Five a day: The truth

Five-a-day or pick-a-number-a-day

The five-a-day campaign is actually a different number-a-day campaign across more than 25 countries. The UK swears by five-a-day. The USA proposes nine-a-day: two and a half cups of vegetables and two cups of fruit every day. Australia suggests five portions of vegetables and two of fruit, where a portion of vegetables counts as 75 grams of cooked vegetables, one cup of salad vegetables, or one small potato and a portion of fruit would be one medium piece (150 grams), one cup of diced fruit pieces or canned fruit, or one cup fruit juice.

The European advice varies as follows: Denmark says eat six-a-day. The Irish have a food pyramid, not a plate (more American) and they go for four (plus)-a-day. The Swiss have five-a-day and tell citizens to go for a variety of colour in their choices. The Belgians and Austrians also favour five-a-day. Italy just says eat more fruit and vegetables – very libertarian. The Spanish have a pyramid with two rows to eat occasionally – the foods on these rows look like (red) meat, sausages, cakes and sweets – and then they have four rows to consume daily – in order of smallest to largest intake recommended – other meat/fish; dairy; fruit and vegetables and then grains. Hence, the Spanish have a free hand in choosing their number-a-day and they also have advice for moderate intakes of wine and beer along the side of their pyramid. The Greek food pyramid is simply called “The Mediterranean Diet” and they quantify three servings of fruit and six servings of vegetables a day. Latvia goes for percentages – 30% of daily intake should be in the form of fruit and vegetables. Germany (spot a centre of engineering expertise) has a three dimensional food pyramid indicating qualitative and quantitative nutritional information. They also have a staircase picture elsewhere on a public health website with fruit and vegetables on the bottom step (the largest group to be consumed); meat, fish and dairy on the next step; German sausages and whole grains on the next step and then other grains and finally junk on the final two steps.[i] This is getting closer to reasonable advice. I also heard anecdotally, from an attendee of the 2009 Amsterdam obesity conference, that the German delegates were recommending 500 grams of vegetables per day while fruit was not quantified. The Hungarians haven’t gone for a pyramid, or a plate – they have a house with no numbers apportioned. [ii]

Where did five-a-day come from?

So where did the pick-a-number-a-day all start? It started as the “National five-a-day for better health” program in 1991 as a public-private partnership between the National Cancer Institute (NCI) and the Produce for Better Health Foundation. The programme started in California, the sunshine state, and has become the world’s largest public-private nutrition education initiative. All States in the USA have a five-a-day co-ordinator and, as we can see above, the programme has spread as far as Australia and Latvia. (Five-a-day has since been trademarked by the National Cancer Institute).

The National Cancer Institute was established in 1937 and is the USA government’s principal agency for cancer research and training. The Produce for Better Health Foundation can be found at the web site “fruitsandveggiesmorematters.org” and their purpose is to get us to eat more fruit and vegetables. The conflict of interest chapter comes later, but we can’t move on without listing some of the sponsors of the Produce for Better Health Foundation:

–    Logistics firms: C.H. Robinson Worldwide, Inc.; Caito Foods, Inc.; Capital City Fruit; Coast Produce Company and J&J Distributing.

–    Specialist producers: Driscoll’s (berries); U.S. Highbush Blueberry Council (blueberries); Ocean Mist (artichokes and fresh vegetables); Giorgio (mushrooms); Columbine Vineyards (grapes); Nature sweet tomatoes; Potandon Produce (potatoes) and Paramount Farms (nuts and flavoured nut snacks).

–    General fresh produce firms: W. Newell & Companies; Eurofresh Farms; Giumarra Companies; General Mills (Green Giant brand); Sun-Maid raisins and dried fruit; Kagome juices and Duda Farm Fresh Foods.

–    Other: such as BASF (the world’s leading chemical company, and a provider of fungicides, insecticides and herbicides); Glad Products Company (containers, bags and ovenware); Nunhems USA (commercial vegetable seeds); The Kidney Cancer Association and McDonald’s.

With the exception of The Kidney Cancer Association and, ironically, McDonald’s, the above represents a list of organisations that stand to benefit if there were a dictat from government that citizens should strive to eat (at least) five portions of fruit and vegetables every single day. Although we may mind less about tomatoes and berries being sponsored, than sugar and white flour, this is still a conflict of interest.

Why five-a-day? Why not? It’s a memorable number. It would have seemed achievable and it was the number of digits on one hand and, I would suggest, no more scientific than this. It was never the outcome of evidence based, thoroughly researched, scientific investigation. It was a marketing campaign – and the most successful nutrition marketing campaign that the world has seen.

Having been launched with no evidence whatsoever, there have been numerous attempts since to post-rationalise and to justify this worldwide campaign. It must be noted at the outset that this was never intended to be an obesity campaign. The involvement of the National Cancer Institute suggests that it was intended to be a programme to help with cancer in some non-quantified way. If it were designed as a general healthy eating campaign – to what end? It is difficult to know what this programme was intended to be, other than an excellent commercial venture for all the companies involved at conception. With no evidence at the time (or since), of any benefit from eating a certain number of fruits and vegetables each day, it is incredible to realise how far this marketing programme has gone. Now, as with so many other elements of our diet advice, we reiterate the slogan daily with no idea from whence it came.

