Fruits and Vegetables Eating Your Way to 5 A Day

Fruits and Vegetables: Eating Your Way to 5 A Day

by Paula Kurtzweil

Are you taking the 5 A Day challenge? You may be if you find yourself:

• snacking on raw vegetables instead of potato chips
• adding fruit to your cereal at breakfast
• using the salad bar when you go out for lunch or to the grocery store
• loading up on juice instead of a usual coffee, tea or soda.

The challenge, offered by the National Cancer Institute--a branch of the National Institutes of Health--is to eat at least five servings of fruits and vegetables a day, and these are some ways consumers are rising to the occasion.

They're taking advantage of the healthful benefits of fruits and vegetables. Studies by the U.S. Department of Health and Human Services, U.S. Department of Agriculture, and the National Academy of Sciences suggest that the nutritional goodness of fruits and vegetables, with a diet that is low in fat, saturated fat and cholesterol and that contains plenty of whole-grain breads and cereals, may decrease the risk of heart disease and cancer.

Fruits' and vegetables' potential to help improve the health of Americans led NCI to begin a multi-year public education campaign in 1992. Its goal is to increase consumers' awareness of the importance of fruits and vegetables and to give consumers ideas on how they can increase their intake. With its partner, the Produce for Better Health (PBH) Foundation--a nonprofit consumer education foundation funded by the produce industry--NCI has taken the "5 A Day for Better Health" message to grocery stores, classrooms, television, work sites, churches, and elsewhere.

Food labeling of fresh, frozen and canned fruits and vegetables may carry the message, too. And if you need more specific nutrition information about a particular item, you can find it in the labeling of most products, as well. The Food and Drug Administration regulates this information, which corresponds to NCI's Five A Day guidance and the government's Dietary Guidelines for Americans.

Emphasis on More

A 1991 NCI and PBH survey, which has the best available, most up-to-date information on consumers' consumption of fruits and vegetables, found that the average American consumer eats only about three servings of fruits and vegetables a day. Forty-two percent eat less than two servings a day. Compare those figures with the five to nine servings a day recommended by the Dietary Guidelines for Americans and you can see that many of us have a way to go.

A major reason to eat more fruits and vegetables is their nutritiousness. Unless baked in a pie or dripping in butter, most are low in fat and calories--except avocados, coconut and olives, all of which contain fat naturally. Many are excellent sources of the important vitamins A and C and provide ample fiber.

In addition, many fruits and vegetables, particularly dried beans and peas, are significant sources of folate, a B vitamin that can help reduce the risk of certain serious and common birth defects. (See How Folate Can Help Prevent Birth Defects in the September 1996 FDA Consumer.)

Produce has other positive qualities. Many items, such as raisins, grapes, cherry tomatoes, and bananas, can be eaten on the spot, with minimal preparation. (Fresh produce in which the peel will be eaten should be rinsed with water beforehand to remove any surface dirt and bacteria.) NCI campaign literature refers to fruits and vegetables as the "original fast food."

"They're easy to pick up and eat," said Daria Chapelsky, state coordinator for NCI's 5 A Day Program. "Just as easy as picking up fast food."

And, unlike other types of foods (such as those high in fat that many of us eat too much of), plain fruits and vegetables are items we don't need to restrict. Genda Potter, a registered dietitian for cardiac patients at Memorial Medical Center in Springfield, Ill., said that factor was a major reason she began a regular 5 A Day class for outpatients.

"I wanted to emphasize something positive," she said. "People often look on dietitians as people 'out-to-ruin-my-enjoyment-of-food.' But fruits and vegetables are foods they can add to their diet rather than something they're going to be told to take away."

No Excuses

Still, for any number of reasons, consumers often find it difficult to eat more fruits and vegetables. They may avoid them because they believe they are too expensive or take too long to prepare. These and other perceived problems became evident to NCI in 1991, when it asked members of small group studies to come up with reasons people may not want to or might be unable to eat at least five servings of fruits and vegetables a day.

