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Fruit and Vegetable Intake: Benefits and Progress of Nutrition Education Interventions- Narrative Review Article



Background: Sufficient intake of fruits and vegetables has been associated with a reduced risk of chronic diseases and body weight management but the exact mechanism is unknown. The World Health Organisation and Food and Agriculture of the United Nation reports recommend adults to consume at least five servings of fruits and vegetables per day excluding starchy vegetables. This review focuses on the importance of fruits and vegetables as well as the benefits and progress of nutrition education in improving intake. Methods: For this narrative review, more than 100 relevant scientific articles were considered from various databases (e.g Science Direct, Pub Med and Google Scholar) using the keywords Fruit and vegetable, Nutrition education, Body weight, Obesity, Benefits and challenges. Results: Existing data suggests that despite the protective effects of fruits and vegetables, their intakes are still inadequate in many countries, especially developing ones. Consequently enhancing strategies to promote fruit and vegetable intake are essential for health promotion among population. A number of reviews confirm that a well planned and behaviour focused nutrition education intervention can significantly improve behaviour and health indicators. Conclusion: Despite challenges in nutrition education intervention programs, they are considered as a good investment in terms of cost benefit ratio. Rapid improvement in trends of nutrition education can be seen in many countries and majority of interventions has been successful in increasing fruits and vegetables intake. It is recommended that health professionals use multiple interventions to deliver information in several smaller doses over time to ensure improved outcomes.
Iran J Public Health, Vol. 44, No.10, Oct 2015, pp.1309-1321 Review Article
1309 Available at:
Fruit and Vegetable Intake: Benefits and Progress of Nutrition
Education Interventions- Narrative Review Article
Dhandevi PEM, *Rajesh JEEWON
Dept. of Health Sciences, Faculty of Science, University of Mauritius, Réduit, Mauritius
*Corresponding Author: Email:
(Received 10 Apr 2015; accepted 10 Aug 2015)
“Fruits and vegetables (F&V) are considered in
dietary guidance because of their high concentra-
tions of dietary fiber, vitamins, minerals, especially
electrolytes; and more recently phytochemicals,
especially antioxidants” (1). Various reviews have
associated low intake of fruits and vegetables with
chronic diseases such as cardiovascular diseases,
blood pressure, hypercholesterolemia, osteoporo-
sis, many cancers, chronic obstructive pulmonary
diseases, respiratory problems as well as mental
health (2- 6). Despite an increasing focus on the
health benefits of fruits and vegetables, their con-
sumption is below the recommended intake
among adults (7, 8). Therefore, considering how
nutritional related health problems have risen
drastically globally, it seems critical that formal
nutrition education aiming to increase knowledge
and fruits and vegetables intake be given priority
in health education programs and health promo-
tion. This review provides an insight into the im-
portance of fruits and vegetables as well as the
Background: Sufficient intake of fruits and vegetables has been associated with a reduced risk of chronic diseases and
body weight management but the exact mechanism is unknown. The World Health Organisation and Food and Agri-
culture of the United Nation reports recommend adults to consume at least five servings of fruits and vegetables per
day excluding starchy vegetables. This review focuses on the importance of fruits and vegetables as well as the benefits
and progress of nutrition education in improving intake.
Methods: For this narrative review, more than 100 relevant scientific articles were considered from various databases
(e.g Science Direct, Pub Med and Google Scholar) using the keywords Fruit and vegetable, Nutrition education, Body
weight, Obesity, Benefits and challenges.
Results: Existing data suggests that despite the protective effects of fruits and vegetables, their intakes are still inade-
quate in many countries, especially developing ones. Consequently enhancing strategies to promote fruit and vegetable
intake are essential for health promotion among population. A number of reviews confirm that a well planned and
behaviour focused nutrition education intervention can significantly improve behaviour and health indicators.
Conclusion: Despite challenges in nutrition education intervention programs, they are considered as a good invest-
ment in terms of cost benefit ratio. Rapid improvement in trends of nutrition education can be seen in many countries
and majority of interventions has been successful in increasing fruits and vegetables intake. It is recommended that
health professionals use multiple interventions to deliver information in several smaller doses over time to ensure im-
proved outcomes.
Keywords: Fruit and vegetable, Nutrition education intervention, Body weight, Obesity, Benefit and challenges.
Pem & Jeewon: Fruit and Vegetable Intake: Benefits and Progress
Available at: 1310
benefits and progress of nutrition education in
improving intake.
Importance of F&V in the diet
Sufficient intake of fruit and vegetables (F&V) has
been related epidemiologically with reduced risk
of many non-communicable diseases. Currently,
much interest are focused on the vital role of an-
tioxidants which impart bright colour to F&V and
act as scavengers cleaning up free radicals before
they cause detrimental health effects (9). Moreo-
ver, fibers found in F&V have been shown to re-
duce intestinal passage rates by forming a bulk,
leading to a more gradual nutrient absorption (10)
hence preventing constipation. They can be fer-
mented in the colon, increasing the concentration
of short chain fatty acids having anticarcinogenic
properties (11) and maintaining gut health. Several
studies have highlighted the CVD risk-reducing
potential of F&V whereby their intake were
strongly associated with lower cardiovascular risk
factors such as lower blood pressure (BP), choles-
terol and triacylglycerol thus preventing premature
cardiovascular disorders (2). Recently Habauzit et
al. (12) reported that fruits containing a high
amount of anthocyanins, flavonols and procya-
nidins, such as berries, grapes and pomegranate
are effective at decreasing cardiovascular risk
while citrus fruits and apples had a moderate ef-
fect on BP and blood lipid level. An increased
consumption of carotenoid-rich F&V maintains
the cholesterol level in blood since they reduce
oxidative damage and cause an increase in LDL
oxidation resistance (13). An increased consump-
tion of cruciferous vegetables was also reported to
cause a decrease in the risk of intestinal, bowel,
thyroid, pancreatic and lung cancer (4).