The Colorado Department of Public Health reviewed the campaign and reported that, from the introduction of the five-a-day Day for Better Health Program in 1991 to 1998, the percentage of Americans who ‘knew’ that they should eat at least five servings of fruits and vegetables each day increased from 8% to 39% and the average consumption of fruits and vegetables increased from 3.9 to 4.6 daily servings per American.[iii] Most conveniently, in terms of dates, there was an article in the Journal of the American Medical Association (JAMA) in 1999 called “The Spread of the Obesity Epidemic in the United States, 1991-1998. This reported that, during this period (when fruit and vegetable intake increased by nearly 20%), obesity increased by 50%, from 12.0% in 1991 to 17.9% in 1998.[iv] I’m not saying that five-a-day caused this, but it certainly didn’t help.

Five-a-day and cancer

Let us turn to the evidence for the condition that five-a-day was intended to help – cancer. In April 2010 a study was published in the Journal of the National Cancer Institute written by Paolo Boffetta, as the lead of a large group of European researchers.[v] The study sought to quantify if cancer risk were inversely associated with intake of fruit and vegetables. The article analysed data from the EPIC (European Prospective Investigation into Cancer) study, involving 142,605 men and 335,873 women for the period 1992-2000. This review of almost half a million people found that eating five portions of fruit and vegetables a day had little effect on cancer risk and the very small difference observed could be explained by other factors. The study also grouped participants into five categories from the lowest intake of fruits and vegetables (0 to 226 grams a day) to the highest intake (more than 647 grams a day). Significantly, the cancer risk did not vary between the five groups. The overall conclusion of the study was that: “A very small inverse association between intake of total fruits and vegetables and cancer risk was observed in this study. Given the small magnitude of the observed associations, caution should be applied in their interpretation.

In November 2010, the UK part of the EPIC study published their findings in the British Journal of Cancer[vi]. Professor Tim Key concluded that: “The possibility that fruit and vegetables may help to reduce the risk of cancer has been studied for over 30 years, but no protective effects have been firmly established.”

Five-a-day and nutrition

One of the key arguments presented as justification for the five-a-day campaign (upon which the UK Department of Health alone has spent £3.3 million over the past four years), is that fruit and vegetables are highly nutritious.[1] We must stop making general and unsubstantiated claims like this. A worldwide instruction to citizens of tens of countries, across three continents, should be based on clear empirical evidence (and that evidence should have been tested and verified before any public health advice was issued). Aside from the fact that there is no such evidence for the health benefit of eating a particular number of a random selection of fruit and vegetables on any medical condition, let us analyse this ‘nutritious’ claim theoretically – starting with vitamins first:

We learned about the fat soluble vitamins, A, D, E and K, in Chapter Twelve. The pure form of vitamin A (retinol), vitamin D3 and vitamin K2 are only found naturally in animal foods (meat, fish, eggs and dairy products) and we can proceed on the basis that vitamin D can only feasibly be consumed naturally in animal foods (unless one can consume 2.2 kilograms of sunshine grown mushrooms in a fat delivery mechanism daily). Seeds, nuts and their oils are the best source of vitamin E. Even where fat soluble vitamins are found in plant sources, as the name suggests, they need a ‘fat’ delivery mechanism. K1 is found in green leafy vegetables and avocado is also a good source. Because of the absence of a ‘fat delivery mechanism’, the K1 in, say, spinach has a bio availability (availability to the body) of 4%, which increases to 13% if it is cooked in butter.[vii]

Vegetables have negligible or zero fat content, so no natural fat delivery mechanism. Two fruits do have a fat content – avocados and olives. If we compare the best source for each of A, D, E and K from avocado or olives, we find that 100 grams of olives delivers the equivalent of 20 micrograms of retinol (assuming that the body is capable of converting carotenes to retinol). Lamb’s liver delivers 7,392 micrograms of retinol per 100 grams. That means we would need to eat three kilograms of olives (4,350 calories) or eight grams of lamb’s liver (11 calories) to meet the recommended dietary allowance of vitamin A. Assuming again that our carotene conversion is optimal, 70 grams of carrots could provide the retinol equivalent, but we would need to eat them with (ideally) butter for this to be absorbed. For vitamin D, avocado and olives score zero; 100 grams of herring provides 40.7 micrograms. Avocado beats olives for vitamin E content – with 100 grams providing a respectable 2.1 milligrams. Sunflower seeds, however, provide 36.3 milligrams per 100 grams and almonds 24.7 milligrams. Avocado contains 21 micrograms of vitamin K1 per 100 grams, which is valuable, but no fruit or vegetable can provide K2.

The water soluble vitamins include the eight B vitamins and vitamin C. The best sources of the B vitamins are meat (especially organ meat), fish, milk and eggs. Whole grains and dried yeast are also a good source of B vitamins, but fruits and vegetables do not appear on lists of top sources of B vitamins. B12, of course, is only found in animal products and therefore must be taken as a supplement by vegans (vegetarians can get B12 in milk and eggs).

So we are left with vitamin C and fruit and vegetables do win the top spots here. Guavas and peppers provide the highest single source of vitamin C from fruits and vegetables respectively – with 228 milligrams per 100 grams for guavas and 183 milligrams per 100 grams for raw yellow peppers. However, as noted earlier in this chapter, the USDA database records many animal and nut sources of vitamin C and in substantial quantities. The more commonly consumed fruits don’t compare quite so favourably with, say, the 43 milligrams of vitamin C per 100 grams of chestnuts: apples have 4.6 milligrams per 100 grams and bananas 8.7 milligrams per 100 grams. So, we don’t even need fruits and vegetables for vitamin C, although they can be good sources of this vitamin.