Their responses led NCI to develop ideas to help consumers overcome reported difficulties in meeting the 5 A Day goal. Some of those ideas follow, along with other information from nutritionists and food safety experts to help consumers overcome any reluctance they may have to eating fruits and vegetables.

Perceived Problem: Fruits and vegetables cost too much.
Possible Solutions:

It may help to realize, according to dietitians, that fruits and vegetables are actually good buys, if you consider that they are nutrient-dense, containing many of the vitamins and minerals we need more of--for example, vitamins A and C. But the foods we often buy in place of them--cookies and chips, for example--usually offer more of the nutrients--fat and sodium, for example--that most of us should eat less of. And the cookies and chips aren't cheap. For example, based on prices at a Rockville, Md., grocery store, a serving of potato chips costs about 25 cents and a serving of packaged chocolate chip cookies about 24 cents. A banana, on the other hand, sold for 17 cents, and the price of an apple ran as low as 13 cents.

"Compared to packaged foods, fruits and vegetables are not expensive," says Diane Quagliani, a registered dietitian and spokeswoman for the American Dietetic Association.

And there are ways to reduce the costs of fruits and vegetables even further:

• Buy fresh fruits and vegetables in season. Not only will they be cheaper but they also will be at their flavor and nutritional peaks, Quagliani says.
• Clip coupons for money off on your favorite canned and frozen fruits and vegetables and juices.
• Watch local grocery advertisements for reduced prices on your favorite fruits and vegetables.
• If you're not partial to a particular brand, compare prices of different brands of canned and frozen fruits and vegetables and juices and buy the cheapest.

Perceived Problem: Fruits and vegetables take too long to prepare.
Possible Solutions:

• Take advantage of grocery store salad bars, which offer ready-to-eat raw vegetables and fruits and prepared salads made with fruits and vegetables.
• Shop for precut and cleaned fruits and vegetables. Many grocery stores now carry packaged precut fruits, such as melons and pineapple; cleaned and cut-up salad greens and stir-fry vegetables; and cleaned, peeled baby carrots.
• Keep on hand canned and frozen fruit, canned and bottled juices, and dried fruits. Just open and use.
• Stock up on frozen vegetables for easy cooking in the microwave oven.
• Prepare fruits and vegetables ahead of time; for example, wash and, if feasible, cut up fresh produce and store it in the refrigerator for handy, immediate use.

Perceived Problem: Fresh fruits and vegetables spoil too quickly.
Possible Solutions:

• If you shop once a week or less often, buy both fresh and processed--that is, canned or frozen--fruits and vegetables, and juices. Use the fresh first; save the processed items for use later.
• Buy both ripe and not-so-ripe fresh fruits and vegetables--for example, yellow and green bananas--so that the not-so-ripe items will last a few days longer and be ready for eating after you've finished the ripe ones.
• Keep fruits and vegetables where you can see them often--on the top shelf of the refrigerator, or, for fruits that don't need refrigeration (such as bananas and apples), on the table or counter or another easy-to-spot-place. The more often you see the fruits and vegetables, the more likely you may be to eat them.

Perceived Problem: Fruits and vegetables contain harmful pesticides.
Possible Solutions:

It is a fact that pesticides are used in the production of most fruits and vegetables sold in this country. They help protect crops from insects, diseases, weeds, and mold, thus helping to increase crop yield. "They allow for production of a plentiful and affordable food supply," said John Jones, Ph.D., pesticides and chemical contaminants strategic manager in FDA's Center for Food Safety and Applied Nutrition.

"They are not contaminants. They are substances applied intentionally for a specific purpose and therefore are subject to very rigorous regulatory control," he said. "A new pesticide law enacted in 1996 puts even tighter controls on the use of pesticides."

Several federal agencies share responsibility for pesticide oversight. The Environmental Protection Agency registers pesticides for food use and sets tolerance levels--the upper permitted limit for pesticide residues in individual foods. FDA enforces these limits for all foods except meat and poultry, which fall under USDA's jurisdiction.