F&V have also been suggested to prevent osteo-
porosis in adults mainly for their rich sources of
calcium and other vitamins which are vital in bone
health (3). The high fiber content of F&V may
play a role in calcium absorption and reduce the
„acid load‟ of the diet (14) enhancing bone for-
mation and suppressing bone resorption which
consequently result in greater bone strength (15).
Moreover, phytoingredients in F&V such as
gooseberry, curcumin, and soya isoflavones have
shown to be protective against lens damage which
occurs due to hyperglycemia (16) and certain fla-
vonoids such as quercetin can prevent oxidative
stress in the pathogenesis of glaucoma (17). Also,
a high intake of F&V was inversely associated
with the risk of COPD and respiratory symptoms
(5). Higher total fruit and vegetable intake is also
associated with lower risk of cognitive decline
hence proved beneficial for mental health (6, 18).
Based on available evidence, a clear relationship
between F&V and diseases has been well estab-
lished however no protective effect of overall fruit
and vegetable intake (FVI) against lung diseases
were found. Green leafy vegetables, rather than
fruit, were suggested to have a genuine protective
effect against lung cancer (19). Risk of proximal
colon cancer, rectal cancer (20) and aggressive and
non-aggressive urothelial cell carcinomas (21) are
not associated with FVI and no protective role
were seen on the risk of endometrial cancer in
post menopausal women (22). The accepted rec-
ommendation is to consume a variety of F&V be-
cause studies demonstrate that a combination of
F&V have more potential benefits rather than a
single fruit or vegetable (23). However further
studies are warranted.
Fruits and Vegetable Intake (FVI), Body
Weight and Obesity
Interestingly, phytochemicals in F&V have been
found to act as anti-obesity agents because they
may play a role in suppressing growth of adipose
tissue (1, 24). Adiposity is closely related to bi-
omarkers of oxidative stress and inflammation
and a diet rich in F&V can modify these adiposity
related metabolic biomarkers in overweight wom-
en (25). A recent study by Vilaplana et al. (26)
demonstrated that Carica papaya and Morinda citrifo-
lia exhibited high lipase inhibition which can be
considered as potential options for the manage-
ment of obesity and maintaining body weight. To
date, the red varieties of Allium cepa, Lactuca sativa,
Capsicum annum, Brassica oleracea var sabellica and or-
ange-fleshed type of Ipomoea batatas appear to be
the richest vegetables sources of potential anti-
obesity phytochemicals that can control the initia-
tion and development of obesity (27).
Iran J Public Health, Vol. 44, No.10, Oct 2015, pp. 1309-1321
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It is also understood that fruits and non-starchy
vegetables are very low in energy since they con-
tain high amount of water and fiber and can be
consumed in a relatively larger amount contrib-
uting to increased satiety to maintain normal
weight (28). Fibers also form a gel-like environ-
ment in the small intestine, resulting in reduced
activity of the enzymes involved in the digestion
of fat, protein and carbohydrates (29). Hence an
increased FVI can help to ease weight loss and
this can be achieved when F&V displace high-en-
ergy-dense foods such as saturated fats, sugar (30)
so that the overall energy density of the diet is re-
duced (31). Additionally, fruits have been sug-
gested to prevent obesity since they add up to die-
tary variety both between and within food groups
and palatability to the diet which has been re-
vealed to be an important predictor of body fat
(32). However discrepancies exist with respect to
F&V with high glycemic index carbohydrates that
are related to a more immediate decrease in appe-
tite and increase in food intake in the short term
(33). High consumption of fructose in F&V is re-
lated to obesity in rodents but no effect has yet
been demonstrated in humans (34). FVI in over-
weight and obese people is much lower than the
recommendation since they tend to restrict intake
of these F&V when trying to lose weight.
A significant relationship was observed between
BMI and vegetable intake whereby overweight par-
ticipants had lower intake of vegetables (35-
37).This finding is consistent to that of Epuru et al.
(38) who also found a clear trend between preva-
lence of obesity and low FVI. Furthermore given
that fruits are often eaten raw but vegetables are
frequently prepared by adding fatty substances (e.g.
oil while frying) which reduce the low energy dense
uniqueness of vegetables, nutritionists should be
careful when promoting FVI among population
because the idea may not work with all target popu-
lation. For instance, the intake of vegetables is as-
sociated with a higher risk of obesity in Chinese
adults due to use of oil for stir frying vegetables
and this highlights the importance of choosing the
right cooking methods (39). Interestingly, many
studies report a decrease in body weight with in-
creased FVI (40- 42). For instance, in a 10 year fol-
low up study, high FVI reduced long-term risk of
weight gain and obesity among Spanish adults (43,
44) demonstrated greater weight loss from high
vegetable intake when a high vegetable diet was
compared with a control diet comprised of „usual
Global Intake of Fruits and Vegetables
According to World Health Organisation STEP-
wise approach to surveillance surveys on chronic
disease risk factors conducted in several African
countries including Mauritius and in line with ex-
isting Food and Agriculture Organisation data,
fruit and vegetable intake (FVI) levels were found
to be below the recommended daily intake of
400g/person (45). With the current „5 A day‟ mes-
sage, a large gap still exists between the recom-
mended and actual intake and many worldwide are
not receiving the quantity or variety of F&V that
they should have (46, 47). Table 1 shows the mean
fruits and vegetables intake (FVI) in selected
Available data reveals that the average FVI is not
positively linked to the status of the country since
greater consumption can be seen in developing
countries such as Uganda and PR China compared
to developed countries such as Denmark, Germa-
ny, UK and France. Data from GEMS/Food clus-
ter diet shows that in US, mean F&V intake is
189.30 g/day and 255 g/day respectively, and re-
cently, adults were found to have F&V about 1.1
times and 1.6 times/day respectively (48). F&V are
consumed in the amount of 146.81 g/day and
176.96 g/day respectively in Hong Kong account-
ing for a total of 324 g/day (49). 209 g/day and
228.6 g/day F&V were reported among adults re-
spectively in Germany and recent German Health
Interview and Examination Survey data report that
women and men consume 3.1 and 2.4 servings of
F&V per day respectively (50). Mean F&V were
179g/day and 133g/day respectively in Malaysia
(51). Current data based from the Canadian Com-
munity Health Survey which measured the number
of times participants consumed F&V, rather than
the actual quantity consumed, reported that only
40.8% Canadians aged >12 years consume F&V 5
or more times per day (52).
