Getting five servings

A day of fruits and vegetables is one of the best ways to prevent cancer, heart disease and stroke. Here are easy ways to achieve that daily goal.

In 1991, the National Cancer Institute set a goal for every American to reach by the year 2000: Eat a minimum of five servings of fruits and vegetables a day.

How'd we do?

Not very well. Only 32 percent of adults meet the daily goal. Among kids aged 2 to 18, it's 25 percent. And that's bad news for our health, young or old. Scientific studies suggest that eating a diet with plenty of fruits and vegetables is a major factor (maybe the major factor) in the prevention of common cancers, heart disease and stroke — the diseases that kill most Americans. That's because these foods are uniquely rich in disease-fighting antioxidants like vitamin C, in fiber and in health-protecting "phytochemicals" like beta-carotene.

But, experts say, it's easy to get your five a day. You don't have to become a vegetarian. You don't even have to give up any so-called "bad" foods. And if you've got kids, it's easy to help them reach the goal, too. Here's what to do.

Understand the long- and short-term benefits of eating more fruits and vegetables. Avoiding heart disease, cancer or stroke is reason enough to eat more fruits and vegetables. But if preventing chronic disease in the future doesn't get you to eat fruits and vegetables today, then consider the immediate health benefits, says Linda Larkey, Ph.D., director of the Women's Cancer Prevention Office at the University of Arizona: "If you eat five servings a day of fruits and vegetables, it's likely you'll have more energy, you'll look and feel a whole lot better, and you'll find it easier to maintain or lose weight."

Know how much a "serving" is. A serving is any of the following:

Have a serving of fruits and vegetables with every meal. "Always think about having fruit with breakfast — raisins on your cereal, for example, a glass of orange juice, or a piece of cantaloupe," says Alan Kristal, D.P.H., professor of epidemiology at the University of Washington and associate head of the Cancer Prevention Research Program at the Fred Hutchinson Cancer Research Center in Seattle, Wash., and a former chef. "At lunch try to eat one vegetable and at dinner try for two. Eating vegetable soups, mixed dishes with added vegetables, and salads makes it easy. At every meal, I think: 'Where are the vegetables and fruits?'"

Snack on fruits and vegetables. "Eat any kind of fruit or vegetables for a snack," says Wendy Demark, Ph.D., R.D., a registered dietitian, and associate professor of surgery at the Duke Comprehensive Cancer Center in Durham, N.C. "Baby carrots, cherries, grapes, to name a few."

Carrot sticks are particularly good, says Cheryl Rock, Ph.D., associate professor of family and preventive medicine at the University of California, San Diego. "They're half the price of potato chips, they transport well — they can fit in a handbag, for example — and they're easy and fast to eat."

Make small additions to your current diet. You don't have to restock your refrigerator and pantry to start eating more fruits and vegetables. "Add them to your diet in small ways," says Larkey. If you make a burrito, for example, add a few more onions and tomatoes. If you eat cereal, add a banana. If you have a can of vegetable soup, toss in 1/2 cup of frozen peas, says Demark. If you're having ice cream, put strawberries on top, says Rock. "If you're having pizza, think about putting vegetables on top, like broccoli and sun-dried tomatoes," she says. A similar suggestion: Add extra vegetables to spaghetti sauce, says Susie Nanney, R.D., a registered dietitian and research project manager for the "High 5, Low Fat" program at the Saint Louis University School of Public Health.

Use any form of fruits and vegetables — canned, frozen, dried or fresh. "Scientific studies show that eating canned or frozen vegetables and fruits also lowers the risk for cancer and heart disease," says Rock.

Don't believe the myth that it costs more to eat healthy. "Compare a glass of soda to a glass of juice," Nanney says. "They're about the same cost, but the juice has lots of nutrients while the soda is nothing but calories. Fruits and vegetables give you the most nutrition for your money." In fact, she says, if you cut back on meat and eat more fruits and vegetables, you'll save money on your grocery bill.

Don't rely on the following foods to help you reach your goal. Sorry, but that slice of blueberry pie for dessert doesn't count as a serving — it doesn't have enough fruit in it, says Tom Baranowski, Ph.D., professor of behavioral nutrition in the Children's Nutrition Research Center at Baylor College of Medicine in Houston. Here are some other foods that Baranowski says don't qualify:

There's nothing wrong with these foods, he says. It's just that they're not going to help protect you against heart disease, cancer and stroke.

Realize that taking a nutritional supplement will not give you the same health benefits as eating fruits and vegetables. "When we take a supplement, we only get a few protective compounds, but fruits and vegetables contain thousands of different beneficial elements — some that scientists know about, and many that are still undiscovered," says Johanna Lampe, Ph.D., R.D., a researcher at the Fred Hutchinson Cancer Research Center in Seattle. "Taking a limited amount of specific nutrients in a pill doesn't have near the protective effect against chronic disease as eating whole fruits and vegetables," Rock agrees.

Help your kids get their "five a day," too. First, the experts say, realize that kids don't dislike vegetables just because they're kids. "In other countries like Japan and India where vegetables are a natural part of the daily diet, kids eat lots of vegetables," says Barbara Dennison, M.D., associate professor of pediatrics at Columbia University in New York and scientist physician at Bassett Healthcare in Cooperstown.

Second, if you follow all the tips in this article, your kids will eat more fruits and vegetables. "Kids tend to eat what parents eat," Dennison says. "If you eat more fruits and vegetables, your kids will eat more fruits and vegetables too."

For children 2 to 10 years old, the key is familiarity, says Dennison. "It may take eight to 10 times for a parent to serve cooked carrots or broccoli before a child will begin to even think about eating that vegetable. But if you serve the food in a nonchalant, relaxed atmosphere — and particularly if you serve the new food with their favorite food — the child will eventually begin to like the new food." Don't force your child to eat the food, says Dennison. It doesn't work. And don't bribe your child with other foods. ("If you eat your peas, you can have ice cream.") "That gives them message that there is something bad about the peas," she says.

As for adolescents, if they haven't gotten in the habit of eating vegetables when they're young, you've got a tough job ahead of you. But there are ways to make it easier, says Bettina Beech, D. P.H., assistant professor at the Center for Community Health at the University of Memphis in Tennessee. Make fruits and vegetables accessible. For example, don't just keep raw, unwashed carrots in the refrigerator. Instead, keep prepackaged baby carrots, cut up, washed and ready to eat.

Realize your teen-ager isn't likely to eat more fruits and vegetables to prevent chronic illness — teens think they're going to live forever. "Find reasons why it would be important and interesting to your teen to eat more fruits and vegetables," Beech says. Let them know that if they eat 'five a day,' they'll have more energy for athletics, a better complexion and be able to maintain a healthy diet without dieting."

By Bill Gottlieb InteliHealth Correspondent

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