Fruit and vegetable consumption and health outcomes: An umbrella review of observational studies

Donato Angelino, Justyna Godos, Francesca Ghelfi, Maria Tieri, Lucilla Titta, Alessandra Lafranconi, Stefano Marventano, Elena Alonzo, Angelo Gambera, Salvatore Sciacca, Silvio Buscemi, Sumantra Ray, Fabio Galvano, Daniele Del Rio, Giuseppe Grosso

Research output: Contribution to journalArticlepeer-review

74 Citations (Scopus)


The aim of this study was to provide a comprehensive evaluation of current evidence on fruit and vegetable consumption and health outcomes. A systematic search for quantitative syntheses was performed. Several criteria, including study design, dose–response relationship, heterogeneity and agreement of results over time, and identification of potential confounding factors, were used to assess the level of evidence. The strongest (probable) evidence was found for cardiovascular disease protection; possible evidence for decreased risk of colon cancer, depression and pancreatic diseases was found for fruit intake; and colon and rectal cancer, hip fracture, stroke, depression and pancreatic diseases was found for vegetable intake. Suggestive and rather limited associations with other outcomes have been found. Evidence of potential confounding by sex and geographical localisation has been reported. Despite findings are consistent enough for hypothesising causation (at least for cardiovascular-related outcomes), further studies are needed to clarify the role of potential confounding factors.
Original languageEnglish
Pages (from-to)652-667
Number of pages16
JournalInternational Journal of Food Sciences and Nutrition
Issue number6
Early online date15 Feb 2019
Publication statusE-pub ahead of print - 15 Feb 2019

Bibliographical note

Unable to set exception as item shows affiliation to NICHE, UU for author.


  • Fruit
  • Vegetable
  • Umbrella review
  • Meta-analysis
  • Evidence
  • Cohort study


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