Pem & Jeewon: Fruit and Vegetable Intake: Benefits and Progress
Available at: 1312
Table 1: Fruits and vegetable consumption in adults in selected countries
Year of up-
dated data
Mean Fruit intake
( g/d )
Mean Vegetable in-
take ( g/d)
Hong Kong ( SAR, PR China)
PR China**
* Data from EFSA database, updated 2013 (53)
** Data from GEMS/Food database, updated 2015 (54)
Likewise, The Healthy People 2010 report (8)
stated that the trends in FVI over the previous
decade were relatively flat and has not been able
to meet the Healthy People 2010 goals. The latter
targets increasing to 75% the proportion of per-
sons aged > 2 years who consume two or more
servings of fruit daily and to 50% those who con-
sume three or more servings of vegetables daily.
Recently published Global Phytonutrient Report
(55) reveals that to achieve the WHO recommen-
dation, most adults should at least double their
current intake of F&V worldwide. Many countries
like France, Spain (56), US, (57) and Mauritius
(58) follow the „5 A Day‟ recommended guidelines.
However presently, it has been reported that 5
servings a day are not enough since those con-
suming 7 or more servings of fruits and vegetables
a day, are having more health benefits and pro-
longed lives [e.g. those who ate 5 to 7 servings of
fruits and vegetables per day had a 36% lower risk
of dying from any cause; 3 to 5 servings was asso-
ciated with 29% lower risk while 1 to 3 servings
was linked with a 14% lower risk] (59). Countries
like Canada, Australia, and Denmark have a rec-
ommendation in the range of 6 to10 servings of
F&V daily (60- 62). Since different countries are
using different guidelines, the ideal recommenda-
tion of F&V is still being debated and there is
need of a unified message to promote intake
around the world.
Requirement and strategies for nutrition edu-
cation to boost FVI
Nutrition education is defined as “any combina-
tion of educational strategies, accompanied by en-
vironmental supports, designed to facilitate volun-
tary adoption of food choices and other food and
nutrition-related behaviors conducive to health
and wellbeing”(63). Educational interventions to
encourage Americans to improve their diets may
prevent rising incidence of heart diseases and save
health care expenditures (64). The high prevalence
of nutrition-related chronic illnesses with obesity
and overweight among the most challenging and
steadily rising public health problems suggests that
nutrition education needs to be a priority for
Iran J Public Health, Vol. 44, No.10, Oct 2015, pp. 1309-1321
1313 Available at:
adults and nutrition educators must be knowl-
edgeable about diet and disease relationships spe-
cific to the population (65). The scope of nutrition
education is broader than just educating about
nutrition in relation to personal health. It can cov-
er a wide range of issues and topics such as an in-
crease in quantity and quality of foods, ways of
improving nutritive value of a diet, importance of
sanitary food handling practices at home, in mar-
ket, factories and institutions serving food to large
numbers of people such as schools, hospitals and
restaurants (66) hence ensuring food safety and
reducing morbidity.
To meet current F&V recommendation, many
countries have developed targeted campaigns and
interventions to increase FVI to adequate level.
Pollard et al. (67) monitored changes in behaviors
regarding FVI in Western Australia before and
after the "Go for 2&5" and found that most
changes mainly in knowledge, attitudes, and be-
haviors concerning FVI took place after the cam-
paign. In particular, respondents who correctly
identified the recommended intake of F&V dou-
bled indicating that health campaign with nutrition
education as an integral component is fruitful.
Resnicow et al. (68) also reported that an “Eat for
Life program”, a multicomponent intervention to
increase FVI conducted resulted in a significant
increase in FVI. These studies are consistent to
that of Ammerman et al. (69) who reviewed the
efficacy of behavioral interventions to modify FVI
emphasizing on studies in North America, Europe
and Australia and noted a significant effect in in-
creasing FVI. Moreover, in an intervention using a
general nutrition course, participants increased
consumption of not only total F&V but also fresh
F&V along with a significant decrease in intake of
high energy density French fries (70). Bensley et al.
(71) compared traditional nutrition education to
that of an internet one and found that both re-
quired follow-up counseling to achieve FVI levels
and in both interventions, those who were pro-
vided counseling consumed more vegetables,
fruits and fruit juice. In order to achieve and sus-
tain FVI at the recommended levels, intervention
alone is not enough as it requires a combination
of other approaches such as social marketing, be-
havioral economics approaches, and technology
based behavior change models to ensure that re-
quired goals are met (72). The findings from pre-
vious reviews are interesting showing that most of
the interventions lead to an increased consump-
tion of F&V at least in the short term. However
no such review has conducted a Meta analysis
quantifying the effectiveness of the interventions.
Few intervention reviews have been done to see
whether nutrition education is effective. One of
such review is that of Taylor et al. (73) who con-
ducted a Meta analysis of various intervention
studies whereby five of them reported significant
positive changes in weight and BMI. Four studies
had effective interventions targeting determinants
of dietary intake and dietary behaviors and nutri-
tional intake. However uncertainty do remains due
to insufficient details provided for nutrition inter-
vention protocols, inconsistency in approach of
delivery and comparisons between delivery modes
and content of information provided to partici-
pants between studies. Eyles et al. (74) found that
tailored nutrition education was a promising strat-
egy for improving the diets of adults over the long
term but stated that future studies should ensure
adequate reporting of research design and reduce
the chances of false-positive findings via more
objective measures of diet. Likewise tailored inter-
ventions were more effective than non-tailored
interventions in improving the short-term dietary
behaviors of participants whereby delivery of in-
formation in several smaller doses over time was
more likely to improve effectiveness (75). Lara et
al. (76) noted that nutrition education was a signif-
icant factor in increasing fruit and vegetable in-
takes and are therefore effective, sustainable in the
long term and considered it to be of public health
significance. Table 2 below summarises findings
of some successful nutrition education interven-
Overall nutrition education contributes signifi-
cantly to a change in food and nutrition related
behaviors but where many components are in-
volved, it achieves positive results in some and
negative in others. Guillaumie et al. (77) con-
cluded that most psychosocial variables signifi-
cantly increased in an intervention group exposed
Pem & Jeewon: Fruit and Vegetable Intake: Benefits and Progress
Available at: 1314
to a nutrition education plan with the exception of
vegetable intake. Assema et al. (78) found an inter-
vention effect in saturated fat intake during the
main meal and fruit juice consumption but not for
daily intake of fruit and vegetables. Contento et al.
