I FELT smug early this morning, sitting down to write this article. I鈥檇 just
consumed a delicious russet apple. Only four more apples to go and I鈥檇 reach the
recommended daily quota. At least that鈥檚 the implication of a recent report in
The Times鈥攈eadlined 鈥淔ive apples a day keep the cardiac surgeon
away鈥�. What wonderful timing, too鈥攊t was Apple Day, 21 October, Britain鈥檚
annual celebration of its distinctive local varieties and the brainchild of the
environmental charity Common Ground.
When my mother read the piece in The Times, she rang to ask whether
five Victoria plums鈥攈er favourite fruit鈥攚ould suffice. How should I
advise her? Further research was called for. Tim Key, the epidemiologist whose
work The Times reported, sighed. 鈥淚 suppose they meant the headline to
be funny. Perhaps I should have written a letter,鈥� he mused.
鈥淎ll we can say, from this study at least, is that it is pretty likely that
eating fruit is beneficial,鈥� said Key, who works at the Imperial Cancer Research
Fund鈥檚 Cancer Epidemiology Unit in Oxford.
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Key鈥檚 follow-up study, published recently in the British Medical
Journal, charted the fates of 11 000 鈥渧egetarians and healthconscious
people鈥� who, years ago, had filled in a brief questionnaire. In the 1970s, these
people were customers of health-food shops, subscribers to a health-food
magazine or members of vegetarian societies. No one had been in touch with them
since.
With so little data to go on, says Key, 鈥渋t鈥檚 amazing that we found
anything鈥�. Yet there was one striking finding: in comparison with those who ate
fruit only rarely, regular fruit eaters were 24 per cent less likely to die of a
heart attack and 32 per cent less likely to die of a stroke.
Of course, it is quite possible that eating fruit was merely associated with
some other healthful characteristic that the questionnaire didn鈥檛 touch
on鈥攖here were no questions about vegetable consumption or exercise, for
instance. 鈥淎nd we have no evidence on the quantity of fruit鈥攓uite likely
one piece is enough,鈥� says Key. 鈥淭he message is not to eat enormous quantities,
but rather that people who don鈥檛 eat it at all might try to eat some every
诲补测.鈥�
So where did the 鈥渇ive fruits a day鈥� idea come from? This seems to be a
mutated version of a recommendation from the US Department of Agriculture that
we should eat between five and nine servings of fruit and vegetables every day.
The concept of 鈥渇ive a day for health鈥� is now well established in the US, says
Carol Williams, visiting lecturer at the London School of Hygiene and Tropical
Medicine. The idea has even arrived in Britain. 鈥淭ake 5!鈥�, Sainsbury鈥檚 advises
shoppers in a leaflet promoting 鈥渉ealthy eating with fruit and vegetables鈥�.
But what exactly qualifies as an item of fruit or veg? 鈥淎 couple of slices of
tomato in a sandwich or a few mushrooms in a chicken and mushroom pie should not
count,鈥� Williams says sternly. 鈥淐onsumers should be told that it is necessary to
eat a bowlful of salad to count as one portion.鈥� Similarly, you must eat two
serving spoonfuls of broccoli, spinach, carrots, parsnips or baked beans (and
three of peas or sweetcorn) to tick off another unit.
For grapes to count, you need to eat a cupful, says Williams. Two whole plums
qualify as another 鈥渋tem鈥� (Mum please note), as does a large slice of melon or
pineapple; or three serving spoonfuls of stewed apple or canned peaches; or half
a serving spoonful of dried apricots or raisins.
Have you got all that? You can鈥檛 blame nutritionists for trying to give us
achievable guidelines. Yet doesn鈥檛 all this strike you as suspiciously precise?
Is this perhaps secretly funded propaganda, put out by a shadowy organisation we
don鈥檛 even know about鈥攕ay, a cabal of greengrocers?
Living in a world rife with pharmaceuticals promotions, the British
Medical Journal is understandably wary of such potential hidden
connections. 鈥淚t has a very strong policy that you should state anything that
could be an embarrassment,鈥� says Key. So at the end of Key鈥檚 paper, the journal
warns us of a 鈥渃onflict of interest鈥�: Key and his colleague Paul Appleby 鈥渁re
members of the Vegetarian Society鈥�.
Key admits his colleagues did find it a bit amusing. 鈥淚t is not
quite like having shares in a tobacco company,鈥� he chuckles. 鈥淏esides, coauthors
Margaret Thorogood and Mike Burr are not vegetarians, so we have a nice balance
of opinions.鈥� But you can鈥檛 be too careful these days, so it鈥檚 only fair to
admit that this article too is written by a vegetarian.
The links between diet and health are now being studied in a Europe-wide
collaboration comparing the long-term health of 300 000 people eating a
diversity of diets. Key鈥檚 unit at Oxford is keen to recruit vegetarians; contact
him at EPIC Study, FREEPOST OF 1716, Gibson Building, Radcliffe Infirmary,
Oxford OX2 6BR. For more information about future Apple Day events, send an
s.a.e. to Common Ground, Seven Dials Warehouse, 44 Earlham Street, London WC2H
9LA.