What does the research show about fruits and vegetables?

Fruits and vegetables

Pooled cohorts link more fruit and vegetables to lower death, heart disease and stroke. The lower death risk leveled off near 5 daily servings in two reviews and near 800 g a day in a third. Links to cancer and type 2 diabetes are weak. One trial lowered blood pressure. Fruit juice was not linked to longer life.

Add to Bio HackChecked 2026-11-13

Status: A food, not a regulated health product. The Dietary Guidelines for Americans, 2025-2030 say to eat whole vegetables and fruits in their original form, washed thoroughly before eating raw or cooking, with serving goals of 3 servings of vegetables and 2 of fruit a day on a 2,000-calorie pattern, and call for 100% fruit or vegetable juice in limited portions or diluted with water [1].
Also called: fruit, vegetables, fruit and vegetables, produce, five a day, 5 a day, leafy greens, green leafy vegetables, salad, berries, apples, citrus fruit, cruciferous vegetables, fruit juice, 100% fruit juice, orange juice
Studied for: longer life, heart health, stroke prevention, cancer prevention, type 2 diabetes prevention, blood pressure, weight loss, mood, depression

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

Shown to help7

StrongLinked to 13% lower death at 5 daily servings than at 2, in pooled cohorts. Lower risk leveled off near 5 servings in two reviews, 800 g in another.
StrongLinked to 8% lower coronary heart disease and cardiovascular disease per extra 200 g of fruit and vegetables a day, in pooled cohorts.
StrongLinked to 21% lower stroke at the highest fruit and vegetable intake than the lowest, and 16% lower per extra 200 g a day, in pooled cohorts.
ModerateLinked to 7% lower type 2 diabetes at the highest fruit and vegetable intake, a link the authors called weak. Fruit and green leafy vegetables showed clearer links than vegetables.
ModerateLinked to 17% lower depression at the highest fruit intake and 14% lower at the highest vegetable intake than the lowest, in pooled cohort studies.
LimitedOne trial found 2 extra daily servings of fresh fruit and vegetables raised vitality, flourishing and motivation over 14 days, with no change in depressive symptoms, anxiety or mood.
LimitedOne trial found systolic pressure fell 4.0 mmHg more over 6 months when adults were coached to eat more fruit and vegetables than in controls.

Reported risks4

ModerateLinked to 7% more type 2 diabetes per daily serving of fruit juice after adjusting for body fat, in pooled cohorts. The authors judged the finding likely to involve bias.How often is not known
ModerateLinked to a 0.03 higher BMI gain per daily serving of 100% fruit juice in children, in pooled cohorts. Adult trials found no significant weight change.How often is not known
ModerateMixed results: a systematic review found conflicting evidence that dietary vitamin K, as in leafy greens, changes anticoagulation with warfarin-type drugs, with effects possibly above 150 μg a day.How often is not known
LimitedUS outbreak data attributed 46% of foodborne illnesses to produce from 1998 to 2008, and more deaths to poultry than to any other food.How often is not known

What it was studied for, and what was found

Shown to help7

Strong

Death from any cause

Linked to 13% lower death at 5 daily servings than at 2, in pooled cohorts. Lower risk leveled off near 5 servings in two reviews, 800 g in another.

Compared with people eating 2 servings a day [2]; one fewer serving a day, in a dose-response model [3]; 200 g a day less, in a dose-response model [4]

The numbers and sources

Effect: Against 2 servings a day, 5 servings was linked to lower death from any cause (HR 0.87, 95% CI 0.85 to 0.90) in two US cohorts, and in a meta-analysis of 26 cohorts (RR 0.87, 95% CI 0.85 to 0.88). About 2 servings of fruit and 3 of vegetables had the lowest death rate, with no further fall above that level [2]. Each extra daily serving was linked to lower death (HR 0.95, 95% CI 0.92 to 0.98), with a threshold around 5 servings a day [3]. Each extra 200 g a day was linked to lower death (RR 0.90, 95% CI 0.87 to 0.93, I² 83%), with lower risk seen up to 800 g a day, about 10 servings of 80 g [4].
Population: 66,719 women and 42,016 men followed from the 1980s to 2014, plus 1,892,885 participants and 145,015 deaths in 26 cohorts [2]. 833,234 participants and 56,423 deaths in 16 cohorts followed 4.6 to 26 years [3]. 95 prospective studies [4].
Sources: [2], [3], [4]
Caveats: Observational. People who eat more fruit and vegetables differ in smoking, exercise and income (confounding), and illness can change what people eat (reverse causation). Heterogeneity was high in one review (I² 83%) [4]. The reviews disagree on where the lower risk levels off, near 5 servings [3][2] or near 800 g a day, which was at the high end of intakes studied [4].