(79) stated that “the reported effectiveness, or lack
thereof, of nutrition education interventions in
various studies depends on many factors, includ-
ing the nature, duration, and power of the inter-
ventions and the degree to which the interven-
tions were implemented as designed”. The author
remarked that in order to assure the success of a
nutrition education strategy, major implications
need to be considered such as developing and
testing instruments with each new target audience
before any intervention study, it will then be fea-
sible to make judgments about the effectiveness
of nutrition education and impact of interventions
on mediating variables would be understood.
Moreover, to be successful, nutrition education
needs to be much more comprehensive than giv-
ing basic nutrition information. It should address
food preferences and sensory affective factors;
person-related factors such as perceptions, beliefs,
and attitudes; meanings and social norms; and en-
vironmental factors (80). Effective nutrition inter-
ventions should have a behavioral focus that will
reduce the targeted risk factors and comprise
strategies that are developmentally and culturally
appropriate (81). Barriers pertaining to health pre-
ventive behaviors along with the determinants of
intake should be taken into account and solutions
should be designed (67). For example, low income
groups can be targeted to opt for cheap sources of
F&V to meet the 5 a day demand (78). Where
possible, consumption of tropical fruits should be
encouraged and at the same time this will increase
the profits of fruit vendors and that of the country
at large. Men can be targeted through educational
campaigns at work and through eye catching ad-
vertisement (73). The government can review tax
on F&V and promote more display areas such as
farmers markets and shops in most regions to in-
crease availability (56). Involvement of stakehold-
ers, ministries, and legislation at higher level can
be thought-out concerning produce and distribu-
tion channel related factors as well as for food
labeling which are sometimes misleading and dif-
ficult to interpret (82). Furthermore, accounting
for the high prevalence of diabetes with 387 mil-
lion cases reported globally which is expected to
rise to 592 million by 2035 (83) and with more
than 1.9 billion adults having obesity problems
(84), diabetes concept of not consuming certain
fruits may lead to further health detriment. Re-
search shows that diabetic people would benefit
greatly from consuming a variety of F&V, which
help to lower degrees of inflammation, to have
better glycemic control, and reduce odds of dia-
betic retinopathy (85). Additionally, there is no
evidence to support that fructose present in fruits
under normal conditions has a negative impact on
the glycemic control in Type 2 diabetes (86).
However, the role of fructose and fruit sugars in
the development of the current obesity and dia-
betic epidemic remains controversial and the gen-
eral population including overweight and obese
person should be given correct information. Nu-
trition intervention programs should aim healthy
food habits including the consumption of F&V
together with physical exercise aiming to reduce
body weight and improve health status. Messages
and interventions should be creative, engaging,
supportive and inexpensive (87) with realistic
goals ensuring that the Mauritian population, also
type 2 diabetic and obese people understand the
message of having fruits just as the general popu-
lation, without fearing worsening of their glycemic
Challenges on nutrition education interven-
tion programs
Despite clear evidence on the benefits of nutrition
education intervention, there are major challenges
that are faced by nutrition educators. These are: a)
realistic educational goals, b) thorough research
designs, c) explicit theoretical bases, and d) valid
and reliable measurements (88). Assuring effective
communication skills of nutrition educators and
the quality of nutrition education or behavior
change interventions implemented is questionable
(89). Quality assurance tools and validated guide-
lines targeting specific target population are uncer-
tain (90).Monitoring and evaluation within inte-
Iran J Public Health, Vol. 44, No.10, Oct 2015, pp. 1309-1321
1315 Available at:
grated programs does not always capture the im-
pact on nutritional status sufficiently or in a timely
manner to allow for improving implementation
(91). Methodological challenge such as small sam-
ple size and mostly female respondents may pre-
vent experimentally conclusive and sustainable
evidence (78). Nutrition education is also influ-
enced by several barriers (92- 95) and predispos-
ing factors such as attitudes, beliefs, values, capac-
ity, self-efficacy, individual differences (96) that
need to be overcome. Thus, several drawbacks of
nutrition education deserve attention.
The relationship between FVI and reductions in
risk for many major health problems is strongly
supported in many research studies but the effects
of F&V on plasma lipid levels, diabetes, and body
weight have yet to be explored. Still, F&V are be-
lieved to be protective against adiposity and are
considered as a potential treatment in the manage-
ment of obesity. Despite their numerous health
benefits, few countries fulfilled 400g daily require-
ment for FVI. Many nutrition education strategies
have positively impacted on people‟s nutrition and
health behavior yet there are many factors which
need to be considered and challenges that need to
be overcome when designing nutrition education
strategies. To be successful, nutrition education
needs to be much more comprehensive than giv-
ing basic nutrition information. Current focus is
on the effectiveness of methods of information
dissemination and validation of educational tools.
It is important for nutrition educators to deal with
dietary behaviors that are associated with specific
diseases adapted to explicit target population. Nu-
trient-based information alone is inadequate. Most
successful strategies have been the delivery of in-
formation in several smaller doses over time. Alt-
hough promoting healthy lifestyles is a challenge,
it can be realized by focusing on positive “to-do”
behaviors, rather than on “not-to-do” behaviors
aiming at increasing the percentage of people
adopting healthier eating habits.
