Abstract P224: Higher Fruit and Vegetable Intake Was Associated With Lower Total and Cause-Specific Mortality in a Nonlinear Dose-Response Manner

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Dong D Wang ◽  
Shilpa N Bhupathiraju ◽  
Yanping Li ◽  
Bernard A Rosner ◽  
Qi Sun ◽  
...  

Introduction: The strength and dose-response relationship between fruit and vegetable intake and mortality are still subjects of debate. Hypothesis: We hypothesized that higher fruit and vegetable intake was associated with lower total and cause-specific mortality in a nonlinear dose-response manner. Methods: We followed 66,719 women from the Nurses’ Health Study (1984-2012) and 42,016 men from the Health Professionals Follow-up Study (1986-2012) who were free from cardiovascular disease (CVD), cancer and diabetes at baseline. Diet was assessed using food frequency questionnaires at baseline and updated every 2 to 4 years. Results: Our study documented 28,333 deaths during follow-up. The 3rd quintile of fruit and vegetable intake was associated with the lowest hazard ratio (HR) of total mortality (HR, 0.87, 95% CI, 0.83-0.90, P nonlinear <0.001) compared to the 1st quintile. The nonlinear dose-response relationship plateaued at about 5 servings/day (svg/d), but above that level, higher intake was not associated with additional risk reduction. We found similar nonlinear associations for CVD, cancer and respiratory disease mortality. Compared to fruit and vegetable intake <1.5 svg/d, the intake level ≥5 svg/d was associated with HRs (95% CI) of 0.84 (0.75-0.93), 0.82 (0.72-0.93) and 0.55 (0.44-0.67) for cancer, CVD and respiratory disease mortality, respectively. Among individual fruits and vegetables, the associations of intakes with mortality were heterogeneous. Higher intakes of most fruit and vegetable subgroups were associated with lower total mortality, whereas higher intake of starchy vegetable such as peas and corn was not associated with total mortality. Conclusions: Higher fruit and vegetable intake was associated with lower mortality; the lowest mortality was observed among those who consumed 5 servings of fruit and vegetables per day (2 servings of fruit and 3 servings of vegetables daily). Our findings also suggest the presence of heterogeneity in the health benefits of individual fruits and vegetables.

Circulation ◽  
2021 ◽  
Vol 143 (17) ◽  
pp. 1642-1654 ◽  
Author(s):  
Dong D. Wang ◽  
Yanping Li ◽  
Shilpa N. Bhupathiraju ◽  
Bernard A. Rosner ◽  
Qi Sun ◽  
...  

Background: The optimal intake levels of fruit and vegetables for maintaining long-term health are uncertain. Methods: We followed 66 719 women from the Nurses’ Health Study (1984–2014) and 42 016 men from the Health Professionals Follow-up Study (1986–2014) who were free from cardiovascular disease (CVD), cancer, and diabetes at baseline. Diet was assessed using a validated semiquantitative food frequency questionnaire at baseline and updated every 2 to 4 years. We also conducted a dose-response meta-analysis, including results from our 2 cohorts and 24 other prospective cohort studies. Results: We documented 33 898 deaths during the follow-up. After adjustment for known and suspected confounding variables and risk factors, we observed nonlinear inverse associations of fruit and vegetable intake with total mortality and cause-specific mortality attributable to cancer, CVD, and respiratory disease (all P nonlinear <0.001). Intake of ≈5 servings per day of fruit and vegetables, or 2 servings of fruit and 3 servings of vegetables, was associated with the lowest mortality, and above that level, higher intake was not associated with additional risk reduction. In comparison with the reference level (2 servings/d), daily intake of 5 servings of fruit and vegetables was associated with hazard ratios (95% CI) of 0.87 (0.85–0.90) for total mortality, 0.88 (0.83–0.94) for CVD mortality, 0.90 (0.86–0.95) for cancer mortality, and 0.65 (0.59–0.72) for respiratory disease mortality. The dose-response meta-analysis that included 145 015 deaths accrued in 1 892 885 participants yielded similar results (summary risk ratio of mortality for 5 servings/d=0.87 [95% CI, 0.85–0.88]; P nonlinear <0.001). Higher intakes of most subgroups of fruits and vegetables were associated with lower mortality, with the exception of starchy vegetables such as peas and corn. Intakes of fruit juices and potatoes were not associated with total and cause-specific mortality. Conclusions: Higher intakes of fruit and vegetables were associated with lower mortality; the risk reduction plateaued at ≈5 servings of fruit and vegetables per day. These findings support current dietary recommendations to increase intake of fruits and vegetables, but not fruit juices and potatoes.


