OPINION | Could a lack of fruit and vegetables in our diets lead us to premature deaths?

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More than one in three low- and middle-income countries face a serious burden from two or three forms of malnutrition – acute and/or chronic undernutrition, micronutrient deficiencies, obesity and diet-related diseases, including type 2 diabetes, cardiovascular diseases (CVDs), and certain types of cancer.

With non-communicable diseases (NCDs) accounting for nearly two-thirds of deaths worldwide, the emergence of chronic disease as the predominant challenge to global health is undisputed.

In South Africa, 51% of all premature deaths can be attributed to NCDs. Over 220 South Africans are killed by heart diseases every day and 10 people suffer a stroke every hour.

Eating more vegetables and fruit every day can protect against diseases such as heart disease, stroke, cancer and diabetes by managing risk factors for these diseases.

These include, reducing blood pressure, reducing cholesterol, supporting weight management, supporting blood sugar management and promoting healthy cell growth.

Vegetables and fruit contain nutrients that are important for your body to function at its best. Eating too few vegetables and fruit can lead to deficiencies and poor health.

Diets high in vegetables and fruit are widely recommended for their health-promoting properties; they have historically held a place in dietary guidance because of their content of vitamins, minerals, dietary fibre and prebiotics, and, more recently, dietary bioactive compounds.

Inadequate intake of vegetables and fruit has been associated with an increased risk of developing NCDs in adults, and an increased risk for stunting (a risk factor for obesity and NCDs) among children.

In line with increasing evidence emphasising the importance of eating plenty of vegetables and fruit every day, the theme for the National Nutrition Week 2021 is Eat more vegetables and fruit every day.

The South African Food Based Dietary Guidelines (FBDGs) also recommends eating “plenty of vegetables and fruit every day”, reflecting the international recommendation, which is supported by the evidence that this contributes to an overall healthier dietary pattern that reduces the risk for disease.

South Africans are encouraged to eat more vegetables and fruit through every stage of their lives.

From the age of 6 months and onwards, in addition to breastmilk, children need different types of foods, and vegetables and fruit should form part of each meal starting with small amounts and building up to five small meals each day.

When it comes to snacking, fresh or frozen vegetables and fruit should be the go-to and foods such as sweets, crisps, biscuits and sugary drinks should be limited.

When having lunch or dinner, half the plate should consist of vegetables or salad.

Implementation tips to ensure the sufficient intake of vegetables and fruit include trying to include a variety of vegetables and fruit in daily meal plans – not only on weekends.

Indigenous vegetables and fruit should be included where possible. Include both cooked and raw vegetables and salads in meals.

It is recommended that a yellow or orange vegetable (carrots, pumpkin, butternut, etc.) or a dark green vegetable (broccoli, spinach, etc.) is eaten at least once a day.

Ideally, one should try and get at least one serving from each of the following categories of food:

  • Dark green leafy vegetables
  • Yellow or orange fruits and vegetables
  • Red fruits and vegetables
  • Citrus fruits.

Portion sizes of vegetables can be more generous if a variety of vegetables is not available.

Canned vegetables, with no added salt or sugar, are good alternatives to ensure a sufficient intake of vegetables.

Salt, sugar, and preservatives are sometimes added during the canning process. Draining and rinsing foods can lower their salt and sugar contents.

To avoid extra sugar, choose fruits that are canned in water or juice instead of syrup.

It is important to read the labels.

If a freezer is available: frozen fruits and vegetables can be a cost-effective option, or buy fresh vegetables or fruit in bulk if it is available at a reasonable price and freeze.

Once vegetables are cut, they need to be boiled or steamed in a little water for a short period to retain most of the nutrients.

Most vegetables can be cooked in a few minutes if they are steamed, microwaved or stir-fried (in a little vegetable oil).

Use the remaining water from boiling or steaming to add flavour and nutrients in the preparation of other dishes.

Growing vegetables and fruit is possible – it can be an affordable and sustainable way to increase dietary diversity and improve health outcomes.

The bottom line is people who eat more fruit and vegetables tend to live longer as these foods can help to protect against heart disease and help reduce the risk for obesity, diabetes, high blood pressure and certain cancers.

*Hayley Cimring and Kinza Hussain are Registered Dietitians at the Heart and Stroke Foundation of South Africa.

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