Ethical considerations
Ethical issues (Including plagiarism, informed
consent, misconduct, data fabrication and/or fal-
sification, double publication and/or submission,
redundancy, etc.) have been completely observed
by the authors.
The Department of Health Sciences, Faculty of
Science, University of Mauritius is acknowledged
for research support. The authors declare that
there is no conflict of interests
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Table 2: Summary and findings of some successful nutrition education interventions
Author, (Year), Location
Study groups
Anderson (2001), USA
N= 296
-Tailored (n= 148)
-Control (n= 148)
6 months
- Fiber intake (g/1000 kcal)
- Fruit & Vegetable intake (g/1000 kcal daily)
Resnicow (2001), France
N= 861
-Self help intervention with 1 telephone cue call
-Self help with 1 cue call and 3 counseling calls ( motivational interviewing)
12 months
-FV intake ( servings/ day, by FFQ)
change in FVI was significantly greater in motivational interview group than in
comparison and self-help groups
Campbell (2002), USA (98)
N= 660
-Tailored ( n= 89)
-Control( n= 93)
6 months
- Fruit intake
-Vegetable intake ( servings/ day)
Total fat ( g/day)
Assema (2005), Netherlands
N= 74
Intervention (n=35)
Control (n=39)
1 month
Vegetable (g per meal)
Fruit (pieces per day)
Fruit juice (glasses per day)
Saturated fat intake ( en % per meal)
Gans et al. (2009), USA
N= 1841
- Non tailored comparison (NT) (n=451)
- Single Tailored packet (ST) (n=454)
-Multiple tailored packet (MT) (n=474)
- Multiple Re- Tailored packet (MRT) (n=462)
7 months
- Fruit & Vegetable intake (servings/day)
-Fat intake (g/day)
MT groups reported significantly higher FVI compared to other groups.
Liu et al. (2009), China
N= 410
Intervention ( n=154)
Control (n=148)
6 weeks
Fruit intake (g/day)
Vegetable intake(g/day)
Soybean & products (g/day)
Meat, poultry & Fish(g/day)
Dairy (ml/day)
Eggs (g/day)
Grain/ Cereals(g/day)
Guillaumie et al. (2012),
-implementation intentions (II) (n=36)
- Self Efficacy ( SE) (n=47)
- Combination of II + SE group (n=52)
- control (n=28)
3 months
Fruit & Vegetable intake
Fruit Intake
Vegetable Intake
FVI increased significantly in the II and II+ SE groups.
Slightly larger increase was observed in II+SE group
Lopez et al. (2013), Spain
N= 14
Control (baseline)
Intervention ( week 16)
4 months
Energy ( Kcal/day)
Protein (g/day)
Carbohydrate ( g/day)
Fat ( g/day)
Saturated Fatty Acids ( g/day)
Monounsaturated fatty acids( g/day)
Polyunsaturated fatty acids( g/day)
Shahril et al. (2013), Malaysia
N= 380
Intervention (n= 205)
Control (n=212)
10 weeks
Energy intake (Kcal)
Carbohydrate (%)
Vitamin C
Fruits (servings/day)
100% fruit juice (servings/day)
Fish (servings/day)
Egg (servings/day)
Milk (servings/day)
Dairy products (servings/day)
Processed foods (servings/day)
Bhurosy et al. (2013), Mauri-
tius (102)
N= 189
Intervention ( n= 98)
Control ( n=91)
2 months
Calcium intake scores
Self efficacy
Knowledge scores
Physical activity level
Alcohol consumption
Abbreviations: FV: Fruit & vegetable; FVI: Fruit & Vegetable Intake; FFQ: Food Frequency Questionnaire; +: positive intervention effect; : negative intervention effect
... Fruit and vegetable consumption plays an important role in people's nutrition and health [1], being associated with a reduced risk of chronic diseases and body weight management [2,3]. ...
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Natural preservatives such as garlic and ginger can be added to the formulation of fresh fruit juices to encourage the consumption of health-promoting foods. In this study, the influence of garlic and ginger and the storage conditions on physicochemical and microbiological characteristics of fruit juices were investigated. The fruit juice assortments were produced from apple, apple and pumpkin, and apple and pomegranate and were treated with 0.5 g garlic powder, 0.5 g ginger powder, and 0.25 g mix of garlic and ginger powders. A total of 12 unpasteurized samples were produced, of which 3 were control samples. Samples stored at 20 and 4 °C were analyzed at 0, 3, 6, and 9 days for water activity (aw), pH, titratable acidity (TA), total soluble solids (TSS), electrical conductivity (EC), vitamin C, color parameters, total number of germs, yeasts, and molds, Listeria, Enterobacteriaceae, and Escherichia coli. Results showed that aw, pH, TSS, and vitamin C content decreased during storage of fruit juice samples, while TA increased. The lowest increase in total number of aerobic mesophilic germs was determined for the apple and pumpkin juice with garlic and ginger and apple juice with garlic.
... Overall, these observations suggest a role for ABA as a key hormone involved in the management of glucose homeostasis and highlight the importance of monitoring ABA levels in these groups of individuals. Notably, based on reports about daily consumption of fruits and vegetables containing ABA, epidemiological evidence indicates that the majority of the population assumes a very low intake of ABA from dietary sources [37]. Due to the multiple positive health effects attributed to the role of ABA [38], interest in supplementing this bioactive molecule through the administration of nutraceutical products rich in ABA is increasing over time, also in view of the nanomolar blood concentrations of this hormone required for its efficacy. ...
