Role of Fruits and Vegetables in Reducing Cardiovascular Disease Risk: A Narrative Review

Abstract

Low consumption of fruits and vegetables (FV) is a major preventable contributor to cardiovascular disease (CVD). Insufficient FV intake has been estimated to account for nearly 3 million CVD deaths and more than 70 million disability-adjusted life years worldwide. This review examines global patterns of FV intake; evidence linking FV consumption to cardiovascular outcomes; underlying biological mechanisms determined through in vitro and in vivo studies; serving size frameworks; current global recommendations; barriers to FV intake; and practical advice to increase FV intake. Although global FV intake has modestly increased in recent decades, consumption remains substantially below recommended levels in all regions, and marked disparities exist among countries. Evidence from meta-analyses of randomized controlled trials and intervention studies of individual fruits and vegetables has shown that FV intake improves cardiometabolic risk factors, and large prospective cohort studies have consistently demonstrated inverse associations between FV intake and CVD incidence and mortality. Experimental mechanistic studies have further supported these findings by identifying shared cardioprotective mechanisms mediated by FV-derived bioactive compounds. However, several practical and theoretical constraints limit the recommendation of adequate FV intake. This review proposes a practical serving-size framework based on macronutrient content, wherein one serving of fruit provides approximately 15 g carbohydrates (~60 kcal), and one serving of vegetables provides approximately 5 g carbohydrates (~25 kcal). By addressing key barriers and presenting practical dietary strategies, this review highlights the importance of promoting FV consumption at both the individual and population levels to decrease CVD risk and improve cardiovascular health outcomes.

Keywords

Cardiovascular disease / CVD / fruits / serving size / vegetables

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