Another good reason to eat your fruits and vegetables

Your grandmother always told you, you couldn’t leave the table until you ate all your vegetables. She was giving you the essence of reducing your chances of dying from cardiovascular disease.

The trouble with testing any dietary hypothesis (even Grandma’s advice on vegetables) is the complexity of understanding nutrition. Unlike drugs, which are based on linear thinking (one drug affects one enzyme and that treats you), nutrition is based on non-linear thinking. That means nutrition is more like a three-dimensional chess match. Whenever you change one component (i.e. amount of fat) in the diet, there will be unintended changes as something else is automatically changed as a consequence (like either an increase in dietary protein or carbohydrate to make up the difference of the reduction of dietary fat). This secondary dietary change may totally obscure what you are trying to study. This explains why so many dietary studies appear to produce such wishy-washy results. To try to get around this constant dilemma, investigators often do extremely large epidemiological studies, using people who are initially disease-free and ask how an exposure to some dietary variable affects the development of a particular disease or more importantly death from a particular disease. These are called prospective cohort studies.

As you might imagine, there are very few of these studies since they require a very large number of subjects, and if the outcome is death, then they have to be followed for a very long time. This also means that these studies are extremely expensive. In a soon-to-be-published article in the European Heart Journal is a massive prospective cohort study (with more than 300,000 subjects and based upon an average of eight years of follow-up) that suggested if you ate more fruits and vegetables, your likelihood of dying of heart disease was reduced by 22 percent (1).

How much is more fruits and vegetables? It is about eight servings per day, and it appeared to be a dose-response effect. For each serving of fruits or vegetables, the risk of death from heart disease goes down by 4 percent. Bottom line, the more fruits and vegetables you eat, the greater the reduction in cardiovascular death.

Since you have to eat, why not eat right if your goal is reducing the risk of death from heart disease. If you are eating more fruits and vegetables, then something must be removed from the diet if the calories are to remain constant. The most logical choice would be reducing grains and starches as you increase fruits and vegetables. In the process, you reduce the glycemic load of the diet and reduce production of insulin. This will not only reduce your risk of dying from heart disease, but also help you lose excess body fat (2)

Notice that I keep emphasizing the words death and dying. The prevailing “wisdom” in the cardiovascular community is that it doesn’t matter what you eat as long as you reduce cholesterol levels. And since increased fruits and vegetables consumption has little impact on cholesterol levels, we are told that if you really want to reduce the risk of dying from heart disease, it’s imperative that you must take a statin drug for the rest of your life. Unfortunately, the research data doesn’t support such optimism. For example, if subjects are studied who have no heart disease (these are called primary prevention studies), then taking statin drugs has no impact on reducing their all-cause mortality (3). In other words, any reduction in cardiovascular death was offset by increases of death from other causes. Not such a good deal if your goal is reducing death whatever the cause. Another group of researchers came to the conclusion after analyzing a number of published trials using statin drugs for the primary prevention of developing heart disease, that there was no compelling reason for their use (4). Since the vast majority of the people taking statin drugs have no established heart disease, this would mean the continued prescription of these drugs comes close to health-care fraud.

But what if you already have heart disease? What is the best way to reduce the risk of dying from it? To answer that question, you undertake secondary prevention studies using death (it’s very easy to measure) as your clinical endpoint. In secondary prevention studies, statins will reduce cardiovascular mortality by about 20 percent in people who already have established heart disease. But if you really want to reduce the likelihood of dying from existing heart disease (like by 70 percent), then you not only have to have the patients increase their intake of fruits and vegetables, but also remove much of the omega-6 fatty acids from the diet and replace them with omega-3 fats (5).

If you do both of these dietary changes (replace grains and starches with more fruits and vegetables as well as replace omega-6 fats with omega-3 fats), then you are essentially following the anti inflammatory diet. That’s how you live longer whether you have heart disease or not.


1. Crowe FL, Roddam AW, Key TJ, et al. “Fruit and vegetable intake and mortality form ischaemic heart disease.” Eur Heart Journal 32: doi 10.1093 (2011)

2. Sears B. “The Zone.” Regan Books. New York, NY (1995)

3. Ray KK, Seshsai SRK, Erqou S, Sever P, Jukema JW, Ford I, and Sattar NS. “Statins and all-cause morality in high-risk primary prevention.” Arch Intern Med 170: 1024-1031 (2010)

4. Taylor F, Ward K, Moore THM, Burke M, Davey-Smith G, Casas JP, and Ebrahim S. “Statins for the primary prevention of cardiovascular disease.” The Cochrane Library Issue 1 (2011)

5. de Lorgeril M, Renaud S, Mamelle N, Salen P, Martin JL, Monjaud I, Guidollet J, Touboul P, and Delaye J. “Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease.” Lancet 343: 1454-1459 (1994)

Nothing contained in this blog is intended to be instructional for medial diagnosis or treatment. If you have a medical concern or issue, please consult your personal physician immediately.