On to minerals – if we look at the minerals with which people are more likely familiar: the best sources of calcium are dairy products and tinned fish; egg yolks, beef, cheese and liver are the best source of chromium; iron is best provided by organ meats; iodine is found in abundance in fish and kelp (seaweed); magnesium and manganese are plentiful in nuts and whole grains; good sources of selenium are organ meats, fish and shellfish and zinc is found in oysters, liver, meat, cheese and fish generally. Potassium is the one mineral for which fruits and vegetables are the best sources. Potassium, however, can also be found in all of nature’s foods, so we don’t need fruits and vegetables to obtain this mineral. Dried fruits and dark green vegetables are good sources of iron, but the organ meats are much better sources.

In conclusion, the statement in the Dietary Guidelines for Americans: “fruits and vegetables are excellent sources of vitamins” is not evidence based. A more accurate statement would be “low/zero-fat fruits are a good source of vitamin C and not much else; fruits with a fat content (avocado and olives) are poorer on vitamin C and better on other vitamins, but still no where near ‘excellent’; vegetables are often a better source of vitamin C than fruit and can also provide some useful fat soluble vitamins when eaten with fat.” For a short and accurate statement, the guidelines should have said “animal products are unbeatable nutritionally”.

Is five-a-day still a good idea despite having no evidence base?

Even if eating a certain number of portions of fruit and vegetables a day does nothing beneficial for cancer and even if the vitamin and mineral analysis does not bode well for fruit and vegetables being a major benefit to health generally, does the five-a-day campaign still have merit? As I write about obesity, I will answer from that perspective. I can only conclude that five-a-day has not been a worthwhile campaign and I present the following arguments as to why it has in fact been deleterious:

–    There is an opportunity cost of having spent so much time and money embedding a message that has not helped obesity (to be fair it was never intended to) when the benefits of embedding an equally simple, but far more effective message, could have transformed the obesity epidemic. The single public health message, which could have made an immense difference, would have been “eat real food.”

–    If the message had been “swap five-a-day”, rather than “eat five-a-day”, this could have helped – provided that junk were swapped out and not meat, fish, eggs, dairy and nutritious foods. My personal experience, working exclusively in the field of obesity, is that people are trying to eat five-a-day in addition to everything else they are eating, not instead of. This can only worsen obesity and, of course, obesity has worsened dramatically since the launch of five-a-day.

–    As if it is not bad enough that people are trying to get their five-a-day on top of everything else, the means by which they are doing this is disastrous for obesity. People are adding more processed food into their diet trying to get their five-a-day. If you review internet advice sites for ‘how to get your five-a-day’, adding sweet corn to (white flour) pizza is one suggestion, eat tinned (syrupy) fruit is another, fruit juices and fructose rich drinks are frequently recommended. We are eating even more processed food trying to get our five-a-day, which is to our overall detriment.

–    Five-a-day is not helpful for the increasing number of people who are increasingly carbohydrate sensitive and for whom fruit and high-carbohydrate vegetables are best avoided.

–    Finally, for anyone who is overweight (that’s two thirds of the ‘developed’ world), unlimited (green) vegetables and salads should be encouraged, but fruit/fructose is best avoided.

The first lesson in nutrition sets out that the body needs macro nutrients (fat, protein and carbohydrate – the need for the latter is debatable) and micro nutrients (vitamins and minerals). The best providers of the essential macro nutrients are animal foods – meat, fish, eggs and dairy. The best providers of vitamins and minerals are animal foods again, with seeds and a few non animal foods (kelp and peppers) being useful. The most nutritious foods on the planet, therefore, are animal foods.

Where is the logic for our governments and dietitians telling us to replace the most nutritious foods on the planet with the one macro nutrient that we arguably don’t even need, and certainly don’t need in the quantities currently recommended? How can our dietitians be so enthusiastic about processed foods, so lacking in micro nutrients that they are invariably fortified? How did we get to the situation that low calorie is more important than high nutrition?

The attack on real food occurs at the highest level. Here is an extract from the Chief Medical Officer’s report for England 2009 (published April 2010): “Meat, butter, cream and cheese can play a part in a healthy balanced diet. In excess they can cause health problems. Their high level of saturated fat finds its way into our diet in biscuits, cakes and pastries, as well as in meat” (my emphasis). If any meat, butter, cream or cheese have ‘found their way’ into processed foods: a) this didn’t happen by magic – food manufacturers put them there; b) they will be the most nutritious ingredients in the end product; and c) this means that we need to avoid the processed foods themselves and not any real foods that may happen to be within them. This is rather like saying that grade A students are bad, because they might find their way into crime.

Is there a five-a-day that would be worthwhile?

After all this, is there a perfect five-a-day? I set about doing what should have been done before any of this started. I went back to the USDA nutrition database and tried to get the Recommended Dietary Allowances (RDAs) from just five foods. This can be achieved with 100 grams of liver, 200 grams of sardines, 200 grams of whole milk, 100 grams of sunflower seeds and 200 grams of broccoli (1,300 calories). There will be infinite combinations of real foods that can provide the RDAs, but I started from the ones known to be highly nutritious.

For interest, I repeated the experiment for a vegetarian diet and the biggest challenge became vitamin D. The RDAs could be met with five foods: 500 grams of whole milk, 450 grams of eggs (10 medium eggs), 300 grams of spinach, 250 grams of raw mushrooms grown in sunshine and 50 grams of sunflower seeds (1,360 calories). Dietary advisors applaud people for choosing a vegetarian diet, but then tell them to avoid eggs and to consume low-fat milk. It then becomes practically impossible for a vegetarian to meet even minimal nutritional requirements. I had returned to eating meat and fish before the research for this part of the book, but, this exercise gave me great concern about what lasting damage I may have done to my health during years of not eating meat and fish. Gwyneth Paltrow may also be re-evaluating her diet after sharing her medical experience on her health website (June 2010). Paltrow’s vitamin D levels were tested by doctors in New York, following a “pretty severe” bone fracture and they “turned out to be the lowest they had ever seen.”[viii]

Vegans can’t get B12 naturally and they would need to eat 2.25 kilograms of (raw sunshine grown) mushrooms in a fat delivery mechanism (e.g. vegetable oil) to get the ‘adequate intake’ for vitamin D and an unusual food like oriental dried radishes to get their calcium – and to repeat this daily. For completeness, the five vegan foods would be 2.25 kilograms of mushrooms, 175 grams of porridge oats, 25 grams of sunflower seeds, 100 grams of oriental dried radishes and 300 grams of spinach (in more vegetable oil) and a vitamin B12 supplement. Without the calories in the vegetable oil, the vegan basket adds up to 1,644 calories – the highest of all three sample ways of getting our nutritional requirement.