FDA collects and analyzes almost 10,000 samples of fruits and vegetables yearly for pesticide residues. Since 1987, when the agency began reporting the results of its monitoring program annually, more than 99 percent of domestic fruit and vegetable samples and more than 95 percent of imported samples have been found free of illegal pesticide residues or had low-level residues that fell within established tolerances. Violations mainly occurred because low-level pesticide residues not approved for a particular product were identified in that food. However, most of the pesticides causing these violations were approved for use on many other foods, Jones said.

"Most violations are not due to the presence of banned pesticides, such as DDT, chlordane and heptachlor, or to very high levels of residues," he said. "Most are due to very low-level residues on the wrong commodity."

So, FDA's position is that the U.S. fruit and vegetable supply does not contain excessive pesticide residues and that the benefits of eating fresh produce far exceeds any risk from residues, Jones said.

However, if you're still concerned, here are some steps you can take to reduce your risk further:

• Wash fruits and vegetables with water and scrub with a dish brush when appropriate: for example, before eating apples, cucumbers, potatoes, or other produce in which the outer skin or peeling is consumed.
• Throw away the outer leaves of leafy vegetables, such as lettuce and cabbage.
• Peel and cook when appropriate, although some nutrients and fiber may be lost when produce is peeled.

What to Eat

For the most part, any fruit or vegetable will do in helping consumers reach their 5 A Day goal. But certain types of fruits and vegetables should be selected regularly because of their nutritional value. These include those that are good sources of vitamins A and C and fiber.

Variety also is important because fruits and vegetables provide other nutrients, such as folate, potassium, calcium, and iron. Varying choices increases the likelihood of getting all the nutritional advantages of fruits and vegetables.

Also, nutrition experts advise against replacing all fruits and vegetables in the diet with dietary supplements because supplements often do not contain all the known--and perhaps unknown--nutritional benefits of fruits and vegetables.

Preparation presents another nutritional concern. Since a reduced-fat, reduced-saturated-fat intake is important to a healthful diet, it's important not to overindulge in fruits and vegetables prepared with high-fat ingredients. Some dishes to look out for include fried vegetables, such as french fries; cooked vegetables in cheese or cream sauces or with added bacon or butter; fruit pies or fruit served with whipped cream; and dips for raw vegetables. Some of these high-fat foods now have reduced-fat versions, such as low-fat dips and whipped toppings.

A Label with a Lot

You can determine the nutritional value of fruits and vegetables by looking at the Nutrition Facts panel on the side or back of labels of frozen and canned items. Nutrition information also is available for many fresh items, under FDA's voluntary point-of-purchase nutrition information program for raw foods. This information may appear on the labels of packaged fresh fruits and vegetables or on posters or brochures at or near the point of purchase.

The nutrition information lists the kinds and amounts of important nutrients in a serving of the fruit or vegetable and gives the Percent Daily Value, which shows how much those amounts contribute to the daily diet.

Some information is required: for example, the amount of fat, fiber, vitamins A and C, and iron and calcium, even if there is none. Some labels will carry additional information, such as the amount of folic acid and iron, depending on the types of label claims made.

You can quickly find fruits and vegetables that provide the nutrients you're looking for--for example, vitamin A or C or both--by looking for short descriptive terms on the front, side or back of the food label. For example, an orange juice label may say "provides 100 percent of the Daily Value for vitamin C." A package of frozen broccoli may state "good source of fiber." These claims refer to the contents of one serving of the item.

Less frequently, you may see longer claims describing the relationship between the labeled food or one or more nutrients in the food to a certain disease or medical condition. Only claims approved by FDA can be used in food labeling. Three approved health claims pertain to fruits and vegetables. These claims can describe how:

• fruits and vegetables may help lower the risk of some cancers
• fruits, vegetables and grain products that contain fiber, particularly soluble fiber, may help reduce the risk of coronary heart disease
• fiber-containing grain products, fruits and vegetables may help reduce the risk of some cancers.

