Fruits and vegetables and their role in a healthy diet

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1 Fruits and vegetables and their role in a healthy diet Agnieszka Kozioł-Kozakowska, PhD Jagiellonian University Medical Collage

2 Lalond s health fields

3 Healthy Eating Pyramid by the National Food and Nutrition Institute Recommended at least 400 g of vegetables and fruits, in 5 portions, of which 1 serving is a glass of juice 200 ml

4 Intake per g/day Consumption of fruits, vegetables and juices in selected EU countries (average of ) 1200,0 1000,0 800,0 Warzywa vegetables Soki juices Owoce fruits 600,0 400,0 200,0 0,0 Greece Grecja Włochy Italy Poland Polska Bułgaria Bulgaria Sourecs: Juices consumption by AIJN,

5 Although most Poles connect healthy eating with the consumption of fruits and vegetables, there has been a steady decline in consumption of vegetables, fruit and their products since * According to GUS surveys of household budgets, the average annual consumption of fruit in Poland in 2015 was about 118 g/d and vegetables 164 g/d (in total= 280 g/dzień) * Poles drink more juice. The annual consumption of juices per person exceeds 14 liters, which gives about 38 ml per person per day. The average annual consumption in Europe is 11,7 liters per person. Countries with the most consumption of juice per person per year are Norway (23 liters), Germany (19 liters) and Denmark (18 liters)** * Dmochowska H. (red.), rozdz. 6 Dochody i spożycie w gospodarstwach domowych, Mały Rocznik Statystyczny. Zakład Wydawnictw Statystycznych, Warszawa 2016, * ** AIJN 2017 Liquid Fruit Market Report**

strawberries, 5 plums, 1 large mandarin orange, 1 medium orange, 1

6 How can we define the portion size? Examples of portions are g of fruit or vegetables 7 strawberries, 5 plums, 1 large mandarin orange, 1 medium orange, 1 medium grapefruit, 1 apricot juice, 2 apricots) or 1 serving of 200 ml 100% fruit juice. 1 medium tomato, cucumber or paprika, 2 glasses of raw leafy vegetables, 1 cup of other raw or cooked vegetables or 1 serving = 200 ml 100% vegetable juice.

7 Meta-analysis of prospective studies prepared by Wang et al. Relation between risk of death for all causes and fruit consumption (number of servings / day) Higher fruit consumption is associated with a lower risk of mortality for all causes, with an average risk reduction of 6% for each additional portion of fruit consumed per day by British Medical Journal Publishing Group Xia Wang et al. BMJ 2014;349:bmj.g4490

8 Oyebode's cohort study (65,226, 7.7-year follow-up) showed a 33% reduction in the risk of cardiovascular mortality in those consuming 7 servings of fruits and vegetables (unlike less than 1 servings a day ). For fruit alone (4 and more servings a day) the risk ratio was 0.82 (18% risk reduction).

The Nurses' Health Study survey of 69 622 women with a 14-year follow-up, had confirmed 1803 strokes.

9 The Nurses' Health Study survey of women with a 14-year follow-up, had confirmed 1803 strokes. Comparing the highest and lowest consumption of flavonoids (such as naringenin and hesperidin), the relative risk of ischemic stroke was 0.81 (hence a 19% decrease in risk, p = 0.04).

According to data collected by Eurostat in 28 European Union countries, 2 million people die each year from cardiovascular disease (CV), which is for 38% of total deaths, 46% in Poland.

10 According to data collected by Eurostat in 28 European Union countries, 2 million people die each year from cardiovascular disease (CV), which is for 38% of total deaths, 46% in Poland. CV is the second leading cause of premature death after cancer. Fig. Mortality by reasons cardiovascular disease Cancer injury Source:

11 Global differences in prevalance of hypertension 2010 The prevalance increase in most countries of the world, including in Poland > 20 year old 2000 Source: Mills K.T. i Circulation. 2016;134: DOI: /CIRCULATIONAHA

In the modern diet, due to the consumption of highly processed foods, there are significant deficiencies of nutrients such as vitamins, minerals or fiber.

12 In the modern diet, due to the consumption of highly processed foods, there are significant deficiencies of nutrients such as vitamins, minerals or fiber. Group: 2,522 W i 1,290 M, Age: ingredient unit men women X(SD) % < RDA X(SD) %< RDA Wit C. mg 77.1 (40.0) 46.5% 81.4 (43.3) 35.5% Kwas foliowy μg (85.3) 65.2% (80.2) 67.3% wapń mg (258.5) 92.9% (278.2) 90.7% Zinc mg 6.7 (2.0) 83.1% 6.6 (1.9) 47.2% selen μg 77.7 (25.2) 3.5% 72.9 (23.6) 5,5%