In my book The Obesity Epidemic: What caused it? How can we stop it? I show how the RDAs can be met with a basket of  nine-foods-a-day (liver, sardines, eggs, whole milk, sunflower seeds, oats, cocoa, spinach and broccoli). One of the problems of trying to pick just five foods is that we end up with many vitamins and minerals over, or under, represented in our diet. We should consume a wide variety of nature’s food. This nine-a-day would be ideal, but the list of foods is not catchy enough for a marketing campaign, which, after all, is what this was. This ‘perfect’ basket also wouldn’t lead to a large increase in fruit and vegetable consumption – which is what the 1991 meeting attendees were no doubt keen to achieve.

The biggest tragedy of five-a-day is that we missed the opportunity to deliver a message that could have made a difference to our health and weight. The drive to eat five fruits and vegetables a day would have been far better directed (and still could be) towards eating more of the most nutritious foods each day. Meat (ideally liver), fish (ideally oily), milk (whole), sunflower seeds and broccoli would be the optimal five-a-day. Mum and granny were right.

(This is an extract from The Obesity Epidemic: What Caused it? How can we stop it?)


[1] Fruit is also widely promoted for its antioxidant properties: a) the antioxidant role in the body is best played by vitamin E and b) if we reduce our exposure to free radicals (processed food, pesticides, smoking, pollution etc), we need fewer antioxidants.

 


[i] http://www.fet-ev.eu/index.php?option=com_content&task=view&id=58&Itemid=116

[ii] The UK, USA and Australian references are in The Obesity Epidemic (below for convenience). The other countries are detailed at the following site: http://www.eufic.org/article/en/page/RARCHIVE/expid/food-based-dietary-guidelines-in-europe/

USA: http://www.health.gov/dietaryguidelines/dga2005/document/default.htm (These have been updated in the 2010 Dietary Guidelines for Americans since The Obesity Epidemic was published.)

UK: http://www.nhs.uk/livewell/5aday/pages/family.aspx

Australia: http://www.nhmrc.gov.au/guidelines/publications/n29-n30-n31-n32-n33-n34

[iii] http://www.cdphe.state.co.us/pp/copan/5-a-day/5ADAY.html

[iv] Ali H. Mokdad; Mary K. Serdula; William H. Dietz; Barbara A. Bowman; James S. Marks; Jeffrey P. Koplan, “The Spread of the Obesity Epidemic in the United States, 1991-1998”, Journal of the American Medical Association, (1999).

[v] Paolo Boffetta et al, “Fruit and vegetable intake and overall cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)”, Journal of the National Cancer Institute, (April 2010).

[vi] http://www.nature.com/bjc/journal/vaop/ncurrent/full/6606032a.html

[vii] www.nutritiondata.com

[viii] http://goop.com/newsletter/88/en/ – Gwyneth Paltrow’s personal web site.

Posted in Gov. Policy, Obesity
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29 comments on “Five a day: The truth
  1. avatar Kim says:

    I’ve been reading around on your site and was generally on board with what you were saying, but this post has me baffled. Leaving aside the fact that it is not suggested that the ‘five-a-day’ will provide all of our RDA of vitamins and minerals, only that they are an important part of a balanced diet (which indeed they are, and the fibre they provide is very good for our health), your suggested ‘better’ five a day is absurdly unsustainable. It’s all very well pointing out an ‘ideal’ of nutrition, but it’s an empty exercise if it’s not actually possible.
    Say, for argument’s sake, that your suggested five a day, including liver and sardines, was implemented and all 56 million of us in the UK got on board. Where does all this liver and sardine come from? The seas are already drastically overfished. Animals are generally more not-liver than liver, so what do we do with all the rest of them that’s nutritionally inferior? Where do we put all the millions and millions of animals that we’d need to eat all this liver every day? Do we discover a new landmass? Do we factory farm on unimaginable levels? Factory farming doesn’t produce good quality meat – it produces meat full of hormones and antibiotics, and diseases like mad cow. It wouldn’t be remotely possible to produce the meat required in ethical, humane ways. Not to mention, ethically raised humane meat takes time and effort to raise and it’s therefore justifiably expensive.
    Eating as you suggest isn’t possible for one small country, let alone for everyone.
    If you go back in time to the fifties when Britons were very much slimmer, we ate far less meat than we do today, not more.
    I’m also leery of your rejection of grains/carbohydrates. If you look at countries/cultures that have historically been healthy, long lived and slim (and not suffering from heart disease), we have the French. They eat quite a lot of white bread and potatoes. We have the Italians – they eat a lot of white wheat pasta. We have the Japanese – they eat a lot of white rice. We only see societies eating almost only meat where there is no other choice.

    A quick comment for the vegan who thinks that they’re getting all their vitamin D from going outside every day, though – not if you live the UK you don’t. At our latitude, we don’t receive enough UVB to produce Vitamin D in our skin from November through to March. For the rest of the year, you need to spend 15 minutes per day in full sunlight, without wearing sunscreen.