In addition, in spring 1996, FDA approved a claim stating that a diet with adequate folic acid may reduce the risk of certain birth defects. This claim might appear, for example, on labels of dried beans, brussels sprouts, asparagus, tomato juice, and orange juice--foods that are excellent or good sources of folate.

A Campaign Continues

Are consumers paying attention to all this information?

In a way, yes, according to a 1996 NCI/PBH survey. That survey found that the percentage of consumers who were aware of the need to eat at least five servings of fruits and vegetables a day rose from 8 percent in 1991 to 35 percent in September 1996.

But whether the information has helped increase Americans' consumption of fruits and vegetables remains to be seen. Late last year, NCI planned to analyze national food consumption data--the most recent of which was collected in 1994--to determine whether fruit and vegetable intake had increased since the 1991 survey. According to Gloria Stables, a registered dietitian and NCI's 5 A Day Program director, NCI plans to release the results this year.

Meanwhile, NCI, the produce industry, state health departments, and other groups will continue the 5 A Day campaign through at least the year 2000. Said Stables, "This is the largest national public-private nutrition education program ever launched."

Paula Kurtzweil is a member of FDA's public affairs staff.

What's a Serving Size?

Here's what the National Cancer Institute recommends as a serving of fruit and vegetables:

• 1 medium fruit or 1/2 cup of small or cut-up fruit

• 3/4 cup (180 milliliters) of 100 percent juice

• 1/4 cup dried fruit

• 1/2 cup raw non-leafy or cooked vegetables

• 1 cup raw leafy vegetables (such as lettuce)

• 1/2 cup cooked beans or peas (such as lentils, pinto beans, and kidney beans)

Tips for Safe Handling of Fruits and Vegetables

E. coli in fresh apple cider.

Salmonella in melons.

Shigella in tossed salad.

These aren't dishes you'd want to order from a menu. They're descriptions of several causes of food-borne illness reported in recent years. The bacteria Escherichia coli O157:H7, Salmonella and Shigella in these fruits and vegetables were the culprits.

Although not commonly associated with food poisoning, fruits and vegetables can harbor disease-causing bacteria. Their growth environment, such as soil, is a rich source of microbes. Poor agricultural practices--such as irrigation with contaminated water--also may introduce bacteria. Poor storage and transportation practices can result in contamination, too, as can poor food handling by grocers, restaurants and consumers in the home.

Industry practices, such as rinsing fresh fruits and vegetables with chlorinated water and transporting them in refrigerated cars, help reduce the risk further. Restaurants and grocers also have certain standards to follow, based on their local food safety laws. These laws are often based on FDA's model food code for food establishments.

But, just as with other foods, safe handling of fruits and vegetables doesn't end there. Consumers have a responsibility, too. Here are some pointers to keep in mind when handling fruits and vegetables, and other foods, as well:

• Wash hands with warm water and soap for at least 20 seconds before and after handling food, especially fresh whole fruits and vegetables and raw meat, poultry and fish.
• Rinse raw produce in warm water. Don't use soap or other detergents. If necessary--and appropriate--use a small scrub brush to remove surface dirt.
• Use plastic, rather than wooden, cutting boards. Bacteria can hide in the grooves of wooden ones.
• Wash cutting boards with a solution of 1 teaspoon (5 milliliters) of chlorine bleach in 1 quart (about 1 liter) of hot water. Always wash boards after cutting raw meat, poultry or seafood and before cutting another food to prevent cross-contamination.
• Store cut, peeled and broken-apart fruits and vegetables (such as melon balls) at or below 41 degrees Fahrenheit (5 degrees Celsius)--that is, in the refrigerator.
• When buying from a salad bar, avoid fruits and vegetables that look brownish, slimy or dried out. These are signs that the product has been held at an improper temperature.

--P.K.