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One of the most relevant aspects in evaluating the impact of natural bioactive compounds on human health is the assessment of their bioavailability. In this regard, abscisic acid (ABA) has attracted particular interest as a plant-derived molecule mainly involved in the regulation of plant physiology. Remarkably, ABA was also found in mammals as an endogenous hormone involved in the upstream control of glucose homeostasis, as evidenced by its increase after glucose load. The present work focused on the development and validation of a method for the determination of ABA in biological samples through liquid-liquid extraction (LLE), followed by liquid mass spectrometry (LC-MS) of the extract. To test method suitability, this optimized and validated method was applied to a pilot study on eight healthy volunteers' serum levels to evaluate ABA concentration after consumption of a standardized test meal (STM) and the administration of an ABA-rich nutraceutical product. The results obtained could meet the demands of clinical laboratories to determine the response to a glucose-containing meal in terms of ABA concentration. Interestingly, the detection of this endogenous hormone in such a real-world setting could represent a useful tool to investigate the occurrence of impaired ABA release in dysglycemic individuals and to monitor its eventual improvement in response to chronic nutraceutical supplementation.
... Among multifactorial interactions, such as limited food availability and accessibility, a lack of nutrition and health knowledge is likely to be a key factor in these results. A review found success in increasing vegetables and fruits intake in many countries by improving nutrition education [21]. A basic and robust system to disseminate nutrition education is required to reach the target of RDI in Mongolia. ...
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Background Healthy diets that consider environmental pressures are required to meet sustainable development goals in Mongolia. This study aimed to clarify the extent of planetary and human health on Mongolian dietary intake. Methods The intake of eight food groups (g/day) was investigated using the national database of the Household socio-economic survey (HSES) 2019 in Mongolia. The boundary intake of the Planetary health diet (PHD) proposed by the EAT-Lancet Commission was considered 100% adequate. The adequacy (%) of food groups in the HSES were calculated in two areas (urban and rural), during the two seasons (cold and warm), and the total by each boundary of the PHD. The differences between the recommended dietary intake (RDI) in Mongolia and the PHD were also investigated in the same manner. Results The adequacy of red meat (i.e., beef, mutton, and horsemeat) in whole areas of Mongolia indicated more than 17 times higher intake (1,738%) than the PHD. The adequacy of vegetables (20%) and fruits (8%) in Mongolia indicated an intake shortage compared to the PHD. These discrepancies in dietary adequacy were greater in rural areas and during the cold seasons than in urban areas and during the warm seasons, respectively. The animal-based protein sources, especially red meat (1,091%), in the RDI of Mongolia were higher than those in the PHD. Conclusion This study found a highly excessive intake of red meat and a low intake of vegetables and fruits compared with the PHD among Mongolian people, especially in rural areas and during the cold seasons. The limited diversity of food in severe geographic conditions, poor accessibility of food retailers, and insufficient nutrition education may have led to these results. Therefore, improvements in the food environment and nutritional education are required.
... Vegetables are recommended as dietary components because they contain high concentrations of fiber, vitamins, minerals, electrolytes, and phytochemicals, especially antioxidants [1]. Regular consumption of vegetables has been associated with reduced risk of many non-communicable diseases and much interest are in recent times, focused on the vital role of antioxidants which impart vegetables with properties to act as scavengers of free radicals which cause detrimental health effects [2]. ...
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Vegetables are rich sources of vitamins, minerals and fibres. They have beneficial anti-oxidative effects. The consumption of vegetables containing heavy metals is a significant cause of many diseases. In this study, the concentrations of heavy metals in the frequently consumed vegetables sold in Gwagwalada central market , Abuja, Nigeria was investigated. Quantitative analysis of heavy metals was done using Atomic Absorption Spectrophotometer (AAS). The concentration level of lead showed that cucumber, cabbage, banana, lettuce, green peas, carrot, and onion had 8.65 ± 1.1, 0.0, 100.40 ± 10.0, 68.00 ± 7.0, 64.76 ± 5.8, 61.28 ± 5.6, and 8.92± 1.1, respectively. There was no traceable level of nickel in the fruits and vegetables while cadmium was observed to be 0.10 ± 0.1 in cabbage alone. The study showed that the fruits and vegetables sampled were contaminated with heavy metals higher than the WHO permissible limits.
... Many studies show the importance of vegetables as the essential sources of nutrition has promoted consumption for vegetables. World Health Organization and FAO reports adults to consume at least five servings of fruits and vegetables per day has been associated with positive health impact, and they are considered as a good investment in terms of cost benefit ratio [4]. In addition to that, highly use of social media by current generation make space for promotion of vegetables consumption for healthier dietary habits that exists through social media and other media sources to contribute to this increase demand for vegetable crops. ...
... The primary downside of not adhering to the recommended fruit and vegetable consumption is that it increases the chance of developing a variety of non-communicable diseases. According to Pem and Jeewon (2015), fibres present in fruits and vegetables have been demonstrated to delay intestinal transit rates by producing bulk, allowing for more gradual nutrient absorption, and thereby reducing constipation. Low vegetable and fruit consumption (less than 5 servings per day) are linked to lower income and unhealthy behaviours. ...
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The World Health Organization (WHO) and the Food and Agriculture Organization (FAO) recommend consuming at least 25 g of dietary fibre daily. Adults with low fibre intake have an increased constipation risk. However, little research has been done on the habitual dietary fibre intake and lifestyle characteristics of functional constipation in Malaysian adults. Thus, the purpose of this study is to determine the dietary fibre intake, lifestyle characteristics, and functional constipation of adults in Malaysia, as well as the association between habitual dietary fibre intake, lifestyle characteristics, and functional constipation. About 318 adults between the ages of 18 and 59 participated and were asked to complete an online questionnaire consisting of three major parts. The components are as follows: i) the assessment of dietary fibre intake by using a semi-quantitative dietary fibre food frequency questionnaire; ii) the assessment of lifestyle factors; and iii) the determination of functional constipation via the Wexner Constipation Scoring System. SPSS 25 was used to analyse the data at a significance level of 0.05. The results indicated that the majority of adults consumed dietary fibre in amounts less than 25 g per day (84.6%). About 97.5% of adults have a healthy lifestyle, and only 2.8% of adults in this study faced constipation. There was no significant association between habitual dietary fibre intake and lifestyle characteristics (p=0.614) or between habitual dietary fibre intake and functional constipation among adults in Malaysia (p=0.147). Continued efforts are needed to increase dietary fibre intake among the adult population.