  2. avatar Poppy Burr says:

    I reiterate two comments already made on this article:

    1. That the original 5-a-day recommendations were not completely fabricated – they were originally based on studies linking increased fruit and veg consumption to decreased all-cause mortality. Recent studies have confirmed this – some saying we should be eating more than 5 portions, and some not, but no studies to my knowledge have concluded that eating less than 5 portions a day is acceptable.

    2. Really – I mean, really – we all know the main benefit of eating fruit and veg is fibre. It reduces intestinal transit time, promotes the growth of beneficial bacteria in the colon, and suppresses appetite. We are only beginning to understand the importance of a healthy intestinal microbiome on all aspects of our health, but suppressing appetite is surely a good thing for the obesity epidemic.

    And make one new comment:

    Why on earth should we limit ourselves to 5 foods a day?! The 5-a-day slogan did not intend to say ‘only eat 5 portion of fruit and veg a day and nothing else’, so why this idea of coming up with 5 foods a day that provide all our nutritional needs, I don’t know.

    The most useful slogan, in my opinion, is ‘eat a balanced diet’ – which is also a commonly repeated idea. There is so much to the science of nutrition that we don’t know yet, that promoting any diet that is limiting in any way (except for processed foods and allergens, if necessary) is bound to cause problems at some point.

    I’m sure we’d all be better informed on the subject if people stopped posting articles with the words “the truth” in the title when all it is is another selective, subjective interpretation of “the truth”.

  3. avatar craig says:

    The recommendations of 5 fruit/ veg portions a day originates from WHO recommendations in 1989, where they recommended a minimum of 400g a day, where one portion was 80g. This is 2 years before you say that it came about.

    Perhaps it was these recommendations that the NCI used when creating the 5-a-day campaign, but it wasn’t just fabricated. Using a minimum of 400g is why different countries recommend different amounts.

    You can read the WHO doc here http://www.who.int/nutrition/publications/obesity/WHO_TRS_797/en/

    where the recommendations are originally made (p112 I think, in part 2.

    I’m not saying a support the 5-a-day campaign, far from it, its over simplified and dated. This said, I do believe that many people will benefit from increasing their fruit/ veg consumption. Whilst a handful of berries may well not be as nutrient dense as liver, it is much easier to eat, and many will argue taste better.

  4. avatar James says:

    I think that there is very good evidence for Five-a-Day that you may be unaware of (see below)! There is an incremental reduction in all cause and cardiovascular mortality (but not cancer mortality) per portion of fruit or vegetable eaten per day, with no incremental benefit in excess of 5 portions per day. A 25% reduction in mortality for people who eat 5 portions of fruit or vegetables (or a mixture) per day compared to those who eat less than 1 portion per day is not to be taken too lightly!

    http://www.bmj.com/content/349/bmj.g4490.long

  5. avatar Bernadette says:

    Hi Zoe, I’m interested in your ‘controversial’ 5 a day recommendations: liver, sardines, spinach, sunflower seeds and eggs. What constitutes a portion of each of these? I think they are a sound recommended with with vegetables and fruit in moderation. Thanks.

    • avatar Zoë Harcombe says:

      Hi Bernadette – hopefully this follow-up may help (http://www.zoeharcombe.com/2014/04/the-perfect-five-a-day/). It depends for different nutrients e.g. vit E – 50g of sunflower seeds would meet the daily need, but you’d then also get lots of other things so you would need less of other options. 70g of liver gives the whole daily need for many nutrients. There are nutritional calculators on line where you can put in what you eat and it calculates the nutrients you’ve had and then you can see what you might be missing.
      Hope this helps
      Best wishes – Zoe

  6. avatar Alison says:

    Hi Zoe, I find your arguments very interesting, I have spent a lot of effort trying to fit in more fruit and veg into my diet! What do you think of the new evidence linking eating fruit and veg with lower mortality?

    http://www.sciencedaily.com/releases/2014/03/140331194030.htm

    I’d be very interested in your thoughts.

    thanks,
    Alison

  7. avatar Rey says:

    You are just a looser trying to sell stupid book aren’t you?

  8. avatar Ady says:

    What are your links to meat industry?

    • avatar Zoë says:

      Hi Ady – none whatsoever. I have no links to any part of the food industry – real or fake. I don’t even allow advertising on any of my sites. I work for no one. I write what I find and believe – not what anyone else may want me to say. I write about conflict and abhor it so I will never be part of it.
      Best wishes – Zoe

  9. avatar Jo says:

    I’ve been reading about salicylates, found in fruit and vegetables (and asprin). Salicylates are found in plants and are there to protect the plant from bacteria, fungi etc. Some people are sensitive to them, and can end up with all sorts of health problems when they try to eat a so called healthy diet by increasing their fruit intake. Worth a read, Zoe, and yet another reason to moderate your fruit intake (as if we needed another).

  10. avatar Al Reeves says:

    Well, Ive been eating the diet recommended diet all the way through and sure enough, I have lost weight and my blood pressure , which was never high particularly, is well down, so thanks, Zoe.

    I had lost weight before by eating similarly to this, in fact about 18Kg, which was quite good. Everyone who I have not seen for a while comments!

    However, some time ago I bought some meal replacement shake powder from GNC. I was surprised that replacing two meals a day actually increased my weight compared to eating REAL food. When I looked at the list of ingredients (you can see it at gnc.com and search for vanilla bean shake).

    The ingredients is frightening!

    To name but a few!