Strong

Heart disease

Linked to 8% lower coronary heart disease and cardiovascular disease per extra 200 g of fruit and vegetables a day, in pooled cohorts.

Compared with 200 g a day less, in a dose-response model [4]; one fewer serving a day, in a dose-response model [3]; people eating 2 servings a day [2]

The numbers and sources

Effect: Per extra 200 g a day, the relative risk was 0.92 (95% CI 0.90 to 0.94, I² 0%) for coronary heart disease and 0.92 (95% CI 0.90 to 0.95) for cardiovascular disease, with lower risk seen up to 800 g a day. Apples and pears, citrus fruit, green leafy vegetables, cruciferous vegetables and salads were each linked to lower cardiovascular disease [4]. Each extra daily serving was linked to lower cardiovascular death (HR 0.96, 95% CI 0.92 to 0.99) [3]. Five servings a day against 2 was linked to lower cardiovascular death (HR 0.88, 95% CI 0.83 to 0.94) [2].
Population: 15 studies for coronary heart disease and 13 for cardiovascular disease [4]. 16 cohorts [3]. Two US cohorts of 108,735 adults [2].
Sources: [4], [3], [2]
Caveats: Observational, with the confounding and reverse causation limits above.

Strong

Stroke

Linked to 21% lower stroke at the highest fruit and vegetable intake than the lowest, and 16% lower per extra 200 g a day, in pooled cohorts.

Compared with the lowest intake category [5]; 200 g a day less, in a dose-response model [4][5]

The numbers and sources

Effect: At the highest against the lowest intake, the relative risk of stroke was 0.79 (95% CI 0.75 to 0.84) for fruit and vegetables, 0.77 (95% CI 0.71 to 0.84) for fruit and 0.86 (95% CI 0.79 to 0.93) for vegetables. Each extra 200 g a day was linked to 32% lower risk for fruit (RR 0.68, 95% CI 0.56 to 0.82) and 11% lower for vegetables (RR 0.89, 95% CI 0.81 to 0.98) [5]. A second review found a relative risk of 0.84 (95% CI 0.76 to 0.92, I² 73%) per 200 g a day of fruit and vegetables [4].
Population: 760,629 participants and 16,981 strokes in 20 cohorts [5]. 10 studies [4].
Sources: [5], [4]
Caveats: Observational. Heterogeneity was high in the second review (I² 73%) [4].

Moderate

Type 2 diabetes

Linked to 7% lower type 2 diabetes at the highest fruit and vegetable intake, a link the authors called weak. Fruit and green leafy vegetables showed clearer links than vegetables.

Compared with the lowest intake category [6]; one fewer serving a day, in a dose-response model [7]

The numbers and sources

Effect: At the highest against the lowest intake, the relative risk was 0.93 (95% CI 0.89 to 0.98) for fruit and vegetables, 0.93 (95% CI 0.90 to 0.97) for fruit and 0.95 (95% CI 0.88 to 1.02) for vegetables. Per 200 g a day of fruit and vegetables it was 0.98 (95% CI 0.95 to 1.01) [6]. Each extra daily serving of fruit was linked to 7% lower risk (RR 0.93, 95% CI 0.88 to 0.99), and each 0.2 extra servings of green leafy vegetables to 13% lower risk (RR 0.87, 95% CI 0.81 to 0.93). Fruit and vegetables combined showed no significant link [7].
Population: 23 cohort studies [6]. 434,342 participants and 24,013 cases in 10 cohort reports [7].
Sources: [6], [7]
Caveats: Observational. The authors described the link as weak, and links for single fruits and vegetables rest on few studies [6].