2019 ◽  
Vol 110 (3) ◽  
pp. 759-768 ◽  
Author(s):  
Tiange Wang ◽  
Yoriko Heianza ◽  
Dianjianyi Sun ◽  
Yan Zheng ◽  
Tao Huang ◽  
...  

ABSTRACT Background Whether changes in fruit and vegetable intake can modify the effect of genetic susceptibility to obesity on long-term changes in BMI and body weight are uncertain. Objective We analyzed the interactions of changes in total and specific fruit and vegetable intake with genetic susceptibility to obesity in relation to changes in BMI and body weight. Methods We calculated a genetic risk score on the basis of 77 BMI-associated loci to determine the genetic susceptibility to obesity, and examined the interactions of changes in total and specific fruit and vegetable intake with the genetic risk score on changes in BMI and body weight within five 4-y intervals over 20 y of follow-up in 8943 women from the Nurses’ Health Study (NHS) and 5308 men from the Health Professionals Follow-Up Study (HPFS). Results In the combined cohorts, repeated 4-y BMI change per 10-risk allele increment was 0.09 kg/m2 among participants with the greatest decrease in total fruit and vegetable intake and −0.02 among those with the greatest increase in intake (P-interaction <0.001; corresponding weight change: 0.20 kg compared with −0.06 kg). The magnitude of decrease in BMI associated with increasing fruit and vegetable intake was more prominent among participants with high genetic risk than those with low risk. Reproducible interactions were observed for fruits and vegetables separately (both P-interaction <0.001). Based on similar nutritional content, the interaction effect was greatest for berries, citrus fruits, and green leafy vegetables, and the interaction pattern persisted regardless of the different fiber content or glycemic load of fruits and vegetables. Conclusions Genetically associated increased BMI and body weight could be mitigated by increasing fruit and vegetable intake, and the beneficial effect of improving fruit and vegetable intake on weight management was more pronounced in individuals with greater genetic susceptibility to obesity.


2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Hongrui Zhai ◽  
Yu Wang ◽  
Wenjie Jiang

Object. Results on the associations of fruit and vegetable intake with risk of chronic obstructive pulmonary disease (COPD) are still in conflict. Hence, we conducted a meta-analysis to quantitatively evaluate the association between fruit and vegetable intake and the risk of COPD. Methods. PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) were searched for relevant studies published up to September 2019. Combined relative risks (RRs) and 95% confidence intervals (CIs) were calculated with the random effects model (REM). Dose-response relationship was assessed by the restricted cubic spline model. Results. There are 8 studies involving 5,787 COPD cases among 244,154 participants included in this meta-analysis. For the highest versus the lowest level, the pooled RR of COPD was 0.75 (95% CI, 0.68–0.84; I2 = 46.7%) for fruits plus vegetables, 0.72 (95% CI, 0.66–0.79; I2 = 1.3%) for fruits, and 0.76 (95% CI, 0.63–0.92; I2 = 62.7%) for vegetables. In subgroup analysis of fruit plus vegetable intake and COPD risk, the inverse association exists in all three study designs. A nonlinear dose-response relationship was found for COPD risk with fruit (Pnon−linearity<0.01). Conclusions. This meta-analysis indicates that fruit and vegetable intake might be related to a lower risk of COPD.


2009 ◽  
Vol 13 (2) ◽  
pp. 276-282 ◽  
Author(s):  
Lin Li ◽  
Martha M Werler

AbstractObjectiveThe present study evaluated the association between fruit and vegetable intake and the incidence of upper respiratory tract infection (URTI) during pregnancy.DesignIn a cohort of 1034 North American women, each subject was asked retrospectively about their fruit and vegetable intake during the six months before the pregnancy and their occurrences of URTI during the first half of pregnancy. Multivariable-adjusted hazard ratios (HR) were calculated with Cox proportional hazards models.ResultsThe adjusted HR of URTI for women in the highest quartile (median 8·54 servings/d)v. the lowest quartile (median 1·91 servings/d) of total fruit and vegetable intake was 0·74 (95 % CI 0·53, 1·05) for the 5-month follow-up period and 0·61 (95 % CI 0·39, 0·97) for the 3-month follow-up period, respectively. A dose-related reduction of URTI risk according to quartile of intake was found in the 3-month (Pfor trend = 0·03) but not the 5-month follow-up. No association was found between either fruit or vegetable intake alone in relation to the 5-month or the 3-month risk of URTI.ConclusionsWomen who consume more fruits and vegetables have a moderate reduction in risk of URTI during pregnancy, and this benefit appears to be derived from both fruits and vegetables instead of either alone.