    Resistant fructooligosaccharides, partially hydrogenated soyabean oil, acesulfame potassium, sucralose. I need go no further!

    I’m just going to flush this stuff down the toilet now! Seriously!

    What a waste of money that was. I could have spent it on steak and leafy green vegetables and lost wait!

  11. avatar Zo says:

    I’m confused as to why you’re picking on 5-plus-a-day campaigns given that most people don’t get their five plus a day anyway, but they do generally eat more than their fair share of animal products. It’s not as if the five plus a day campaigns are telling people to eat less meat or fewer animal products.

    Also interesting that you don’t respond to any of the comments that are remotely critical of this post :/

  12. avatar Shaun says:

    Sorry, there was an ‘inconsistency’ I forgot to ask about:
    5. Vegans will tell you that eating animal products (meat, eggs, etc) causes your blood to become ‘acidic’—especially dairy which apparently leads to your bones leaching out calcium and leading to osteoperosis—is this acidity issue true?

    Thanks,

    Shaun.

    • avatar Zoë says:

      Hi Shaun – thanks so much for your really interesting post. Bear with me on the questions – got a full day today but will answer these asap
      Bye for now – Zoe

  13. avatar Shaun says:

    Hi Zoe,

    I got onto your website from the book “The Meat Fix” by John Nicholson. In his book he puts forth your assertions that fruit and vegetables only really contribute a single vitamin. I was very shocked and extremely skeptical at reading this. Having just read information on your site, I am now much more open to your assertions. I think it is brilliant that you are looking at the whole issue of nutrition and obesity from a ‘macro’ point of view.

    I have just ended a stint of about 8 months as a Vegan. *Ended* mind you. I tell you, those Vegans can be damn convincing. They roped me in—especially the “Best Speech You Will Ever Hear” by the Vegan God Gary Yourovsky (don’t get me wrong, I think what is happening to animals is atrocious). But as I am now learning, there are a few facts that Vegans like to conveniently leave out, or skew, such as “Meat rots in your gut”, when in fact, by the very definition of ‘rotting’ it’s actually fruit and vegetables that “rot in your gut” as the cellulose is broken down (somewhat) by microbial action and meat etc is broken down by enzymes. I’m also very shocked to hear that in fact insoluable fibre may be responsible for causing the likes of colon cancer.

    Then there is the whole “humans are herbivores because of teeth, jaw, hands, carb-digesting saliva, low-acidity stomach, bipedal, very long intestinal tract, our babies want to eat the apple and play with the rabbit” etc etc.

    Now, I consider myself somewhat intelligent (software engineer in defence/aerospace), yet I find myself in the rediculous, pathetic, annoying and angering situation of being a 40 year-old adult human who has NO IDEA WHAT TO EAT! In my opinion, when an intelligent person is confused, it generally means that person is being LIED TO. I’m not naive, I know our governments and industry are lying to us all the time (soy, vegetable oil, margerine). Thirty-odd years of health and nutrition advice from our government and these ‘expert’ nutritionist and dietitians—Result: Australia is one of the FATTEST countries in the world, with one of the highest rates of Type II diabetes…Well done ‘experts’.

    Anyway, now that I’m coming fully around to The Meat Fix and the Paleo way etc, there are still inconsistancies that I am restling with, and I was wondering if you could address them:
    1. Apparently human’s saliva is designed to start digesting carbohydrates, and Vegans will tell you that humans are carbohydrate-type animals and we are designed to get our primay energy from carbs…why is that the case and how does that compare with what you say about humans getting their nutrients and energy from meat, animal fat, etc;
    2. Our stomach acidity is much lower than that of carnivores, why then are we apparently meat-eaters?
    3. Why have we been led to believe that fruit and vegetables not only contain a plethora of vitamins and minerals, but also vital antioxidants (this may be a political/commercial so I’ll forgive you if you don’t want to answer that one).
    4. What is the ‘meat’ source of antioxidants—or is the requirement for antioxidants only by the very fact of our modern diet being a concoction of chemicals and hydrolized vegetable oils? (I think you actually answer that above but it would be interesting for you to elaborate if possible).

    Thanks,

    Shaun.

    • avatar Zoë says:

      Hi Shaun
      Got the to do list done! Some quick Q&A’s here:

      1. Apparently human’s saliva is designed to start digesting carbohydrates, and Vegans will tell you that humans are carbohydrate-type animals and we are designed to get our primay energy from carbs…why is that the case and how does that compare with what you say about humans getting their nutrients and energy from meat, animal fat, etc;

      Carbohydrates do start being broken down in the mouth with salivary enzymes. Protein is broken down in the stomach and fat is digested in the small intestine. The body needs protein and fat for cell repair, growth etc. The body can use fat or carbohydrate for energy. We don’t need carbohydrate at all – the ice age only ended 10,000 years ago and our ancestors survived for c. 30,000 years during the ice age with likely no or extremely little vegetation at all. The body will prefer to get energy from carbs, but that doesn’t mean that we need them. Analyse any food on the USDA database and you can see for yourself the nutrients in meat, fish, eggs, dairy vs grains/fruit. Veg/salad is good stuff – but not as good as animal foods.

      2. Our stomach acidity is much lower than that of carnivores, why then are we apparently meat-eaters?
      Barry Groves is the one I look to for the omnivore advice. There’s a great presentation of his here. Also check out Lierre Keith .

      3. Why have we been led to believe that fruit and vegetables not only contain a plethora of vitamins and minerals, but also vital antioxidants (this may be a political/commercial so I’ll forgive you if you don’t want to answer that one).
      Fruit and veg do contain antioxidants, but just not as many as other substances that are not promoted. Barry has a great chart here. Why is coffee not being promoted for example? I think that the overhype of fruit and veg is a post rationising attempt to justify the 5-a-day campaign. The cart has ended up before the horse!