Food education through cooking programs have been identified to promote healthy eating among individuals, especially among the youngest. It was intended to evaluate the impact of a set of food education sessions in students of the 3rd cycle of basic education (from the 7th to the 9th grade) to promote the consumption of functional foods and improve their cooking skills. A pre- and post-session questionnaire and a global assessment of the sessions were applied. Twenty-three students aged between 13 and 14 participated in the activity, mostly male (60.9%). About 95% of the students had a normal weight and 4.8% were overweight. There was an improvement in the cooking skills of the students, especially in their confidence in making sauces and soup. About 70% of students are very/very willing to increase the frequency of meals prepared by themselves and consider it important to introduce themes related to functional foods in the syllabus in the 3rd cycle of basic education.
In modern agriculture, sustainable production and efficiency are unimaginable without the use of agrochemicals such as pesticides, fertilisers, herbicides, etc. Nanotechnology has the potential to augment food quality, plant protection, detection of plant and animal diseases, monitoring of plant growth, global food production, and seed quality. The potential for a wide range of applications makes a basic understanding of nanotechnology important. This article presents an introduction to nanotechnology and discusses the implications of it for the tomato crop. The review aims to systematise and discuss research data related to the effect of nanomaterials on tomato, an important fruit crop used as a model plant for research which provides knowledge about this fast-developing research area.
Background: Solar drying seems to be a feasible technique for preserving and extending the shelf life of perishable fruits all year round in developing nations like Tanzania. However, there have only been a few studies on the effect of solar drying on the microbiological load and shelf-life stability of dried fruits. Objective: The purpose of this study was to examine the effects of solar drying techniques on the physicochemical properties, microbial loads, and shelf life of dried mango and pineapple. Methods: Fruits were properly cleaned, peeled, cut into 5 mm-thick slices, and dried in cabinet mixed-mode and tunnel dryers for 3 and 2 days respectively. The dried samples were packaged in high- and low-density polyethylene bags and stored at 28 °C for six months before being analyzed for moisture, aw, pH, and total bacterial and fungal loads using standard methods. Shelf life was predicted by kinetic reaction and regression analysis methods. Results: Tunnel-dried samples had significantly (p
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Laboratory-based investigations indicate that the consumption of foods with a low energy density (kcal/g) decreases energy intake. Although low-energy-dense diets are recommended for weight management, relations between energy density, energy intake, and weight status have not been clearly shown in free-living persons. A representative US sample was used to determine whether dietary energy density is associated with energy intake, the weight of food consumed, and body weight and to explore the influence of food choices (fruit, vegetable, and fat consumption) on energy density and body weight. A cross-sectional survey of adults (n = 7356) from the 1994-1996 Continuing Survey of Food Intakes by Individuals and two 24-h dietary recalls were used. Men and women with a low-energy-dense diet had lower energy intakes (approximately 425 and 275 kcal/d less, respectively) than did those with a high-energy-dense diet, even though they consumed more food (approximately 400 and 300 g/d more, respectively). Normal-weight persons had diets with a lower energy density than did obese persons. Persons with a high fruit and vegetable intake had the lowest energy density values and the lowest obesity prevalence. Adults consuming a low-energy-dense diet are likely to consume more food (by weight) but to have a lower energy intake than do those consuming a higher-energy-dense diet. The energy density of a variety of dietary patterns, including higher-fat diets, can be lowered by adding fruit and vegetables. Our findings support the hypothesis that a relation exists between the consumption of an energy-dense diet and obesity and provide evidence of the importance of fruit and vegetable consumption for weight management.
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Background: Consumer testing was a prime consideration in developing specific South African food-based dietary guidelines (FBDGs) which were nationally adopted in 2003. Objectives: This study aimed to determine the consumer's ability to apply the FBDGs appropriately, in terms of identifying foods/drinks according to the FBDG food categories; perceived importance of and barriers to applying each FBDG; and planning a typical day's meals to reflect the FBDGs. Design: A cross-sectional study of 333 women from different cultural and socio-economic backgrounds. Setting: KwaZulu-Natal, South Africa. Methods: Data collection comprised focus-group discussions (n = 103) and structured individual interviews (n = 230). Results: The identification of foods/drinks according to the FBDG food categories reflected a high level of comprehension by participants of these food categories. Participants from all study samples endorsed the importance of applying the FBDGs, predominantly for health reasons. Participants cited barriers to the application of the FBDGs as affordability, availability, household taste preferences, routine food-purchasing habits, time constraints, traditional/habitual food-preparation methods, and persistent attitudes. Only three FBDGs were mentioned as difficult to apply, namely, "fruits/ vegetables", "foods from animals" and "legumes". Meal plans did reflect the FBDGs, illustrating the flexibility of their use across cultural and socio-economic differences. Conclusions: Consumer testing of the FBDGs was mainly positive. The study has highlighted areas of confusion regarding certain concepts, terminology and misconceptions, and has identified barriers to application. These concerns can be addressed through the reformulation and retesting of certain dietary guidelines, and the provision of explanatory consumer information and health-worker training materials.
Clinical evidence shows that combining advice to increase fruit and vegetable consumption with caloric restriction is an effective strategy for weight management. The purpose of this review is to evaluate epidemiologic evidence to determine whether it supports an association between fruit and/or vegetable consumption and body weight. Few studies have been designed to specifically address this issue, and those that are available vary in methodology and offer inconsistent results. We make recommendations on how to strengthen future studies so that the influence of fruit and vegetable consumption on body weight in free-living individuals is better understood.
A diet high in fruits and vegetables is associated with decreased risk for chronic diseases. In addition, because fruits and vegetables have low energy density (i.e., few calories relative to volume), eating them as part of a reduced-calorie diet can be beneficial for weight management. Healthy People 2010 health objectives include increasing to 75% the percentage of persons aged >/=2 years who eat at least two daily servings of fruit (objective 19-5) and increasing to 50% the proportion of persons aged >/=2 years who eat at least three daily servings of vegetables, with at least one third being dark green or orange vegetables (objective 19-6). To assess the level of fruit and vegetable consumption among adults by state and demographic characteristics, data from the 2005 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. This report describes the results of that analysis, which indicated that 32.6% of adults consumed fruit two or more times per day and 27.2% ate vegetables three or more times per day. The results underscore the need for continued interventions that encourage greater fruit and vegetable consumption among U.S. adults.