2020 ◽  
Vol 112 (6) ◽  
pp. 1540-1546 ◽  
Author(s):  
Teresa T Fung ◽  
Ellen A Struijk ◽  
Fernando Rodriguez-Artalejo ◽  
Walter C Willett ◽  
Esther Lopez-Garcia

ABSTRACT Background Prior research has suggested that the antioxidative and anti-inflammatory potential of fruits and vegetables may ameliorate aging-related frailty. Objective We sought to prospectively examine the association between fruit and vegetable intake and incident frailty in older women. Design We followed 78,366 nonfrail women aged ≥60 y from the Nurses’ Health Study from 1990 to 2014. In this analysis, the primary exposure was the intake of total fruits and vegetables, assessed with an FFQ administered 6 times during follow-up. Frailty was defined as having ≥3 of the following 5 criteria from the FRAIL scale: fatigue, poor strength, low aerobic capacity, having ≥5 illnesses, and ≥5% weight loss. Cox models adjusted for potential confounders were used to estimate HRs and 95% CIs for the association between fruit and vegetable intake and incident frailty. Results In total, 12,434 (15.9%) incident frailty cases were accrued during follow-up. Total fruit and vegetable intakes were associated with a lower risk of frailty (adjusted HR comparing 7+ servings/d compared with &lt;3 servings/d: 0.92; 95% CI: 0.85, 0.99). The inverse association appeared to be stronger for those with physical activity above the median (P-interaction &lt; 0.05). Among physically active women, compared with those who consumed &lt;3 servings/d, the HR for 7+ servings/d was 0.68 (95% CI: 0.57, 0.81). Conclusion Higher fruit and vegetable intake was associated with a lower risk of frailty in this cohort of US women aged ≥60 y. Because of limited evidence on intakes of fruits and vegetables and the development of frailty, more data are needed to confirm our results.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tessa R. Englund ◽  
Valisa E. Hedrick ◽  
Sofía Rincón-Gallardo Patiño ◽  
Lauren E. Kennedy ◽  
Kathryn W. Hosig ◽  
...  

Abstract Background In 2015, the Partnership for a Healthier America launched the branded Fruits & Veggies (FNV) Campaign to apply a unique industry-inspired marketing approach to promote fruit and vegetable sales and intake to moms and teens in two US pilot markets: Fresno, California and Hampton Roads, Virginia. The aims of this cross-sectional study were to: 1) assess brand awareness and fruit- and vegetable-related outcomes among FNV Campaign target audiences in the California and Virginia market locations; and 2) examine whether reported awareness of the FNV Campaign was associated with differences in fruit- and vegetable-related cognitive and behavioral outcomes. Methods Data for this cross-sectional study were collected using an online survey administered to a non-probability convenience sample (n = 1604; February–July 2017) of youth aged 14–20 years (n = 744) and moms aged 21–36 years (n = 860) in the two pilot markets. Descriptive statistics were computed and outcomes compared between unaware and aware respondents, controlling for sociodemographic covariates. Multivariate analysis of covariance (MANCOVA) was conducted to assess whether fruit- and vegetable-related attitude, belief, and encouragement outcomes differed by FNV Campaign awareness; logistic regression was used to examine associations between FNV brand awareness and dichotomous variables (fruit- and vegetable-related behavioral intentions, trying new fruits and vegetables); and ANCOVA was used to assess associations with daily fruit and vegetable intake frequency. Results Approximately 20% (n = 315/1604) of respondents reported awareness of the FNV Campaign. Youth that reported awareness of the FNV Campaign (n = 167, 22.4%) had higher intentions to buy (p = 0.003) and eat (p = 0.009) fruits and vegetables than unaware respondents. Mothers that reported awareness of the FNV Campaign (n = 148, 17.2%) reported greater encouragement for friends and family to eat fruits and vegetables (p = 0.013) and were approximately 1.5 times more likely to report trying a new fruit or vegetable (p = 0.04) than mothers unaware of the Campaign. Daily fruit and vegetable intake frequency did not differ by Campaign awareness. Conclusions FNV Campaign awareness was associated with limited but positive short- and intermediate-term cognitive and behavioral outcomes among target audience respondents. These findings can inform future research to enhance understanding and improve the FNV Campaign as it is expanded to new markets nationwide.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michelle C. Kegler ◽  
April Hermstad ◽  
Regine Haardörfer