      4. What is the ‘meat’ source of antioxidants—or is the requirement for antioxidants only by the very fact of our modern diet being a concoction of chemicals and hydrolized vegetable oils? (I think you actually answer that above but it would be interesting for you to elaborate if possible).

      The main points are in the ref note in the article above: Fruit is also widely promoted for its antioxidant properties: a) the antioxidant role in the body is best played by vitamin E and b) if we reduce our exposure to free radicals (processed food, pesticides, smoking, pollution etc), we need fewer antioxidants. There was an interesting article last week about a new study showing antioxidants may be harmful for cancer.

      5. Vegans will tell you that eating animal products (meat, eggs, etc) causes your blood to become ‘acidic’—especially dairy which apparently leads to your bones leaching out calcium and leading to osteoperosis—is this acidity issue true?

      Tea beckons so just cutting and pasting something from another article of mine:
      Best wishes – Zoe

      a) The body needs to maintain a pH balance of 7.4 at all times. Moving even 0.5 points away from this can be fatal. Hence the body manages this perfectly for us and will do so, no matter what we eat.
      b) The alkaline diet is vegan and, by definition, does therefore not provide retinol, vitamin B12, vitamin K2 or heme iron. Additionally, many vitamins and minerals are extremely difficult to get in a vegan diet e.g. vitamin D, unless the person eats 2.2kg of sunshine grown mushrooms, in a fat delivery mechanism (e.g. olive oil) daily.
      c) Any diet that cuts out all processed food is good – The Alkaline Diet has this in its favour. However, it also cuts out the most nutritious foods – meat, fish, eggs and dairy – and it has no means of delivering complete proteins as a result.
      d) The natural diet to which we evolved – hunter/gatherer – would have delivered acid foods in the form of meat/fish/animals and alkaline foods in the form of any vegetation available and this would have given us natural balance. Interestingly, most nuts and seeds are also acid based foods. Hence, during cold periods with no vegetation, all of our food intake would have been acidic – this has not been a problem for the body (indeed the main acid in our stomach is hydrochloric acid – a pretty corrosive substance!)
      Having read “Wheat Belly” on the day that the journalist called was very timely, as I had not realised the extreme acidity of wheat, as a food. Here’s a useful colour chart (part way down the page) to show the alkalinity vs. acidity of different foods (http://www.pureliquidgold.com/acid-alkaline-forming-foods.htm) Sugar is described as “acid” and wheat, white flour and pasta as “most acid.”

  14. avatar tizzy says:

    If you have ANY biology background, you would know that there is no such thing as vegetables. No, I’m not crazy! All veggies are fruits. Seed dispersal objects. So….its bad science to say we need one and not the other… Also, there are many more beneficial nutrients in food than the ones you see in the nutrition label… i.e. lycopene, etc. ….

  15. avatar Edna says:

    Zoe – I can’t find your source for the French advising “five a day or fewer”. I can’t see it on the link in your refs, although I may be looking for the wrong keyword. Can you point me in the right direction please?

  16. avatar Zoë says:

    Top find Travis! What a joke! Many thanks for this :-)

  17. avatar Travis Koger says:

    In order to see how pathetic and ludicrous this campaign is now, check out the Lifestyle section under the Nutrition tab on this link for Heinz Past Meals – Spaghetti Plus Meatballs.

    http://www.heinz.co.uk/ourfood/pasta/pastameals/spaghetti-plus-meatballs

    LOL!

  18. avatar John says:

    Hi,

    I wanted to point out something quite drastic you did not mention, not even in passing. Which has a very large impact on bowel, eosophageal, stomach cancers. Fibre…fruits and vegetables come with a large ammount of fibre, meats, fish and other animal products don’t. Your arguement however clever it tries to be is fundamentally flawed because you ignored this point.

    Although, I agree it is blatently obvious that the arguements made by others are also flawed when it comes to direct impact through nutrition on well being, disease, cancer and viruses.

    Since potatoes provide a high level of everything your body requires daily, adding vegetables or fruit for fibre makes sense. Meats are generally redundant with the addition of vitamin supplements but they do add a good ammount of fats and protien which would be what this diet is laking. If you want to eat heathily…eat varies on your three portions. It really is that simple.

    I belive that governments have addopted this idea of “five a day” so that they can push foods. Foods that people were not eating and were therefore hurting economies as opposed to wanting to help people physically.

  19. avatar Brad says:

    Hi Zoe,

    I found your site through a recent post by Gary Taubes, and I’m loving what I’ve read so far! I have a question about getting the RDA from the 5 omnivorous foods you selected. When I plug those into CRON-O-METER at the quantities you specified, I come up short on Potassium. I’m getting 2640mg with a RDA of 4700mg (56% RDA). Any idea why our results are different?

    Also, I’ve been following the Paleo scene and was wondering what you think about grains and seeds containing anti-nutrients, or problematic proteins that can damage the gut lining. I’m referring specifically to sunflower seeds since you include them in your “five-a-day.” Would it help to soak/sprout these before consuming?

    Thanks and I look forward to reading your posts regularly!

    • avatar Zoë says:

      Hi Brad – many thanks for your kind words.
      The suggested 5-a-day wasn’t meant to deliver all of every nutrient we need – it was meant to show that if you wanted to invent a 5-a-day slogan – at least base it on 5 of the most nutritious foods! In my book “The Obesity Epidemic: what caused it? how can we stop it?” I did the exercise to try to get all the nutrients with RDA’s for the USA and found that 9 foods would do it for omnivores – potassium not included, however, as explained in the passage. The passage is below.