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About Dr. Barry Sears

Dr. Barry Sears is a leading authority on the impact of the diet on hormonal response, genetic expression, and inflammation. A former research scientist at the Boston University School of Medicine and the Massachusetts Institute of Technology, Dr. Sears has dedicated his research efforts over the past 30 years to the study of lipids. He has published more than 30 scientific articles and holds 13 U.S. patents in the areas of intravenous drug delivery systems and hormonal regulation for the treatment of cardiovascular disease. He has also written 13 books, including the New York Times #1 best-seller "The Zone". These books have sold more than 5 million copies in the U.S. and have been translated into 22 different languages.

47 thoughts on “Another good reason to eat your fruits and vegetables

  1. The maqui concentrate that Scott is discussing is the most concentrated form with approximately 32,000 ORAC units per gram of material containing exceptionally high levels of delphinidins. It’s the delphinidin fraction that is reponsible for much of the anti-inflammatory activity.

  2. In this post you stated, “Since the vast majority of the people taking statin drugs have no established heart disease, this would mean the continued prescription of these drugs comes close to health-care fraud.” Can you tell me where I can access the information that this statement is based on.
    Will see if I can google the Cochrane Library Issue 1 2011.

    • It’s the balance of the protein to the glycemic load at each meal that is important for hormonal control. This is why adequate protein coupled with lots of vegetaqbles is the best prescription for fat loss.

    • I agree with you. It would be great if you could just plug in what you are about to eat and it would convert it to block. Do you have anything like that coming out soon?

      • Lot of people like it easy way to do anything. I started the Zone diet many years ago and I love it. I have lost 18 pounds, feel better and have more energy. I am 62 years old but I feel a lot younger. Now being in the Zone is very easy for me. I can just eyeball 3 blocks of protein. I don’t have to measure or calculate anything. Mainly I followed Dr Sears advise. Like for protein, if it is the size of palm of your hand, it is 3 blocks or the number of blocks you need.

    • I suggest that you compared the mortality data in reference #5 (the Lyon Diet Heart Study) to all the published statin studies. You will hard pressed to find any that reduces fatal heart attacks by 70% or completely eliminates sudden cardiac death. This is how I support my statements.

  3. I was just wondering if you have any suggestions on dealing with a shift work schedule and long days. I switch from days to nights, and afternoons that follows no patterns. I also work a 12 hour shift so am up for longer than my last meal of the day. How do you suggest I remain in the zone when I am up for 20- 24 hours, do I continue on with more meals or fast even though I’m not sleeping? Also, because I don’t have a regular routine day, will the zone still work for me when say on Monday my breakfast is at 7 am, but on tuesday it’s at 7 pm?

    Anyone have any suggestions? I eat 11 blocks a day.

  4. ORAC scores are derived from test-tube (in-vitro) experiments and while a high ORAC score is presumed to optimize human health and wellness, I am unaware of any peer-reviewed published papers that correlate in-vitro scores with in-vivo (a living human body). The reality is the human body is limited in its capacity to absorb nutrients and what is not metabolized is eliminated. I would guess that there is a degree of variability depending on many factors, intestinal flora, genetics, allergies, etc., etc.. This has been one of the research frustrations with the doses of reseveratrol necessary to see the same benefits in humans as seen in rats. And since less than 2% of rat research relates to humans these experiments must be kept in perspective. In light of all this I find eating whole foods as much as possible and taking the time to relish every bite keeps me feeling and looking great. BTW, did you know that simply slowing down and chewing your food not only improves your digestion but also the nutrients you absorb. The American Journal of Clinical Nutrition reported that people who chewed almonds 25-40 times absorbed more healthy unsaturated fats and felt more satisfied than when they finished in 10 chews. The extra chewing beaks down fiber and cells releasing nutrients and making them more bioavailable.

  5. With all this talk of the importance of actually “eating” fruits and vegetables, how does taking”pills” if you will, justify the good Dr.’s packets of “supplements”, (if I may use that term), as a better source of those nutrients. Ps I HAVE already purchased the $66 “Fish Oil” and the other starter nutrient packets that help enable the better obsotion or activation of the “oil”. A leap of faith from me…anyone……bueller…anyone?? lol

  6. Usually a serving is 1/2 cup of fruit or 1/2 of vegetables. However, the glycemic loads can be highly variable with those standard sizes. That’s why I like to use blocks to calculate the necessary amounts of carbohydrates to balance out the protein at a meal.

