Cost-effectiveness is modern medicine’s mantra. Put another way, when cheap solutions are found for common problems, let us embrace them.

One of medicine’s most common and vexing problems is death. It is a phenomenon with very close to 100% penetrance among the population. To date, no double-blind, crossover studies have been performed identifying a way to reduce its prevalence. However, a recently published study found a cheap and effective way to delay the onset of this condition. The Journal of Epidemiology and Community Health has just published an article which seems to point towards a very cheap and probably effective means to reduce mortality rates. The intervention that seems to work is salad. Yes, salad. Actually, fruits and vegetables themselves fill the bill also.

The intriguing study was not double-blinded, nor was there a crossover component. It was an observational analysis, but was nonetheless intriguing. The authors looked at over 65,000 adult British subjects (the country still being a monarchy) who completed annual health surveys between 2001-2008. During this time, 7% of the sample died. Notably, those who ate between one and three servings of fruit and veges per day had 12% lower mortality rates than those who ate less than one serving. Those who ate seven or more servings per day saw a 33% reduction in mortality.

A couple of random factoids from the study which you can drop at the dinner table while eating a nice crispy Caesar or spinach salad:

• The reduction in mortality seemed to be due to less cancer and less cardiovascular deaths.
• Vegetables were more protective than fruit.
• Consumption of frozen and canned fruit actually led to increased mortality.
• The trends towards lower death rates as vegetable and fruit consumption increased was even more impressive when the numbers for the first year of the study were dropped.
• The role of different types of salad dressings was not looked at in the study.

Yes, death will come to us all. But if there is a simple way to delay it, why not do so? As always, keep in mind that individual results may vary.

Richard Fleming, MD