Considering the severity of diabetes and its worldwide spread, there is need for the development of functional food supplements as complementary medicines for high fructose-induced secondary complications of diabetes such as cataract. With the increased knowledge of the heterogeneous nature of the disease, there is scope for more challenging and targeted therapies. The present scenario indicates that the majority of research uses experimental animals and in vitro experiments. Foods or phytoingredients such as gooseberry, curcumin, and soya isoflavones have shown promising potential in the control of lens damage occurring because of hyperglycemia. Based on traditional systems, single and multiple herb formulations are available in the market, but these need rigorous validation. Vitamins such as A, C, and E as well as carotenoids have been reported to be useful adjuvants in treating this problem. Among the individual molecules, amino acids, or their peptides, some metabolites such as carnosine and taurine have the protective effects.
Glaucoma is a major cause of irreversible blindness worldwide and is characterized by cupping of the optic nerve head and irreversible loss of retinal ganglion cells. Elevated intraocular pressure (IOP) due to a reduction in aqueous outflow is a major risk factor in the development of glaucoma and the progression of glaucomatous damage to the optic nerve. The trabecular meshwork (TM) is subjected to different types of stress, such as oxidative stress. Oxidative stress is able to affect the cellularity of TM and is reported to trigger degeneration in the human TM and its endothelial cell components, subsequently leading to an increase in IOP and glaucoma. Increasing evidence indicates that reactive oxygen species (ROS) play a key role in the pathogenesis of glaucoma. Flavonoids such as quercetin (3,5,7,3',4'-pentahydroxy flavone) can protect cells from oxidative stress. Quercetin is one of the most widely distributed flavonoids, present in fruits, vegetables, and many other dietary sources. It has been shown that certain flavonoids can induce antioxidant responsive element-dependent gene expression through the activation of nuclear factor (erythroid-derived 2)-like 2 (Nrf2). This review supports the hypothesis that oxidative stress is an important step in the pathogenesis of glaucoma and that quercetin might be a relevant target for both prevention and therapy.
Fruit and vegetables have been consistently identified in epidemiological studies as key components of dietary patterns associated with cardiovascular health-protective effects. The vascular protective effects of fruits have been largely ascribed to their content in polyphenols. Current limited evidence from randomized controlled trials together with experimental data on vascular bioactivity suggests that fruits containing relatively high levels of anthocyanins, flavonols and procyanidins, such as berries, grapes and pomegranate are effective at reducing cardiovascular risk, particularly with respect to anti-hypertensive effects, improvement in endothelial function and inhibition of platelet aggregation. Citrus and apples, fruits rich in flavanones and hydroxycinnamic acids/flavan-3-ols/procyanidins, respectively, were reported to have a moderate impact on blood pressure, endothelial and platelet functions and to exhibit hypolipidemic effects. Future long-term well-controlled intervention studies with purified polyphenols are required to determine to what extent there is a causal link between a specific fruit polyphenol compound and a lower risk of cardiovascular disease.
The present article reviews research about the psychological determinants of human eating behavior. A hypothetical model of food choice and intake is introduced, presenting various factors influencing eating behavior. Internal factors include sensory food aspects. Among the external factors are information, the social context and the physical environment. Processes such as mere exposure, Pavlovian conditioning and social learning shape the relationships between these factors, food liking and eating behavior. The relative contribution of the various determinants is discussed. In spite of a scarcity of studies, liking for the sensory aspects of food seems to be at the center of the development, maintenance and change of dietary patterns. Consequently, efforts for promoting healthy eating behavior might benefit from an increased attention towards learning principles and food likes in the development of interventions. Existing intervention strategies are criticized and preliminary suggestions are formulated to enhance their effectiveness.
The objective of this study was to ascertain nutrition knowledge amongst primary school children in an informal settlement in Gauteng, South Africa. A nutrition knowledge questionnaire was developed and tested for internal reliability using Cronbach Alpha methods. Pre- and postintervention tests were completed with experimental and control groups. Long-term tests were completed with the experimental group. Data were analysed descriptively using SPSS, version 17.0. The Nutrition Education Programme (NEP) was implemented over nine hours, with seven hours for teaching the information in the activity book and completion of the relevant activities, and two hours for the games, over nine sessions. An immediate improvement in nutrition knowledge amongst the experimental group (13.4 percent), from pre- (45.4 percent) to postintervention (58.8 percent) was achieved. Retention of knowledge was present in 21 out of 38questions, with only two remaining unchanged. The retention on nutrition knowledge was evident. It is recommended that a method needs to be determined to encourage continuous revision of nutrition information in order to support future planning and training. Further studies need to be carried out to determine the impact on dietary behaviour and examine if there is any link between certain dietary practices and related nutrition knowledge.
Abstract Considering the severity of diabetes and its worldwide spread, there is need for the development of functional food supplements as complementary medicines for high fructose-induced secondary complications of diabetes such as cataract. With the increased knowledge of the heterogeneous nature of the disease, there is scope for more challenging and targeted therapies. The present scenario indicates that the majority of research uses experimental animals and in vitro experiments. Foods or phytoingredients such as gooseberry, curcumin, and soya isoflavones have shown promising potential in the control of lens damage occurring because of hyperglycemia. Based on traditional systems, single and multiple herb formulations are available in the market but these need rigorous validation. Vitamins such as A, C, and E as well as carotenoids have been reported to be useful adjuvants in treating this problem. Among the individual molecules, amino acids or their peptides, some metabolites such as carnosine and taurine have the protective effects. Keywords: Aldose reductase inhibition; diabetic cataract; foods; herbs; polyol pathway