Moderate

Depression

Linked to 17% lower depression at the highest fruit intake and 14% lower at the highest vegetable intake than the lowest, in pooled cohort studies.

Compared with the lowest intake category [8]

The numbers and sources

Effect: In cohort studies, the relative risk of depression at the highest against the lowest intake was 0.83 (95% CI 0.71 to 0.98) for fruit and 0.86 (95% CI 0.75 to 0.98) for vegetables. Cross-sectional studies gave 0.76 for fruit and 0.75 for vegetables. Each extra 100 g a day of fruit or of vegetables was linked to 3% lower risk in cohort studies [8].
Population: 27 publications, 16 cross-sectional, 9 cohort and 2 case-control, with 18 studies pooled [8].
Sources: [8]
Caveats: Observational, and most studies measured diet and mood at one time point. Low mood can lower appetite for fresh food, which runs the link backward (reverse causation).

Limited

Vitality and wellbeing in a trial

One trial found 2 extra daily servings of fresh fruit and vegetables raised vitality, flourishing and motivation over 14 days, with no change in depressive symptoms, anxiety or mood.

Compared with diet as usual, and text message reminders with a voucher to buy fruit and vegetables [9]

The numbers and sources

Effect: Only the group given 2 extra daily servings of fresh fruit and vegetables improved in vitality, flourishing and motivation across 14 days, against the other two groups. Depressive symptoms, anxiety and daily mood did not change. The gains were not explained by blood vitamin C or carotenoids [9].
Population: 171 young adults aged 18 to 25, 67% female, who ate little fruit and vegetables [9].
Sources: [9]
Caveats: One short trial with self-reported outcomes, in which participants knew their group.

Limited

Blood pressure

One trial found systolic pressure fell 4.0 mmHg more over 6 months when adults were coached to eat more fruit and vegetables than in controls.

Compared with a control group not given the intervention [10]

The numbers and sources

Effect: Self-reported intake rose by 1.4 portions a day in the intervention group and 0.1 in controls. Systolic pressure fell 4.0 mmHg more (95% CI 2.0 to 6.0) and diastolic 1.5 mmHg more (95% CI 0.2 to 2.7) than in controls. Plasma carotenes and vitamin C rose more, and total cholesterol changes did not differ between groups [10].
Population: 690 healthy adults aged 25 to 64 from a UK primary care health center, followed 6 months [10].
Sources: [10]
Caveats: One trial, with intake self-reported.

Mixed results1

Moderate

Body weight

Mixed results: one pooled analysis of trials found 0.54 kg less weight with more fruit and vegetables, while another found no effect on weight loss.

Compared with trial arms eating fewer fruit and vegetables [11]; control groups the abstract does not describe [12]

The numbers and sources

Effect: In 8 trials of adding fruit and vegetables without advice to cut other foods, weight change was 0.54 kg lower (95% CI -1.05 to -0.04, I² 73%) in the high intake arms, and energy intake did not differ significantly. The arms differed by a mean 133 g a day [11]. In trials aimed at weight loss or preventing gain, the effect size was -0.16 (95% CI -0.78 to 0.46) in 2 trials meeting all criteria and 0.04 (95% CI -0.10 to 0.17) in 7 trials meeting all or most [12].
Population: 1,026 participants in 8 trials lasting 4 to 52 weeks, mean 14.7 weeks [11]. 7 trials of at least 8 weeks [12].
Sources: [11], [12]
Caveats: Few trials, with high heterogeneity in the first review [11].

Not shown to help1

Limited

Fruit juice and death

Limited evidence: in two US cohorts, fruit juice was not linked to death from any cause or from specific causes, unlike whole fruit.

Compared with people drinking less fruit juice [2]

The numbers and sources

Effect: Higher intakes of most fruits and vegetables were linked to lower death, while intakes of fruit juice, and of starchy vegetables such as potatoes, peas and corn, were not linked to total or cause-specific death [2].
Population: 66,719 women and 42,016 men in two US cohorts [2].
Sources: [2]
Caveats: Observational, from one research group's cohorts.

