrients and fiber may be lost when produce is peeled

Choose Organic

We recommend organic fruits and vegetables because they contain less pesticide residue. We believe they also provide better flavor and are a better nutritional choice than conventionally grown produce.

Organic food is produced by farmers who emphasize the use of renewable resources and the conservation of soil and water to enhance environmental quality for future generations. Organic food is produced without using most conventional pesticides, petroleum-based fertilizers, or sewage sludge-based fertilizers, bio-engineering, or ionizing radiation. Organic systems replenish and maintain soil fertility, eliminate the use of toxic and persistent pesticides and fertilizers, and build biologically diverse agriculture.

According to the Consumers Union and The Environmental Working Group, the top fruits and vegetables to buy organic because of potential pesticide residue are:

• Peaches
• Apples
• Pears
• Green beans
• Grapes
• Strawberries
• Raspberries
• Spinach
• Tomatoes
• Cantaloupe

Ways to Transition to Organic Fruits and Vegetables

• Shop at farmers markets
• Buy a share in a community supported agriculture (CSA) program
  • For more information, check out http://www.nal.usda.gov/afsic/csa/
• Join a food co-op
• Buy organic produce in-season and freeze/preserve
• Grow your own fruits and vegetables
• Ease into buying organic produce

Ideas to Increase Fruits and Vegetable Consumption

1. Do it gradually.
2. Snack on raw vegetables instead of chips and crackers.  To keep it interesting, try dipping vegetables in hummus, salsa or low-fat dip.
3. Add fruit to your cereal or yogurt at breakfast.
4. Order salads as an appetizer when out to dinner.
5. Get creative.  Add vegetables to dishes that don’t always include them, like scrambled eggs, rice or pasta dishes, pizza and casseroles.
6. Drink your fruit (including fruit just past it’s prime) in the form of a fruit smoothie.
7. Choose salads as your main course for lunch or dinner.   For variety, top your salads with dried cranberries, sunflower seeds or other nuts.
8. In hot weather, frozen fruit such as grapes, sliced kiwis, sliced peaches and strawberries are a refreshing snack.
9. Enjoy salad bars at restaurants or grocery stores.
10. When craving a sweet treat, try dried fruit.
11. Buy fresh fruits and vegetables in season.
12. Frozen fruit and vegetables are frozen soon after harvest and can be eaten during the off season as a nutritious alternative to fresh produce.
13. Watch local grocery advertisements for reduced prices on your favorite fruits and vegetables.
14. Try fruit for dessert.
15. Prepare fruits and vegetables ahead of time in a way you like to eat them so they are readily available and desirable to you when you are hungry.
16. Fill half of your plate with fruits and/or vegetables.
17. Choose a rainbow of fruits and vegetables daily.

This Facts About document is published by Monica Myklebust, MD, and Jenna Wunder, MPH, RD, at University of Michigan Integrative Medicine Clinical Services. Our mission is to care for people using an Integrative Medicine model that reaffirms the importance of relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches to achieve optimal health and healing.

Resources

10 Fruits and Vegetables to Buy Organic
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Fruits & Vegetables
Nutrition Source, Harvard School of Public Health
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Fruits and Vegetables: Eating Your Way to 5 A Day
Kurtzweil, P.
Federal Citizen Information Center, Pueblo, Colorado
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The Health Value of Fruits and Vegetables
Iowa State University Extension
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High ORAC Foods May Slow Aging.
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How do I get started with cancer fighting nutrition?
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Pesticide Residues on Fresh Fruits and Vegetables: What’s the Risk?
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North Carolina State University Cooperative Extension
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Accessed February 17, 2006

Phytochemicals to Protect our Health
Vegetarian Nutrition. A practice group of The American Dietetic Association

Phytochemicals - Vitamins of the Future?
Dresbach, S.
Ohio State University Extension Fact Sheet, Family and Consumer Services
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Accessed February 24, 2006

Top Antioxidant Foods
Diana Dyer web site
www.cancerrd.com
Accessed February 24, 2006

What color is your food?
Garden-Robinson, J.
North Dakota State University Extension Service, August 2003.
http://www.ext.nodak.edu
Accessed February 24, 2006

Why fruits and vegetables are so important for your health
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Accessed February 24, 2006

Original Research and Review Articles

Broekmans WMR, et al.  Fruits and vegetables increase plasma carotenoids and vitamins and decrease homocysteine in humans. The Journal of Nutrition. 2000;130:1578-1583.

Darlington LG, et al.  Antioxidants and fatty acids in the amelioration of rheumatoid arthritis and related disorders. British Journal of Nutrition. 2001;85(3):251-269.

Djoussé L, et al.  Fruit and vegetable consumption and LDL cholesterol: the National Heart, Lung, and Blood Institute Family Heart Study. American Journal of Clinical Nutrition. 2004;79: 213-217.

He F, et al.  Fruit and vegetable consumption and stroke:  meta-analyis of cohort studies.  The Lancet. 2006; 367(9507):320-326.

Lampe JW.  Health effects of vegetables and fruit: assessing mechanisms of action in human experimental studies. American Journal of Clinical Nutrition.1999;70(suppl):475s-490s.

Liu, RH.  Potential synergy of phytochemicals in cancer prevention:  mechanism of action.  Journal of Nutrition. 2004; 134(12 Suppl):3479s-3485s.

Position of the American Dietetic Association:  Phytochemicals and functional foods.  Journal of the American Dietetic Association. 1995; 95(4):493-496.

Ribaya-Mercado JD, et al.  Lutein and zeanthin and their potential roles in disease prevention.  Journal of the American College of Nutrition. 2004; 23(6): 567s-587s.

Van Duyn MAS, et al.  Overview of the health benefits of fruit and vegetable consumption for the dietetics professional:  selected literature.  Journal of the American Dietetic Association. 2000;100(12):1511-1521.