Abstract Background The home provides the physical and social context for the majority of eating behaviors for U.S. adults. This study describes eleven dimensions of the home food environment among a national sample of U.S. adults and identifies which are associated with diet quality and overweight/obesity. Methods A national sample of U.S. adults ages 18 to 75 was recruited from an online survey panel. Respondents (n = 4942) reported on foods available in the home, including 1) fruit and vegetables, 2) salty snacks/sweets, 3) less healthy beverages, as well as 4) food placement, 5) shopping practices for fruits and vegetables, 6) food preparation, 7) portion control methods, 8) family meals from restaurants, 9) family household practices around TV and eating, 10) presence of a TV in the dining area, and 11) ownership of a scale. Self-reported height and weight, fruit and vegetable intake, and percent calories from fat were also assessed. Results Mean household size was 2.6, 32.7% had children in the home, and 23.1% lived alone. The majority were White (67.7%), with 12.3% Black and 14.3% Hispanic. Mean age was 44.4 and 48.3% were men. In multivariable models, seven features of the home food environment were associated with meeting the recommended fruit and vegetable intake guidelines, with food placement, meal preparation, frequency of shopping for fruit, and a greater variety of fruits and vegetables available in the home most strongly associated. Eight of 11 features were associated with percent energy from fat, including restaurant food for family meals, salty snacks and sweets availability, less healthy beverages availability, food placement, meal preparation, frequency of shopping for fruit, family eating with the TV on, and having a TV in the dining area. More diverse fruit and vegetable availability was associated with lower odds of overweight/obesity, and more frequent family eating while watching TV was associated with increased odds of overweight/obesity. Conclusion Targeting these dimensions of the home food environment may be a promising approach for future intervention research.


Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Linda M Oude Griep ◽  
Jeremiah Stamler ◽  
Queenie Chan ◽  
Linda van Horn ◽  
Lyn M Steffen ◽  
...  

Background: The color of the edible portion of fruits and vegetables, reflecting the presence of pigmented phytochemicals, may be used as an indicator of their nutrient profile. Previous cohort and intervention studies have documented beneficial associations of fruits and vegetables with blood pressure (BP). However, whether the color of fruits and vegetables is associated with BP is unknown. Methods: We used cross-sectional data from the International Study of Macro-/Micronutrients and Blood Pressure (INTERMAP) on 4,680 men and women ages 40-59 years from Japan, China, United Kingdom, and United States. During four visits, eight BP measurements and four 24-hr dietary recalls were completed. Fruits and vegetables were categorized in 4 color groups: green, orange/yellow, red/purple, and white. BP regression coefficients per 2SD higher intake were estimated using multivariable linear regression models. To estimate overall associations, country-specific regression coefficients were pooled, weighted by inverse of their variance. Adjustments were for age, gender, sample, intake of total energy and alcohol, 24-hr urinary sodium excretion, smoking, education, dietary supplement use, adherence to any special diet, history of cardiovascular diseases or diabetes, family history of hypertension, use of medication (antihypertensive, cardiovascular or for diabetes), body mass index, and intake of low-fat dairy, fibre-rich grain products, red and processed meats, fish and shellfish, and mutually for other fruit and vegetable color groups. Results: Average daily fruit plus vegetable intakes (g/1000 kcal) was 183 in the total population, varying from 129 in the United Kingdom to 222 in China. White fruits and vegetables contributed 32% of total fruit and vegetable intake, orange/yellow 27%, green 26%, and red/purple 15%. Fruit and vegetable color groups were weakly related to each other, partial r values ranged from 0.08 for green with red/purple to 0.15 for white with orange/yellow. Fruit and vegetable color groups were highly correlated with dietary and urinary potassium; highest correlation coefficients were for white fruits and vegetables (r=0.46 for dietary and r=0.26 for urinary potassium). Green fruits and vegetables were also highly related to beta-carotene (r=0.40) and dietary fiber (r=0.40), orange fruits and vegetables to vitamin C (r=0.59), and white fruits and vegetables to dietary fibre (r=0.49). Green fruit and vegetable intake higher by 90 g/1000 kcal was associated with a systolic BP difference of -1.19 mm Hg (P<0.05). Green fruits and vegetables comprised mainly green vegetables including: cabbages (52%), lettuces (21%), dark leafy (10%), and a heterogeneous group (17%). Other fruit and vegetable color groups and total fruits plus vegetables were not associated with BP. Conclusion: Higher intake of green fruits and vegetables may contribute to lower systolic BP.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Jessie L Parker ◽  
Liwei Chen ◽  
Diane C Mitchell ◽  
Hsin-Chieh Yeh ◽  
Cheryl Anderson ◽  
...  