More Information

5 A Day Program
National Cancer Institute
EPN 232
6130 Executive Blvd., MSC 7330
Bethesda, MD 20892-7330
Telephone: (1-800) 4-CANCER

Produce for Better Health Foundation
1500 Casho Mill Road
Newark, DE 19174-6035
Telephone: (302) 738-7100

FDA
Office of Consumer Affairs (HFE-88)
Rockville, MD 20857
Telephone: (1-800) 532-4440
(10 a.m. to 4 p.m. Eastern time, Monday through Friday)

Also check with:

• grocery stores
• state health departments. Ask for the 5 A Day coordinator.

What About Waxes?

A thin wax-like coating is often applied to some fruits and vegetables after harvesting. This is mainly to keep the produce fresh longer by sealing in moisture.

"Contrary to belief, it is not applied just to make fruits and vegetables look pretty," a United Fresh Fruit and Vegetable Association brochure says.

Some fruits and vegetables typically--but not always--coated with wax are apples, melons, grapefruit, peaches, oranges, rutabagas, cucumbers, squash, and tomatoes, according to the association.

FDA regulates these waxes, or coatings, as food additives approved or "generally recognized as safe" for human consumption. However, some consumers have concerns about their use. Vegetarians and others who avoid animal products may worry that fruits and vegetables contain animal-based waxes, such as oleic acid. Some people fear that the wax traps pesticides, making the fruit or vegetable unsafe to eat--even though FDA's pesticide monitoring program indicates that pesticide residues on fruits and vegetables are consistently within acceptable safe limits.

If consumers want to avoid waxed fruits and vegetables, FDA regulations that took effect in 1994 may help them identify the appropriate products for them. These regulations require produce packers or grocers to provide point-of-sale information about the presence of waxes on fresh fruits and vegetables. This information can appear on labels of individual products, packing cartons (if they are used at the point of sale), or on counter cards or signs. The information will say that the product is:

• Coated with food-grade animal-based wax to maintain freshness, or
• Coated with food-grade vegetable-, petroleum-, beeswax-, and/or shellac-based wax or resin to maintain freshness. If only one of these types of waxes is applied, the label can simply identify the type, such as "vegetable-based."

FDA also will allow the statement "No wax or resin coating" on fresh fruits and vegetables that do not contain wax.

Besides reading labeling information, consumers can reduce their concerns about waxes by rinsing fruits and vegetables with warm water and, when appropriate, scrubbing with a brush. This will eliminate much of the wax.

--P.K.

The chart below is also available as a 77K PDF file.

A High Five

In selecting your daily intake of fruits and vegetables, the National Cancer Institute recommends choosing:

• At least one serving of a vitamin A-rich fruit or vegetable a day.
• At least one serving of a vitamin C-rich fruit or vegetable a day.
• At least one serving of a high-fiber fruit or vegetable a day.
• Several servings of cruciferous vegetables a week. Studies suggest that these vegetables may offer additional protection against certain cancers, although further research is needed.

High in Vitamin A*

apricots
cantaloupe
carrots
kale, collards
leaf lettuce
mango
mustard greens
pumpkin
romaine lettuce
spinach
sweet potato
winter squash (acorn, hubbard)

High in Vitamin C*

apricots
broccoli
brussels sprouts
cabbage
cantaloupe
cauliflower
chili peppers
collards
grapefruit
honeydew melon
kiwi fruit
mango
mustard greens
orange
orange juice
pineapple
plum
potato with skin
spinach
strawberries
bell peppers
tangerine
tomatoes
watermelon

High in Fiber or Good Source of Fiber*

apple
banana
blackberries
blueberries
brussels sprouts
carrots
cherries
cooked beans and peas (kidney, navy, lima, and pinto beans, lentils, black-eyed peas)
dates
figs
grapefruit
kiwi fruit
orange
pear
prunes
raspberries
spinach
strawberries
sweet potato

Cruciferous Vegetables

bok choy
broccoli
brussels sprouts
cabbage
cauliflower

*Based on FDA's food labeling regulations

(Source: National Cancer Institute)

FDA Consumer magazine (March 1997)

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