Background

Fruits and Vegetables (FV) consumption is crucial for the prevention of noncommunicable diseases (NCDs), especially in subjects with obesity since they are more prone to develop NCDs compared to the general population. However, it has been widely shown that FV intake is below than that recommended from international guidelines. For this reason, several companies offer FV concentrates, but it remains unclear whether they represent a potentially effective means of reducing the burden of NCDs. The present study aimed at assessing the effect on cardiovascular health of supplementation with FV concentrates of subjects suffering of metabolic syndrome and/or obesity.

Methods

We used a Markov chain simulation model to simulate the effectiveness of supplementing the US population affected by metabolic syndrome/obesity with FV concentrates by linking the direct effect of each concentrate on a clinical surrogate (total cholesterol (TC), low-density lipoprotein (LDL), plasmatic homocysteine (HCY), systolic blood pressure (SBP)) with the effect of the same surrogate on coronary heart diseases (CHD), heart failure (HF) or stroke. For the linkage between FV concentrate and the clinical surrogates, data from nutritional trials were used. A systematic review on Pubmed, Scopus, Embase, and Web of Science according to the PRISMA guidelines was done to identify such nutritional trials. For linkage between clinical surrogates and CHD/HF/stroke, data from a recent meta-analysis were used.

Results

Supplementation had only a small effect on the prevention of CHD/HF/stroke events. Orange juice concentrate seemed to be the most effective in preventing CHD cases, which resulted in the prevention of 29.12 (95% C.I. 18.34-57.4) and 22.47 (13.5-49.67) million cases through the effect on TC and LDL, respectively, in 2025.

Conclusions

Further large clinical trials should be done to better clarify the role of FV concentrates on cardiovascular health of such subjects.