New research indicates that when it comes to heart health, the types of fruits and vegetables consumed may be just as important as the amount.
Most healthy eating advice focuses on quantity: eat more fruits and vegetables, aim for five servings a day, and your heart will benefit. But new research suggests that when it comes to cardiovascular health, which fruits and vegetables you choose may be just as important as how many you eat.
Researchers from the University of Reading, Harvard Medical School, the University of California, Davis, and Mars, Inc. found that most people are not consuming enough flavanols, naturally occurring plant compounds linked to better heart health and a lower risk of cardiovascular disease. Surprisingly, this gap remained even among many people who regularly met recommended fruit and vegetable intake targets.
The study, published in Food and Function, analyzed biomarker data and dietary information from more than 30,000 people in the United Kingdom and the United States. Rather than relying solely on food questionnaires, researchers measured biomarkers that can provide a more objective picture of flavanol intake.
According to the findings, fewer than one in five participants consumed enough flavanols to reach levels previously associated with meaningful cardiovascular benefits.
Dr Javier Ottaviani, the paper’s lead author, said: “Flavanols can significantly reduce the risk of dying from cardiovascular disease, but only if you consume enough of them. Most people assume that eating plenty of fruit and vegetables covers this, but what this research shows is that the specific choices you make matter far more than the total amount. Including a handful of blackberries, a whole apple or having a cup of green tea alongside your meal could make a real difference to how much of these beneficial compounds you actually consume and absorb from the diet.”
Most People Fall Short of Recommended Flavanol Intake
Earlier research, including the COSMOS study, the largest clinical trial of flavanols to date, found that consuming 500 mg of flavanols per day significantly lowered the risk of death from heart disease. The new findings suggest that most people do not come close to reaching that amount, even when following general healthy eating recommendations such as the NHS Eatwell Guide.
Among the foods with the highest flavanol levels per serving are:
- Plums (500 g (17.6 oz), roughly one punnet): approximately 450 mg of flavanols
- Cranberries (250 g (8.8 oz), roughly one punnet): approximately 300 mg of flavanols
- Blackberries (200 g (7.1 oz), roughly one punnet): approximately 250 mg of flavanols
- Green tea (one 250 ml cup (8.5 fl oz)): approximately 200 mg of flavanols
- Broad beans/fava beans (80 g (2.8 oz), a small handful): approximately 140 mg of flavanols
- Cherries (400 g (14.1 oz), roughly one punnet): approximately 130 mg of flavanols
- Apples with skin (200 g (7.1 oz), one medium apple): approximately 110 mg of flavanols
- Strawberries (200 g (7.1 oz), roughly one punnet): approximately 90 mg of flavanols
- Blueberries (150 g (5.3 oz), roughly one punnet): approximately 80 mg of flavanols
- Pinto beans (40 g (1.4 oz), two tablespoons dry): approximately 70 mg of flavanols
Could Dietary Guidance Become More Specific?
The results suggest that dietary guidance may become more effective by focusing not only on the amount of fruits and vegetables people eat, but also on the specific foods they choose.
Professor Gunter Kuhnle of the University of Reading said: “Five-a-day is the right message, but we may need to think more carefully about which five. Different fruits and vegetables offer very different nutritional benefits beyond vitamins and minerals, and as our understanding of these compounds grows, there is a real opportunity to make dietary guidance more specific and more effective. This research is a step towards understanding what that might look like in practice.”
Reference: “Adhering to dietary guidelines does not yield flavanol intake levels associated with beneficial cardiovascular effects” by Javier I. Ottaviani, John W. Erdman, Francene M. Steinberg, JoAnn E. Manson, Howard D. Sesso, Hagen Schroeter and Gunter G. C. Kuhnle, 8 June 2026, Food & Function.
DOI: 10.1039/D6FO00867D
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