The diet and lifestyles of more than 300,000 people across eight countries in Europe found that people who ate at least eight portions of fruits and vegetables a day had a 22% lower risk of dying from heart disease than those who ate three portions a day.
Each additional portion in fruits and vegetables was linked to a 4% lower risk of death.
One portion counted as 80 grams, such as a small banana, a medium apple, or a small carrot.
Heart disease is the leading cause of death in the U.S. and around the world, accounting for more than one in every four deaths in the United States, according to the CDC.
The average intake of fruits and vegetables in the various countries was five servings a day.
Spain, Greece, and Italy were the leaders in fruit and vegetable eating. Italian men enjoyed 7.5 portions a day, and Spanish women 6.7 portions.
Healthy eating tailed off the further north the researchers looked in Europe.
U.K. men managed 4.1 portions a day, and women 4.8 portions.
Swedish men and women were the worst, with only 3.5 and 2.9 portions a day.
The researchers say factors like cost and availability of fruit and vegetables are likely to account for differences in intake.
Data came from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study.
Every Portion Counts
Study researcher Francesca Crowe, MD, of the Cancer Epidemiology Unit at the University of Oxford in England, tells WebMD by email, “We do need to be cautious in our interpretation of these findings as participants with a higher intake of fruits and vegetables tended to be slightly healthier overall. So we are unable to say whether the association between fruits and vegetables and heart disease is causal.”
In other words, did the fruits and vegetables make people healthier, or are people who eat better also more likely to have healthier lifestyles?
Crowe says healthy eating also needs to be added to healthy lifestyle behaviors as well as other recommendations “such as not smoking, not having high blood pressure or high blood lipids [cholesterol] and being in a healthy weight range.”
Stepping up from five servings to eight servings a day might be hard, but Crowe says, “It may be a more manageable public health guideline to recommend that everyone increases their intake by one portion per day.
“This is a much more modest effect for an individual but if everyone could achieve this then at a population level the impact would be quite large.”