Methods for determining diet and disease relationships rely on approaches that include measurement errors and biases, which contributes to the disparities in study outcomes.  Many studies have reported the health benefits of fruit and vegetable consumption on several non-communicable diseases, but the quantities needed to gain the benefit vary among studies.  Biomarkers are being developed to reflect consumption of individual fruits and vegetables.  However, an estimate of total fruit and vegetable consumption has yet to be established.  Owen and colleagues conducted a study to address this need and report their results in the April 2021 issue of The Journal of Nutrition.

The data used for their analyses were obtained from the National Diet and Nutrition Survey, which is a continuous, cross-sectional survey of the general population in the UK.  Intake data were derived from a 4 day food diary.  Data for model development included the intake of 96 fruits and vegetables from 1746 subjects during years 5-6.  Data for validation of the model generated was from years 7-8 of the study and included 1865 independent observations.

The predicted model included data for tomatoes, apples, carrots, bananas, pears, strawberries, and onions.  Both the observed and predicted total fruit and vegetable intakes were positively correlated in the model development and validation groups (R2 = 0.761 and 0.702, respectively).  The authors concluded it may be possible to use a concise list of fruits and vegetables to predict total fruit and vegetable intake, and that those included would make viable targets for biomarker development.

In a commentary on this article, Landberg agrees that this approach could reduce the information necessary to estimate total fruit and vegetable intake.  Considering that patterns of fruits and vegetables consumed by different populations vary, Landberg suggests it may be difficult to develop a set of biomarkers that reflects total fruit and vegetable intake in different populations.


Owen EJ, Patel S, Flannery O, Dew TP, O’Connor LM.  Derivation and validation of a total fruit and vegetable intake prediction model to identify targets for biomarker discovery using the UK National Diet and Nutrition Survey.  Journal of Nutrition, Volume 151, Issue 4, April 2021, Pages 962–969,

Landberg R. Does simplified estimation of total fruit and vegetable intake pave the way for accurate biomarkers of the same?  Journal of Nutrition, Volume 151, Issue 4, April 2021, Pages 751–752,

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