  7. 2 21 11
    At age 76…Now I find that many, if not most people over age 55 will develop Diverticulosis. And, as age increases the number of sufferers increases to at least 75 percent! A neighbor’s son who has it likes to call it “ticuloslis”. After reading a book By Dr. Joan McClelland, it seems the Zone Diet would be protective… she suggests a similar eating style. I wish I knew that twenty years ago. Doctors recommend a diet with no seeds, peanuts or peanut butter. Dr McClelland states there is little scientific information to support this. Question: She thinks it is not good to eat Melba toast. This brings a bio-chemistry professor to mind (Penn State about 1960) emphasizing that the brownish, outer layer of the common glazed doughnut is “practically indigtestable.”
    For snacks, do you think one would be correct in eating fewer Zone Bagel chips and Zone Cinnamon toast and substitute the softer zone cookies instead. It seems logical to me.

  8. For those looking for block calculating aids, have developed a block calculating aid. Cost nz 139.00. Kevin and Carol Bateman are certified zZone instructors.

  9. I love the concept and just read again the Age-free zone. I particularly like the concept initiated by Barry of seeing foods as constant IV drip of hormonal nutriments throughout the day.
    Best way to stay without hunger – feel nourisshed – clear headed and a great way to stay thin.

  10. I have been following the Zone nutritional plan for several months now. I have been running and doing CrossFit and have recently taken up cycling. I have no idea how to eat prior to or after a long ride. Any suggestions?

    • 30 to 45 minutes prior to your ride have a balanced Zone snack (about 100 calories) to start the hormonal responses you will need to maximize your metabolism during the exercise. Right after ride is the best time to reload muscle glycogen. This is most effectively accomplished with another Zone meal (at least 400 calories) within 2 hours after the ride and ideally 30 minutes after the ride.

  11. i am 32 years old i would like to lose weight but i have tryed everything loseing but did not succeded in that at all i really need help with it can you give me some sort of diet plan or i am going to get thuis access fat removed jea gray

    • Your problem lies with a lack of satiety. This can be enhanced with the right balance of the protein to the glycemic load at each meal and snack. If you are not hungry, then cutting back on calories is a lot easier. Losing body fat is a slow process and you can expect to lose about 1 pound of fat per week. Gastric bypass surgery fails in 25% of patients, so developing a life-long dietary program to control satiety should be your #1 goal. Clinically the anti inflammatory diet has been the most effective in burning fat faster than any other dietary program.

  12. Hello. I love the Zone but am in London and would love to find somewhere I could get some ZOne products, help etc. I can’t justify the costs of getting it from the states, are you going to bring anything over here? I tell everyone what a fantastic lifestyle (don’t say diet!!) the Zone is, but would just love to get more stuff here,l also would love to do a cruise but not easy from here either.

    Kindest regards


  13. We have an active program in Italy and Spain. In fact, I am leaving tomorrow to do a number of lectures in both countries. With time, we will hopefully be in England. The rate limiting step is developing of an appropriate partner to develop the necessary educational program to support any Zone products.

    • Hi Dr Sears

      What about down here in Australia? It would be great to buy Zone products that were actually made here. Shipping is very expensive from the US.


  14. What is your take on products like Juice Plus which recommends their product as a simple way of getting 17 fruits and vegetables a day. Is that too much? Or is even this supplement only effective when eaten with the proper balance of protein and fat? How do you put it in the zone, assuming you are not against this.

    • We checked out the ORAC levels of a complete day of Juice Plus products several years ago. The total ORAC intake was 800 ORAC units per day. One capsule of the Zone Polyphenols contains 8,000 ORAC units. The difference is that we use the isolated polyphenols as opposed to simply taking dried fruits and vegetables that still contain sugars and other non-polyphenol materials. Isolated polyphenols are quite expensive, but well worth it..

      I believe a person should take in at least 10,000 ORAC units per day. If one is taking fish oil as a supplement then more polyphenols are needed to protect the EPA and DHA from oxidation inside the body. That’s why I take about 40,000 ORAC units per day. It is virtually impossible to take too many polyphenols.

      Polyphenols work in their own right. They simply extend the anti-inflammatory properties of the Zone diet.

  15. I’m impressed, I must say. Actually rarely do I come across a web site that’s educative and exciting, and I want to tell you, you may have hit the nail on the head. Your concept is great; the difficulty is something that not sufficient people are discussing intelligently about. I’m really satisfied that I stumbled throughout this in my seek for something referring to it.

  16. Pingback: Vegetables and Fruits: Get Plenty Every Day |

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