The escalating global epidemic of
overweight and obesity is a serious public health concern contributing to more
than two million deaths each year. Although obesity itself claims few lives,
there is a strong link between obesity and diet related non-communicable
diseases such as diabetes, cardiovascular disease, high blood pressure and
certain cancers that are known to be fatal.
Childhood and teenage obesity
affects both developed and developing countries across all socio-economic
groups, irrespective of gender or ethnicity. Rapid societal changes and
urbanization in the form of consumption of fast foods, consuming meals outside
of the home, eating high calorie (high fat, low fiber) foods and high intake of
sweetened beverages in addition to low levels of physical activity have
contributed in a major way to obesity.
High fruit and vegetable
consumption is associated with less or slower weight gain over lengthy time
intervals among adults, and to a lesser degree among children.
Low fruit and vegetable intake,
according to WHO, is also among the top ten risk factors for mortality, causing
around 14 percent of gastrointestinal cancer deaths, about 11 percent of
ischemic heart disease deaths, and about 9 percent of stroke deaths globally.
The WHO report further recommends intake of 'a minimum of 400g of fruits and
vegetables per day for the prevention of chronic diseases such as heart
diseases, cancer, diabetes and obesity'.
A number of studies have found
that teenagers who ate fewer than five servings of fruits and vegetables in a
day tended to be heavier. The five-a-day program, initiated in the United
States and implemented in several countries, was created to promote fruit and
vegetable consumption to revert the increase of obesity-related diseases. This
involved consuming at least five servings of fruits and vegetables a day.
Increased body weight associated
with low consumption of fruits and vegetables is a serious problem in Brazil as
well. So, Marta Rieth and her colleagues, from Porto Alegre, Brazil, conducted
a study to investigate whether Southern Brazilian adolescents were following
the five-a-day program and whether gender, age, and education affected the
feeding patterns in any way. The study has been published in the Nutrition
The study included 568
adolescents (281 boys and 287 girls) aged 12 to 19 years. The daily consumption
of fruits, vegetables, rice and beans were recorded using a food frequency
questionnaire and questions. ANOVA, ANCOVA and Modified Poisson regression were
used in the analysis.
The results indicated consumption of five daily servings
of fruits and vegetables only in 23 percent of the participants. 36.7 percent
of boys and 31 percent of girls consumed less than one serving of fruit daily,
and 58.4 percent of boys and 44.6 percent of girls consumed less than one
serving of vegetables per day. Therefore, the overall five-a-day consumption
was lower than that in the American adolescents, most probably because of low
publicity of the program in Brazil.
The investigators also found that being overweight was
associated with increased intake of five-a-day, irrespective of age, gender,
vigorous physical activity, and higher alcohol consumption. They hypothesized
that 'those adolescents eat more everything, including fruits and vegetables,
or even that those who have the higher BMI are eating more fruit and vegetables
because they are trying to lose weight'.
The association between vigorous physical activity and
higher intake of fruits has been attributed to adolescents with positive habits
including lower rate of smoking and other healthy behaviors.
Similarly, the association between education and
consumption of fruits and vegetables was not very significant because of a
small range of years at school. However, other studies have found direct
association between socioeconomic status and fruit and vegetable intake.
Fruits and vegetables, and rice and beans intake were not
independently associated with gender, but the higher prevalence of obesity
among boys aged 18 to 19 years, was explained away as higher muscular
development of boys than girls.
The investigators thus concluded that 'Adolescents from
Southern Brazil have lower frequency of consumption of five servings a day of
fruits and vegetables combined'.
Rieth MA, et al. Fruits and vegetables intake and
characteristics associated among adolescents from Southern Brazil. Nutrition
Journal 2012, 11:95 doi:10.1186/1475-2891-11-95