Background: Increased intake of fruits and vegetables (F/V) may protect against adiposity, but effects on weight have been inconsistent. Our objective was to examine the relationship between fruit and vegetable intake and weight, using direct and indirect measures of dietary intake: self-reported 24-hour recall and serum carotenoid levels. Methods: Participants from the PREMIER lifestyle intervention trial were included in this analysis (n=554). Dietary measures included 24-hour dietary recalls and serum carotenoid levels, from a fasting blood sample. The outcome was weight in pounds. Nested linear mixed models were used to examine the association between F/V and weight. Results: Mean F/V increased from 4.6 (SD 2.4) to 5.6 (SD 3.2) (p=<.01), mean serum carotenoids increased from 53.2 (SD 31.9) to 68.1 (SD 42.5) (p=<.01). At 18 months, participants in the lowest quintile of fruit and vegetable change reported an average intake of 4.42.8 servings of fruits and vegetables, and those in the highest quintile of change reported an average intake of 7.73.2 servings. In a multivariate model adjusting for age, race, gender, intervention, energy, study site, and time, lower body weight was associated with higher F/V intake measured by dietary recall (−0.63 lbs, 95% CI −0.83 to −0.42, per 1 serving increase in F/V) and serum carotenoids (−0.13 lbs, 95% CI −0.15 to −0.11, per 1 ug/dl increase in carotenoids). Results were somewhat attenuated but consistent after additional adjustments for working heart rate, exercise, calories from sugar-sweetened beverages, marital and employment status, and alcohol use . Conclusions: Greater fruit and vegetable consumption was associated with decreased body weight. Results were consistent for both objective and self-reported measures of fruit and vegetable intake.


2019 ◽  
Vol 11 (12) ◽  
pp. 3398 ◽  
Author(s):  
Barbara Groele ◽  
Dominika Głąbska ◽  
Krystyna Gutkowska ◽  
Dominika Guzek

Fruit and vegetable intake is indicated among the features of sustainable diets, while children’s intake is strongly associated with the intake of their parents, as well as the availability of food products and their accessibility at home. The aim of the study was to analyze the mother-related determinants of children at-home fruit and vegetable dietary patterns in a Polish national sample of children aged 3–10 years. The random quota sampling (with quotas for age, education, and place of residence) was conducted to recruit the national representative sample of Polish mothers of children aged 3–10 years (n = 1200) who were interviewed using a Computer-Assisted Telephone Interviewing (CATI) method. They were asked about their children’s at-home fruit and vegetable dietary patterns, which were later compared in sub-groups that were stratified for age, educational background, marital status, place of residence, occupational status, and total net income in households. The indicated features, but not marital status, were indicated as determinants of children at-home fruit and vegetable dietary patterns. Children of younger mothers more often than others consumed fruits, whereas those of older mothers consumed vegetables. Children of mothers who had a lower level of education more commonly than others consumed fruits alone as a dish, and they had a higher preference for them, while those of mothers who had a higher level of education had a higher consumption of vegetables than others, although they had a medium preference for them. Children of mothers from villages had a lower consumption of vegetables and fruits than others, although they had a higher preference for fruits. Children of mothers with no professional job had a lower consumption of vegetables than others and more often consumed them processed, although they had a higher preference for fruits and vegetables. Children of mothers with low income had a lower consumption of vegetables than others and more often consumed fruits in a dish with other products, although they had a higher preference for fruits and vegetables. To summarize, an indication of a high preference for fruits and vegetables by mothers is not accompanied by the higher consumption and recommended dietary patterns for fruit and vegetable intake by their children. In particular, the sub-samples of mothers who had a low level of education, were from villages, did not have a professional job, and had low income may either overestimate the fruit and vegetable preference of their children or do not offer them sufficient amount of fruits and vegetables, although they indicate a higher preference. In order to encourage more sustainable diet following, in terms of the fruit and vegetable intake, it is essential to introduce actions toward the properly planned nutritional education for the indicated target groups.


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