Do We Need 7-a-day?
With recent research suggesting that we increase our fruit and vegetable consumption to 7-a-day from the current 5-a-day guidelines, does the initial science that brought us the 5-a-day message solid enough to withstand this new research of increasing this to 7 portions a day?
Over the past century the health concerns of the British population have changed significantly. At the beginning of the 20th century the main health concerns were communicable diseases whilst the present day focus has shifted to non-communicable diseases such as obesity, type 2 diabetes and coronary heart diseases. Public health has focused over the past decades to prevent the onset of these preventable non-communicable chronic diseases. This has been done through a number of intervention and prevention programmes whereby the population or specific sub-groups within it have been specifically targeted to modify their behaviour so as to enhance their health both in the short and long term.
The current 5-a-day campaign owes its origin to a campaign launched in the US back in 1991 and since then has been adopted in one form or another by other countries. The scientific claims behind this campaign was based on studies that linked fruit and vegetable consumption to cancer prevention. It is important to note that a subsequent report published by the World Cancer Research Fund (WCRF) stated that the advice of this campaign is broad as there are no known specific protective effects of fruit and vegetables, whether in combination or not, still requires confirmation.
Not only is the science that initiated this campaign vague, focusing on five portions again has no scientific basis. Whilst food variety is an important component to ensure that micronutrient requirements are met, the number of portions required was literally pulled out of thin air.
The big concern surrounding the 5-a-day message is that it does not focus on the differences between fruit and vegetables or about swapping junk food for fruit and vegetables. Rather, it is about eating these in conjunction with items that are already high in sugar. Instead of advocating fresh fruit and vegetables, examples of how to easily incorporate fruit includes consuming tinned fruit and vegetables including high sugar items such as corn and peas to a pasta bake. Science keeps indicating that this excess sugar consumption is contributing to the current obesity and diabetes epidemics.
What counts as part of your 5-a-day?
A quick look at the NHS’s Change4Life website campaign you may be shocked to see that smoothies count towards 2 of your 5-a-day portions. If you would like more information on the sugar content of popular health drinks (some of which have been endorsed as contributing to the 5-a-day target) found in stores, the Daily Mail wrote a good piece on the topic in March 2013.(15 WORST sugary drinks in Britain Daily Mail dated 1 April 2013. Please see: http://ow.ly/sax7C )
What is concerning is the emphasis placed on fruit consumption rather than vegetable. Vegetables, in the context of overall health, are a richer source of minerals and vitamins as well as dietary fibre which is important for bowel health. Fruits on the other hand mostly contain sugar. There are no guidelines to specify the fruit to vegetable ratio, this is left up to the individual and as we know, most people will choose fruit over vegetables.
Although the Change4Life website does mention that potatoes do not count towards the 5-a-day target, there is no mention, or help, on how to incorporate other vegetables into the diet. They do mention briefly on how certain vegetables do not count as they are mostly a form of starch (yet no more information on the fact that starch is digested into its sugar components). This guidance is less than helpful and quite confusing to say the least.
Scientific Basis against sugar consumption
With the World Health Organisation (WHO) currently reviewing it's position on daily sugar intake, the UK government needs to take stock of the emerging evidence to reduce sugar consumption in all its forms when advising the public.
The current obesity and diabetes epidemic in the UK is constantly mentioned in the media, however the debate is greatly biased towards perceived common sense rather than based on solid scientific research.
By readjusting the macronutrient content in the nation’s diet, the health benefits range from weight loss to reduced cardiovascular disease and diabetes risk.