Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany.
Eur J Nutr. 2012 Sep;51(6):637-63. doi: 10.1007/s00394-012-0380-y. Epub 2012 Jun 9.
Vegetables and fruit provide a significant part of human nutrition, as they are important sources of nutrients, dietary fibre, and phytochemicals. However, it is uncertain whether the risk of certain chronic diseases can be reduced by increased consumption of vegetables or fruit by the general public, and what strength of evidence has to be allocated to such an association.
Therefore, a comprehensive analysis of the studies available in the literature and the respective study results has been performed and evaluated regarding obesity, type 2 diabetes mellitus, hypertension, coronary heart disease (CHD), stroke, cancer, chronic inflammatory bowel disease (IBD), rheumatoid arthritis (RA), chronic obstructive pulmonary disease (COPD), asthma, osteoporosis, eye diseases, and dementia. For judgement, the strength of evidence for a risk association, the level of evidence, and the number of studies were considered, the quality of the studies and their estimated relevance based on study design and size.
For hypertension, CHD, and stroke, there is convincing evidence that increasing the consumption of vegetables and fruit reduces the risk of disease. There is probable evidence that the risk of cancer in general is inversely associated with the consumption of vegetables and fruit. In addition, there is possible evidence that an increased consumption of vegetables and fruit may prevent body weight gain. As overweight is the most important risk factor for type 2 diabetes mellitus, an increased consumption of vegetables and fruit therefore might indirectly reduces the incidence of type 2 diabetes mellitus. Independent of overweight, there is probable evidence that there is no influence of increased consumption on the risk of type 2 diabetes mellitus. There is possible evidence that increasing the consumption of vegetables and fruit lowers the risk of certain eye diseases, dementia and the risk of osteoporosis. Likewise, current data on asthma, COPD, and RA indicate that an increase in vegetable and fruit consumption may contribute to the prevention of these diseases. For IBD, glaucoma, and diabetic retinopathy, there was insufficient evidence regarding an association with the consumption of vegetables and fruit.
This critical review on the associations between the intake of vegetables and fruit and the risk of several chronic diseases shows that a high daily intake of these foods promotes health. Therefore, from a scientific point of view, national campaigns to increase vegetable and fruit consumption are justified. The promotion of vegetable and fruit consumption by nutrition and health policies is a preferable strategy to decrease the burden of several chronic diseases in Western societies.
蔬菜和水果是人类营养的重要来源，它们富含营养物质、膳食纤维和植物化学物质。然而，目前尚不清楚增加公众蔬菜和水果的摄入量是否可以降低某些慢性病的风险，以及应该为这种关联分配多少证据强度。
因此，对文献中可用的研究进行了全面分析，并针对肥胖、2 型糖尿病、高血压、冠心病（CHD）、中风、癌症、慢性炎症性肠病（IBD）、类风湿关节炎（RA）、慢性阻塞性肺疾病（COPD）、哮喘、骨质疏松症、眼病和痴呆症等疾病评估了各自的研究结果。在判断风险关联的证据强度、证据水平和研究数量时，还考虑了研究质量及其基于研究设计和规模的相关性。
对于高血压、CHD 和中风，有确凿证据表明增加蔬菜和水果的摄入量可以降低疾病风险。有充分证据表明，一般来说癌症的风险与蔬菜和水果的摄入量呈负相关。此外，有证据表明增加蔬菜和水果的摄入量可能有助于防止体重增加。由于超重是 2 型糖尿病的最重要危险因素，因此增加蔬菜和水果的摄入量可能会间接降低 2 型糖尿病的发病率。独立于超重，有充分证据表明增加摄入量对 2 型糖尿病的风险没有影响。有证据表明，增加蔬菜和水果的摄入量可以降低某些眼病、痴呆症和骨质疏松症的风险。同样，目前关于哮喘、COPD 和 RA 的数据表明，增加蔬菜和水果的摄入量可能有助于预防这些疾病。对于 IBD、青光眼和糖尿病性视网膜病变，关于蔬菜和水果摄入量与这些疾病之间的关联的证据不足。
本研究对蔬菜和水果摄入量与几种慢性病风险之间的关联进行了批判性评价，结果表明高日常摄入量这些食物有助于促进健康。因此，从科学角度来看，增加蔬菜和水果摄入量的国家运动是合理的。通过营养和健康政策促进蔬菜和水果的消费是减少西方社会几种慢性病负担的更优策略。