      On the grains and seeds – I’m not a fan of wheat at all but I do think many people can tolerate grains (rice, oats, couscous) in moderation and they can be a versatile and enjoyable part of one’s diet and so don’t necessarily have to be ruled out by everyone. Nutritionally they won’t ever compete with quality meat/fish/eggs, but diet is also about enjoyment, practicality and flexibility and Paleo will be a step too far for many people. If someone is overweight or shows signs of not being able to tolerate grains then they have more reason to ditch them, but we don’t all need to. I have not seen seeds put in the same category and I wouldn’t see them as problematic. I’ve seen people suggest soaking grains (which for me takes away the practical element – if you need to soak something overnight to avoid problems, just don’t eat the problem in the first place!) but I think we should eat things in their most natural form and, for seeds, that means – they come in shells. Where the shells are edible – eat them – where they aren’t shell them. It just makes getting vit E a whole lot easier if you sprinkle a few sunflower seeds on your mixed salad – makes the salad crunchier too!

      Hope this helps
      Best wishes – Zoe

      “I did an interesting experiment, using the United States Department of Agriculture (USDA) food and nutrition database and the USA per capita consumption of sugars and flour. I analysed the nutritional value for the 121 grams of sugars and 170 grams of flour consumed by the average American. I then tried to see if I could get the American Recommended Dietary Allowances (RDAs) from eating approximately the same number of calories (1,076) in real food. The USDA database does not have information for Biotin and it only records 11 minerals. There is not even an RDA for vitamins B5, D and K or for the minerals calcium, potassium, sodium and manganese. There is an “Adequate Intake” (AI) apportioned instead. The concept of RDA is bad enough. As Sally Fallon Morell said “why am I only allowed a certain level of nutrition?”

      I compared the 12 vitamins available and eight minerals – those for which there was both information available and an RDA, plus calcium and manganese, as important macro and trace minerals respectively. The results are summarised in Appendix 3.

      The outcome was that only the requirement for selenium was met by the flour and sugar intake. Every other nutritional requirement was woefully lacking. All RDA’s and AI’s could be achieved by eating 1,077 calories comprising the following: 35 grams of porridge oats; 125 grams of whole milk (not low fat); 75 grams of liver; 50 grams of broccoli; 200 grams of spinach; 25 grams of cocoa powder; 125 grams of sardines (oil based, bones included); 200 grams of eggs and 20 grams of sunflower seeds. The most interesting lessons were not the results, but the exercise itself. It illustrated the following:

      – It is difficult to get even the RDA for many nutrients and very difficult to get the RDA for some (calcium, magnesium, zinc, vitamin D and vitamin E were the most difficult) and this is with every food on the planet theoretically available.

      – In our preoccupation with macronutrients, we seem to have forgotten about micronutrients. If we eat food to obtain the vital micronutrients, the macronutrients will be what they will be (take care of the pennies and the pounds/dollars look after themselves). If we eat food to try to meet some made-up macronutrient composition, the micronutrients are likely impossible to consume. It is an inescapable fact that processed carbohydrates have little or no natural nutrition and even nature’s carbohydrates are comprehensively beaten by nature’s fats and proteins. Telling people to avoid fat is the same as telling us to avoid nutrition.

      – Our parents and grandparents were brought up on relatively cheap, highly nutritious, foods like liver, eggs and sardines. Cod liver oil was commonly administered by previous generations. When you see the vitamin A and D content of the latter, our elders were very sensible. We shun such foods nowadays and should not.

      – This is the most nutrition that we can derive from even real foods. This makes no allowance for: the quality of the food; nutrients lost in harvesting or over use of the land; cooking methods; or the fact that some nutrients need others for their absorption.
      What are the implications of this for the obesity epidemic? The body has a substantial and varied nutritional requirement. If we base our meals on starchy foods and consume an average 1,100 largely useless calories, we still have a nutritional requirement to be met. The body will continue to seek food in an attempt to get the nutrition it needs. We may then consume another 1,100 calories, likely as nutritionally lacking as the first batch and we arrive at a population that is both overfed and undernourished. That’s another way of defining obesity.”

  20. avatar jake3_14 says:

    Mich,

    Have you had your vit. D levels measured with a 25,OHD test? If so, what were the results? If not, how do you know your vit. D level is adequate? Also, how are you determining your daily protein requirements?

  21. avatar jake3_14 says:

    I eat a real-food. low-carb diet, but I take issue with one of your assertions.
    Since you state that “Potassium is the one mineral for which fruits and vegetables are the best sources. Potassium, however, can also be found in all of nature’s foods, so we don’t need fruits and vegetables to obtain this mineral,” why do you later say, “The best providers of vitamins and minerals are animal foods again, with seeds and a few non animal foods (kelp and peppers) being useful.” Tomatoes and spinach are very high in this mineral, and I include low-sodium V8 juice (800 mg potassium/cup) and a curried spinach (1000 mg potassium/cup) in my diet daily.

  22. avatar Mich says:

    And why were you comparing the calorie counts of the theoretical diets you imagined – I thought calories didn’t matter according to your books?

  23. avatar Mich says:

    I’m vegan and I’ve been getting my vitamin D from GOING OUTSIDE everyday. B12 is made by bacteria, not animals. I’ll stick to taking the bacterial sources rather than consume animal flesh. Since my vegetables, grains, legumes average out at 15% of their energy from protein, I frequently far exceed my actual protein needs of about 25g per day – getting around 60g. I also eat all I want, don’t stick to a random diet, and enjoy everything I eat. Go figure.

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