Amounts studied

Cohort reviews modeled risk per 200 g a day and used 80 g as a serving, with the lowest risk at 800 g a day, about 10 servings, for heart disease, stroke and death, and at 550 to 600 g a day, 7 to 7.5 servings, for total cancer [4]. Another used 77 g for a vegetable serving and 80 g for fruit [3]. The US cohorts found the lowest death rate at about 5 servings a day, 2 of fruit and 3 of vegetables [2]. The trials added a mean 133 g a day for a mean 14.7 weeks [11], 2 servings a day for 14 days [9], and 1.4 portions a day over 6 months [10]. The Dietary Guidelines set goals of 3 servings of vegetables and 2 of fruit a day [1].

Risks

Reported risks3

ModerateHow often is not known

Fruit juice and type 2 diabetes

Linked to 7% more type 2 diabetes per daily serving of fruit juice after adjusting for body fat, in pooled cohorts. The authors judged the finding likely to involve bias.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Each daily serving of fruit juice was linked to 5% higher type 2 diabetes (95% CI -1% to 11%) before adjusting for adiposity and 7% (95% CI 1% to 14%) after. The link was not significant in studies that measured diabetes objectively [13]. A later review found positive links for fruit juice and fruit drinks, based on few studies [6].
Population: 17 cohorts with 38,253 cases over 10,126,754 person-years [13]. 23 cohorts [6].
Sources: [13], [6]
Caveats: Observational, with high heterogeneity (I² 51% to 58%) [13].

ModerateHow often is not known

Fruit juice and weight gain in children

Linked to a 0.03 higher BMI gain per daily serving of 100% fruit juice in children, in pooled cohorts. Adult trials found no significant weight change.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: In children, each extra daily serving of 100% fruit juice was linked to a 0.03 higher BMI change (95% CI 0.01 to 0.05). In adult cohorts, weight gain was 0.21 kg (95% CI 0.15 to 0.27) in studies not adjusted for calories and -0.08 kg in studies that were. Adult trials found no significant change against noncaloric drinks (-0.53 kg, 95% CI -1.55 to 0.48) [14].
Population: 45,851 children with a median age of 8 in 17 cohorts. 268,095 adults in 6 cohorts and 19 trials [14].
Sources: [14]
Caveats: No trials in children. The adult trial interval was wide [14].

LimitedHow often is not known

Foodborne illness from produce

US outbreak data attributed 46% of foodborne illnesses to produce from 1998 to 2008, and more deaths to poultry than to any other food.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Using outbreak data, the authors attributed 46% of an estimated more than 9 million yearly US foodborne illnesses from major pathogens to produce [15].
Population: US foodborne disease outbreaks, 1998 to 2008 [15].
Sources: [15]
Caveats: An estimate from outbreak data, which the authors note may not reflect all foodborne illness. It is a share of illnesses, not a rate among people who eat produce.

Mixed results1

ModerateHow often is not known

Vitamin K and warfarin

Mixed results: a systematic review found conflicting evidence that dietary vitamin K, as in leafy greens, changes anticoagulation with warfarin-type drugs, with effects possibly above 150 μg a day.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Across 2 dietary trials and 9 observational studies, some found that higher vitamin K intake went with falls in INR, while others suggested a minimum intake was needed for stable anticoagulation. Median vitamin K1 intakes were 76 to 217 μg a day, and an effect may appear only above 150 μg a day. The authors found that restricting dietary vitamin K did not appear to improve anticoagulation quality [16].
Population: People taking vitamin K antagonists for atrial fibrillation, prosthetic heart valves or venous clots, in 11 studies [16].
Sources: [16]
Caveats: Studies varied in INR targets and in how stability was measured [16].

Claims tested and not found

That eating more fruit and vegetables leads to weight loss on its own. In trials aimed at weight loss, adding fruit and vegetables had no discernible effect on weight [12].
That eating more fruit and vegetables lifts depressive symptoms within weeks. In a 14-day trial, 2 extra daily servings did not change depressive symptoms, anxiety or mood [9].
That fruit juice is linked to longer life the way whole fruit is. In two US cohorts, fruit juice was not linked to total or cause-specific death [2].