13 Nutritional value Vitamins Mineral Dietary fiber Biologically active compounds

14 Mineral components in fruits Fruits Ca Fe Mg P K Fruits Ca Fe Mg P K Pear 9 0, Apple 6 0, Peach 6 0, Apricots 13 0, Plum 6 0, Cherries 16 0, Gooseberry 25 0, Black lilac 38 1, Blackberries 29 0, Raspberries 25 0, Blackcurrant 55 1, Currant 33 1, Stawberries 16 0, Grapes 10 0, Cranberry 8 0, Pineapple 13 0, Bananas 5 0, Lemons 26 0, Grapefruit 12 0, Orange 40 0, Source: USDA -

15 Mineral components in vegetables Vegetables Ca Fe Mg P K Vegetables Ca Fe Mg P K Red beets 16 0, Carrot 33 0, Parslay 138 6, Broccol 47 0, Brussels 42 1, Cauliflower 22 0, Cabbage 47 0, French bean 37 1, Tomatoes 10 0, Zucchini 15 0, Pumpkin 21 0, Rhubarb 86 0, Cucumber 16 0, Lettuce 36 0, Spinach 99 2, Potatoes 12 0, Onion 22 0, Asparagus 24 2, Source: USDA -

16 Acid folic Excess animal protein in the diet Excess metionin 1 cup of beet juice covers the RDA for folic acid Deficiency B6, B12 and folic acid Food products spinach 155 Folate (µg/100g) brussels asparagus bean 130 cauliflower 120 broccoli 90 beans 87 Increase in blood levels of Hcy

17 Beetroot juice Nitrate source, increasing physical fitness in active people. Preliminary studies show that use immediately prior to exercise (running, cycling) improves exercise capacity. May provide support for high altitude hypoxic training.

18 Antioxidants are substances that in the body at relatively low concentration. They significantly inhibit the oxidation of molecules in the tissues and body cells. Antioxidant guards can be divided into: -physiological organism that the body produces and regenerates in metabolic processes (eg antioxidant enzymes), -compounds and substances taken daily from the diet - vitamins, plant substances.

19 The role of antioxidants: They reduce the risk of atherosclerosis-inhibiting platelet aggregation, They protect against ischemic heart disease - antihypertensive effect - dilatation of peripheral blood vessels, They reduce the risk of cancer. Facilitate the body detoxification of carcinogens.

20 Vegetables, fruit, juices-active ingredients Rui Hai Liu, Health-Promoting Components of Fruits and Vegetables in the Diet, American Society for Nutrition. Adv. Nutr. 4: 384S 392S, 2013

21 VEGETABLES AND ORANGES AND YELLOW: The richest source of alpha carotene Very rich source of beta carotene 21

22 RED VEGETABLES AND FRUIT: The richest source of lycopene Rich source of flavanols 22

23 CITRUS FRUITS The richest in flavonoids Very rich in lycopene and flavors 23

24 BERRIES: -The richest in anthocyanins and flavonoids 24

25 Benefits of proper consumption of fiber Beneficial in constipation. Stabilization of sugar level. Regulation of cholesterol level. Lowering of blood pressure. Helpful in losing weight. Prevention of colon cancer.

26 Total fiber content and soluble fiber in products Clemens R., Drewnowski A., Ferruzzi M.G., Toner C.D., Welland D., 2015, Squeezing fact from fiction about 100% fruit juice. Advance of Nutrition, 6,2, 236S 243S Salvin J.L, LIoyd B., 2012, Health benefits of fruit and vegetables. Advances of Nutrition, 3,4,

27 Source: 2016 European Guidelines on cardiovascular disease prevention in clinical practice. doi: /eurheartj/ehw106 Recomendations od European Society of Cardiology 2016 Saturated fatty acids should deliver <10% of energy demand and be replaced by polyunsaturated fatty acids; Avoid consuming processed foods containing unsaturated trans fatty acids, and from natural sources should account for <1% of total energy consumption. <5 g of salt per day; g fiber per day, preferably from whole grains 200 g of fruit per day (2-3 servings); 200 grams of vegetables per day (2-3 servings); Fish 1-2 times a week, one of which should be fat one. Consumption of alcoholic beverages should be limited to 2 glasses a day (20 g / d alcohol) for men and 1 glass of wine per day (10 g / d alcohol) for women; Discourage the consumption of soft drinks sweetened with sugar and alcoholic beverages.

28 Source of water Water Food including fruits, vegetables and juices Water in human body Oxidative water

29 DIET FULL OF VEGETABLES AND FRUITS- BENEFITS Low energy density and high nutritional value. Low saturated fat and cholesterol. High content of complex carbohydrates and dietary fiber, lower sugar. High content of vitamin C and potassium, low sodium content. High content of biologically active compounds.

30 Thank you for your attention!

EASY WAYS TO EAT MORE FRUITS AND VEGETABLES AS PART OF A HEALTHY DIET.

EASY WAYS TO EAT MORE FRUITS AND VEGETABLES AS PART OF A HEALTHY DIET. This is a text-only 508 accessible version for the visually impaired. For a full-color brochure, see: www.fruitsandveggiesmatter.gov/downloads/aa_womens_brochure.pdf Page 1- Left column (back cover) EASY