Is five a day enough?
Some experts now say we should eat eight or more – while others say fruit and veg are over-hyped. Toby Manning goes in search of the magic number
Tuesday 22 March 2011
For most of us, just getting our five a day inside us is struggle enough. Will a generous squirt of ketchup allow us to squeeze through? Can't Fruitellas count? (No and no, by the way.) How demoralising then to discover that new advice says that eight portions a day is the ideal healthy goal. No wonder this study has barely been reported: we can't cope with this kind of good news.
This latest advice stems from this January's European Heart Journal, where a study from the massive and still continuing European Prospective Investigation into Cancer and Nutrition (EPIC), found that people consuming eight portions of fruit and vegetables a day had a 22 per cent lower risk of dying from ischaemic heart disease (IHD) than those consuming three portions or fewer. That's a big percentage: more than a fifth increase in your chances from eating just a few extra portions each day. Lead author, Dr Francesca Crowe, of Oxford University agrees: "This study shows a 4 per cent reduced risk of dying from IHD for each additional portion of fruit and vegetables consumed."
It might be news to us, but the fact that five a day doesn't cut it is old news for most health bodies. The World Cancer Research Fund has long recommended 5-10 portions. A recent survey for the UK's Institute of Optimum Nutrition showed that the healthiest people ate eight portions. What's more, outside of unhealthy Britain the government bar is set way higher. In Denmark it's six a day, in Australia seven, in Spain eight, in Greece nine, in Canada "up to 10" and in Japan, a dizzying 17. Reading these figures is a bit like doing the eye test, starting off great guns, then getting fuzzier as you go.
Tim Lang, professor of food policy at City University, London, is unsurprised by these latest findings. "I've been giving speeches saying nine a day for a long time. The drift of scientific evidence is ever upwards." Lang has acted as a government advisor in the past and says, "This is yet another piece of research which adds pressure on the Government. We need to narrow the gap between the evidence and what politicians are prepared to sanction through public advice."
"Prepared to sanction"? Yes, you read that right. The UK Government attributes five a day to the World Health Organisation (WHO). But typical of the confusion that surrounds the whole issue, this is inaccurate. State Nutritionist Susan Foerster and Californian food producers united in 1998 to increase local consumption of fresh produce. Five portions then? Simply double average consumption. Californian policy was then adopted by the federal government, trademarked by the American National Cancer Institute, and only then taken on by the WHO. Professor Lang was present when our own government came on board in the optimistic Nineties. "It was a political fudge," Lang says, "there was very little evidence basis for it. They just chose a figure that was aspirational but not so high as to be perceived as impossible to reach." In other words, our government aimed low because Brits' diets were so rubbish, they thought that five was the best we could manage.
You can sort of see their point, though, as we're not doing so great even on five a day. Last year's Department of Health White Paper showed that only three in 10 people achieved that target. Worse still, 2008 figures from fresh produce organisation Freshfel Europe reveal that Europeans consumed slightly less fruit while vegetable consumption actually fell by 13 per cent. Are people so fazed by the whole thing that they're giving up? Forget the fruit, pass the biscuits.
If you're disgruntled by the shifting goalposts, that's nothing compared to the reaction of maverick nutritionist and obesity writer Zöe Harcombe. "If the idiot powers-that-be try to get people to eat eight a day instead of the already fattening and unjustifiable five a day it will make the obesity epidemic worse," Harcombe seethes. But fattening? Five a day's supposed to be healthy, surely?
"People are majoring on fruit because it's sweeter and the fructose [fruit sugar] is simply converted into fat." A simple internet search confirms substantial support for this contention. Harcombe goes on: "We shouldn't make the usual bad science leap from association to causation and say: 'more portions of fruit and veg means less risk of dying from heart disease.' Does being in the bath cause singing?"
Going even further by referring to that original Californian scheme, Harcombe claims the whole five-a-day campaign is a con. "There just isn't any benefit from eating fruit and vegetables," she claims, though by now she may have lost most people.
So Harcombe sees this latest survey as casting around for benefit after last year's report on the same EPIC study suggested a weaker connection between fruit and veg and cancer than previously claimed. Despite a lot of negative headlines, the World Cancer Research Fund defends five a day. Dr Rachel Thompson said: "In men 2.6 per cent and in women 2.3 per cent of cancers could be prevented if people ate another two portions of fruit and vegetables a day." In the UK alone that could still save 7,000 lives a year.
All the nutritionists and experts you talk to are, inevitably, convincing, making it almost impossible not to change your view with each new bit of advice. It leaves you wanting to leave them to fight it out and let the victor present us with a single, coherent message. Last year's Health Food Manufacturer's survey revealed that 50 per cent of people were confused about the Government's nutrition advice.
So what does the Government have to say? "We are providing clear advice on why and how people can change their lifestyles, so people can make informed, healthier choices," says a Department of Health spokesman. "However, ultimately individuals have to take responsibility for their own diet."
Victoria Taylor, senior dietician at the British Heart Foundation (who part-funded the EPIC research) is more sympathetic. "We get criticised a lot for changing our advice. Five a day is a really positive message – one that's consistent and that people understand. Let's keep working towards that before moving the goalposts further."
How to get your eight a day
Get your head (and teeth) around a "portion"
A "portion" is an 80g serving. For fruit this is equivalent to half a grapefruit, two kiwi fruits, one apple or 14 cherries. For veg, it's two broccoli spears, three tablespoons of carrots or four tablespoons of green beans. Or a decent-sized bowl of salad.
Dried fruit counts in small amounts
Get it in your muesli, add it to your porridge, but a Picnic bar won't do. Nor will dried fruit grazing: only one 30g portion a day will count.
Spuds are out
They count in France and Australia, but not the UK. Many believe this is because the Government wanted to avoid us thinking five portions of chips would do the job. Sainsbury's were forced to axe an ad in 2008 suggesting potatoes were one of your five. Yams and plantains don't count either, but sweet potatoes do.
A soupcon of Soup is good for you
Ideally homemade. Not, obviously, Oxtail.
Sauce things up with tomatoes
Tomatoes contain lycopene which, though some reports have challenged it, is reckoned to be a good anti-cancer agent. Lycopene is better absorbed by the body when broken down by cooking – in soups, sauces and purée. Ideally, make your own to avoid processed foods' additional fats and salts.
You can't catch up with ketchup
Despite surveys suggesting one in ten children and one in ten people in Scotland believe otherwise, ketchup doesn't count. Many children also think pasta counts.
Baked beans (three tablespoons) count
But only once. Heinz had to take off the "healthy eating" claim from its products, though, due to the amount of salt, sugar and fat.
Juicing the figures
A 150 ml glass of unsweetened juice only counts as one portion, however much you drink. A smoothie can stretch to two portions, with a variety of ingredients, while a banana milk shake is a fair cheat.
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