Fiber supplements Grapefruit Added sugar Dietary nitrate Mediterranean diet

Sources

US Department of Agriculture and US Department of Health and Human Services. Dietary Guidelines for Americans, 2025-2030. realfood.gov. 2026. https://cdn.realfood.gov/DGA.pdf
Wang DD, Li Y, Bhupathiraju SN, et al. Fruit and Vegetable Intake and Mortality: Results From 2 Prospective Cohort Studies of US Men and Women and a Meta-Analysis of 26 Cohort Studies. Circulation. 2021. https://doi.org/10.1161/circulationaha.120.048996
Wang X, Ouyang Y, Liu J, et al. Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies. BMJ. 2014. https://doi.org/10.1136/bmj.g4490
Aune D, Giovannucci E, Boffetta P, et al. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality: a systematic review and dose-response meta-analysis of prospective studies. International Journal of Epidemiology. 2017. https://doi.org/10.1093/ije/dyw319
Hu D, Huang J, Wang Y, et al. Fruits and vegetables consumption and risk of stroke: a meta-analysis of prospective cohort studies. Stroke. 2014. https://doi.org/10.1161/strokeaha.114.004836
Halvorsen RE, Elvestad M, Molin M, Aune D. Fruit and vegetable consumption and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of prospective studies. BMJ Nutrition, Prevention and Health. 2021. https://doi.org/10.1136/bmjnph-2020-000218
Li M, Fan Y, Zhang X, et al. Fruit and vegetable intake and risk of type 2 diabetes mellitus: meta-analysis of prospective cohort studies. BMJ Open. 2014. https://doi.org/10.1136/bmjopen-2014-005497
Saghafian F, Malmir H, Saneei P, et al. Fruit and vegetable consumption and risk of depression: accumulative evidence from an updated systematic review and meta-analysis of epidemiological studies. British Journal of Nutrition. 2018. https://doi.org/10.1017/s0007114518000697
Conner TS, Brookie KL, Carr AC, et al. Let them eat fruit! The effect of fruit and vegetable consumption on psychological well-being in young adults: A randomized controlled trial. PLOS ONE. 2017. https://doi.org/10.1371/journal.pone.0171206
John JH, Ziebland S, Yudkin P, et al. Effects of fruit and vegetable consumption on plasma antioxidant concentrations and blood pressure: a randomised controlled trial. The Lancet. 2002. https://doi.org/10.1016/s0140-6736(02)98858-6
Mytton OT, Nnoaham K, Eyles H, et al. Systematic review and meta-analysis of the effect of increased vegetable and fruit consumption on body weight and energy intake. BMC Public Health. 2014. https://doi.org/10.1186/1471-2458-14-886
Kaiser KA, Brown AW, Bohan Brown MM, et al. Increased fruit and vegetable intake has no discernible effect on weight loss: a systematic review and meta-analysis. The American Journal of Clinical Nutrition. 2014. https://doi.org/10.3945/ajcn.114.090548
Imamura F, O'Connor L, Ye Z, et al. Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. BMJ. 2015. https://doi.org/10.1136/bmj.h3576
Nguyen M, Jarvis SE, Chiavaroli L, et al. Consumption of 100% Fruit Juice and Body Weight in Children and Adults: A Systematic Review and Meta-Analysis. JAMA Pediatrics. 2024. https://doi.org/10.1001/jamapediatrics.2023.6124
Painter JA, Hoekstra RM, Ayers T, et al. Attribution of foodborne illnesses, hospitalizations, and deaths to food commodities by using outbreak data, United States, 1998-2008. Emerging Infectious Diseases. 2013. https://doi.org/10.3201/eid1903.111866
Violi F, Lip GY, Pignatelli P, Pastori D. Interaction Between Dietary Vitamin K Intake and Anticoagulation by Vitamin K Antagonists: Is It Really True?: A Systematic Review. Medicine. 2016. https://doi.org/10.1097/md.0000000000002895

Everything in the library

Shown to help7

Reported risks4

What it was studied for, and what was found

Shown to help7

Mixed results1

Not shown to help1

Amounts studied

Risks

Reported risks3

Mixed results1

Claims tested and not found

Related

Sources