Evaluating the potential health gain of the World Health Organization's recommendation concerning vegetable and fruit consumption.
OBJECTIVE
The World Health Organization (WHO) recommends a daily intake of at least 400 g of vegetables and fruit. The aim of this paper was to evaluate the public health benefit of meeting this WHO recommendation by applying a statistical method that combines estimated intake distributions and simulated intake changes.


METHODS
The benefit of an increased consumption of vegetables and fruit was quantified by the preventable proportion of diseases. This proportion was estimated by a general formula derived in the paper that incorporates individual relative risks. Three different strategies of increasing usual intake were simulated and compared. The first strategy assumes that all individuals increase their intake by the same amount, the second assumes a constant increase among low consumers, and the third simulates individual increments necessary to meet the WHO recommendation. Calculations were made for three different scenarios with varying relative risks.


RESULTS
The third simulation strategy turned out to be the most appropriate one to quantify the potential health gain of the current dietary recommendation. Applying this strategy to prevent cancer, the proportion of preventable cases was country-specific. Estimates for France and Sweden were 21.9% and 19.3%, respectively, which are somewhat lower than the non-specific figure published by the World Cancer Research Fund.


CONCLUSIONS
To improve estimates of the preventable proportion of diseases, the estimation formula presented here can be applied. Its application requires intake data to estimate the initial intake distribution in the population and to simulate adequate dietary changes.
Hoffmann
Kurt
K
Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, D-14558 Bergholz-Rehbrücke, Germany.
Boeing
Heiner
H
Volatier
Jean-Luc
JL
Becker
Wulf
W
D004034:Diet Surveys; D005602:France / Q000453:epidemiology; D005638:Fruit; D006293:Health Promotion / Q000706:statistics & numerical data; D006801:Humans; D009369:Neoplasms / Q000453:epidemiology* / Q000517:prevention & control*; D018673:Nutrition Policy; D011336:Probability; D018570:Risk Assessment / Q000379:methods*; D013548:Sweden / Q000453:epidemiology; D014675:Vegetables; D014944:World Health Organization