Eating a greater variety of vegetables and fruits could extend life expectancy and reduce the  risk of cardiovascular disease

A study carried out by the Food, Nutrition, Development and Mental Health Research Group of the Rovira i Virgili University (URV), the IISPV and the CIBEROBN in collaboration with the Temerty Faculty of Medicine of the University of Toronto (Canada) shows that eating a wide variety of fruits and vegetables (regardless of the quantity) is associated with greater longevity and at the same time a lower risk of developing obesity and hypercholesterolemia.

Variety of vegetable and fruit intake can be important for our health. Eating a greater variety of vegetables and fruits could reduce all-cause mortality, as well as risk factors for cardiovascular diseases, specifically obesity and hypercholesterolemia.

These are findings of an internationally conducted study by the Unitat de Nutrició Humana, Grup Alimentació, Nutrició, Desenvolupament i Salut Mental of the Rovira i Virgili University (URV), the Pere Virgili Health Research Institute (IISPV) and the Centro de Investigación Biomédica en Network de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), in collaboration with the Temerty Factuly of Medicine of the University of Toronto (Canada), which examined the association between the variety in the consumption of vegetables and fruits and cardiovascular health and mortality. Along with these findings, the need for additional studies exploring the importance of variety in vegetable and fruit intake on cardiovascular health was highlighted.  

Although there are a large number of scientific studies that support the importance of consuming a large amount of vegetables and fruits (5 servings a day) due to their cardioprotective qualities and other healthy qualities, until now there was a lack of clear scientific evidence on the importance of consuming a greater variety of fruits and vegetables in the diet and their impact on health. The present study addresses this gap in evidence that had been noted by health authorities, including the European Food Safety Authority (EFSA). Assessing the impact of variety of vegetables and fruits on cardiovascular health and mortality has important clinical implications, as it may aid in informing the development of future dietary strategies to prevent or delay mortality and promote healthy aging.

To investigate this gap in knowledge, the researchers of this study conducted a systematic review and meta-analysis of observational studies summarizing all available evidence. Through this method, all relevant scientific evidence is collected and statistical methods are applied to synthesize the results. In addition, the Grading of Recommendations Assessment, Development, and Assessment (GRADE) approach was applied, which makes it possible to assess the certainty of the scientific evidence obtained with the scientific results. This tool has been adopted by more than 100 major organizations worldwide, including the World Health Organization, to make recommendations on clinical practices and health policies.

With the present systematic review of the studies published to date, a meta-analysis of 12 unique observational studies was carried out, involving almost 300,000 participants, with a complete evaluation of the certainty of the evidence on the impact of the consumption of a variety of vegetables and fruits on cardiovascular health and all-cause mortality. The analyses showed that consumption of a greater variety of vegetables and fruits was associated with an 11% lower risk of mortality from all causes. In addition, a higher intake of varied vegetables and fruits was also associated with a lower risk of obesity and hypercholesterolemia.

Although this evidence supports that, regardless of the quantity, the variety in the intake of fruits and vegetables is beneficial for health and improves life expectancy, the authors specify that additional studies with a higher level of evidence are necessary to better understand the importance of the reported associations.

According to Dr. Stephanie Nishi, first author of this study, “Dietary diversity, as illustrated by increased fruit and vegetable variety, has long been recognized as a key component of diet quality.  Vegetables and fruits, in general, are rich in nutrients; however, consuming a combination of different varieties of fruits and vegetables that have different nutrients, amounts of nutrients, or bioactive components could have superior health benefits. So to speak, they could act as an orchestra where the combination of different musical instruments (in this case fruits and vegetables) achieves a better symphonic sound”.

According to Dr. Jordi Salas-Salvadó, “This research builds on a previous study by the PREDIMED-Plus team that illustrated in more than 6,500 participants that greater variety in fruit and vegetable intake was associated with higher diet quality and a healthier lifestyle in an older Mediterranean population”.

Dr. Nancy Babio, a senior author of the study, said, “While there is some scientific evidence about the importance of consuming enough fruits and vegetables in relation to health, this study is the first to summarize the evidence related to the variety “.

This work, published in the scientific journal Nutrients, has been carried out by the Unitat de Nutrició Humana, Grup Alimentació, Nutrició, Desenvolupament i Salut Mental of the Department of Biochemistry and Biotechnology of the URV  by Dr. Stephanie Nishi, Visiting Professor and Canadian Institutes of Health Research (CIHR) Postdoctoral Fellow, in collaboration with predoctoral researchers Nadine Khoury and Cristina Valle Hita, and senior authors Dr. Jordi Salas-Salvadó, Professor of Nutrition and Bromatology at the URV and Director of the Unit and Dr. Nancy Babio, Associate Professor.  All these authors are part of CIBEROBN and IISPV. Along with international collaboration with Dr. Andreea Zurbau, Postdoctoral Fellow in the Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto.

Bibliographic reference: Nishi, S.K.; Khoury, N.; Valle Hita, C.; Zurbau, A.; Salas-Salvadó, J.; Babio, N. Vegetable and Fruit Intake Variety and Cardiovascular Health and Mortality: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2023, 15, 4913. https://doi.org/10.3390/nu15234913