scholarly journals Fruit and Vegetable Intake and Mortality

Circulation ◽  
2021 ◽  
Vol 143 (17) ◽  
pp. 1642-1654 ◽  
Author(s):  
Dong D. Wang ◽  
Yanping Li ◽  
Shilpa N. Bhupathiraju ◽  
Bernard A. Rosner ◽  
Qi Sun ◽  
...  
Keyword(s):  
Respiratory Disease ◽  
Dose Response ◽  
Fruits And Vegetables ◽  
Vegetable Intake ◽  
Meta Analysis ◽  
Total Mortality ◽  
Fruit And Vegetables ◽  
Fruit And Vegetable Intake ◽  
Specific Mortality

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.

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 ◽  
...  
Keyword(s):  
Dose Response ◽  
Fruits And Vegetables ◽  
Vegetable Intake ◽  
Total Mortality ◽  
Fruit And Vegetable Intake ◽  
Fruit And Vegetable ◽  
Dose Response Relationship ◽  
Disease Mortality ◽  
Specific Mortality

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.

scholarly journals Comparative validity of vitamin C and carotenoids as indicators of fruit and vegetable intake: a systematic review and meta-analysis of randomised controlled trials

2015 ◽  
Vol 114 (9) ◽  
pp. 1331-1340 ◽  
Author(s):  
Mary Pennant ◽  
Marinka Steur ◽  
Carmel Moore ◽  
Adam Butterworth ◽  
Laura Johnson
Keyword(s):  
Vitamin C ◽  
Dose Response ◽  
Vegetable Intake ◽  
Meta Analysis ◽  
Fruit And Vegetables ◽  
Fruit And Vegetable Intake ◽  
Fruit And Vegetable ◽  
Post Intervention ◽  
Blood Concentrations ◽  
Evidence Quality

AbstractCirculating vitamin C and carotenoids are used as biomarkers of fruit and vegetable intake in research, but their comparative validity has never been meta-analysed. PubMed, EMBASE, CENTRAL, CINAHL and Web of Science were systematically searched up to December 2013 for randomised trials of different amounts of fruit and vegetable provision on changes in blood concentrations of carotenoids or vitamin C. Reporting followed PRISMA guidelines. Evidence quality was assessed using the GRADE system. Random effects meta-analysis combined estimates and meta-regression tested for sub-group differences. In all, nineteen fruit and vegetable trials (n1382) measured at least one biomarker, of which nine (n667) included five common carotenoids and vitamin C. Evidence quality was low and between-trial heterogeneity (I2) ranged from 74 % for vitamin C to 94 % forα-carotene. Groups provided with more fruit and vegetables had increased blood concentrations of vitamin C,α-carotene,β-carotene,β-cryptoxanthin and lutein but not lycopene. However, no clear dose–response effect was observed. Vitamin C showed the largest between-group difference in standardised mean change from the pre-intervention to the post-intervention period (smd0·94; 95 % CI 0·66, 1·22), followed by lutein (smd0·70; 95 % CI 0·37, 1·03) andα-carotene (smd0·63; 95 % CI 0·25, 1·01), but all CI were overlapping, suggesting that none of the biomarkers responded more than the others. Therefore, until further evidence identifies a particular biomarker to be superior, group-level compliance to fruit and vegetable interventions can be indicated equally well by vitamin C or a range of carotenoids. High heterogeneity and a lack of dose–response suggest that individual-level biomarker responses to fruit and vegetables are highly variable.

scholarly journals Improving fruit and vegetable intake attenuates the genetic association with long-term weight gain

2019 ◽  
Vol 110 (3) ◽  
pp. 759-768 ◽  
Author(s):  
Tiange Wang ◽  
Yoriko Heianza ◽  
Dianjianyi Sun ◽  
Yan Zheng ◽  
Tao Huang ◽  
...  
Keyword(s):  
Body Weight ◽  
Genetic Susceptibility ◽  
Genetic Risk ◽  
Fruits And Vegetables ◽  
Vegetable Intake ◽  
Genetic Risk Score ◽  
Fruit And Vegetable Intake ◽  
Fruit And Vegetable

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.

scholarly journals Fruit and Vegetable Intake and the Risk of Chronic Obstructive Pulmonary Disease: A Dose-Response Meta-Analysis of Observational Studies

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Hongrui Zhai ◽  
Yu Wang ◽  
Wenjie Jiang
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Dose Response ◽  
Vegetable Intake ◽  
Meta Analysis ◽  
Fruit And Vegetable Intake ◽  
Chronic Obstructive ◽  
Response Relationship ◽  
Fruit And Vegetable ◽  
Dose Response Relationship ◽  
Obstructive Pulmonary Disease

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.

scholarly journals Low circulating 25-hydroxyvitamin D level is associated with increased colorectal cancer mortality: a systematic review and dose–response meta-analysis

2020 ◽  
Vol 40 (7) ◽  
Author(s):  
Guanghai Wu ◽  
Mei Xue ◽  
Yongjie Zhao ◽  
Youkui Han ◽  
Shuai Zhang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Sample Size ◽  
Dose Response ◽  
Meta Analysis ◽  
Geographic Location ◽  
Response Analysis ◽  
Hydroxyvitamin D ◽  
Specific Mortality ◽  
25 Hydroxyvitamin D

Abstract Epidemiological studies have suggested inconclusive associations between 25-hydroxyvitamin D (25(OH)D) and survival in patients with colorectal cancer (CRC). The aim of the present study was to quantitatively assess these associations. PubMed, EMBASE, and Web of Science databases were systematically searched for eligible studies. Subgroup analyses based on study geographic location, publication year, length of follow-up time, sample size, and stage were conducted to explore the potential sources of heterogeneity. Dose–response relationships and pooled hazard ratios (HR) for overall and CRC-specific survival comparing the highest versus the lowest categories of circulating 25(OH)D concentrations were assessed. Overall, 17 original studies with a total of 17,770 CRC patients were included. Pooled HR (95% confidence intervals) comparing highest versus lowest categories were 0.64 (0.55–0.72) and 0.65 (0.56–0.73) for overall and CRC-specific survival, respectively. Studies conducted in the U.S.A., with median follow-up time ≥ 8 years, larger sample size, and including stage I-III patients showed a more prominent association between 25(OH)D concentrations and overall survival. The dose–response analysis showed that the risk of all-cause mortality was reduced by 7% (HR = 0.93; 95% CI: 0.90, 0.95), and the risk of CRC-specific mortality was reduced by 12% (HR = 0.88; 95% CI: 0.84, 0.93) for each 20 nmol/l increment of 25(OH)D concentration. This meta-analysis provides evidences that a higher 25(OH)D concentration is associated with lower overall mortality and CRC-specific mortality.

scholarly journals Fruit and vegetable intake and risk of upper respiratory tract infection in pregnant women

2009 ◽  
Vol 13 (2) ◽  
pp. 276-282 ◽  
Author(s):  
Lin Li ◽  
Martha M Werler
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Fruits And Vegetables ◽  
Vegetable Intake ◽  
Fruit And Vegetable Intake ◽  
Upper Respiratory Tract ◽  
Fruit And Vegetable ◽  
Upper Respiratory

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.

scholarly journals The influence of fruit and vegetable intake on the nutritional status and plasma homocysteine levels of institutionalised elderly people

2007 ◽  
Vol 10 (3) ◽  
pp. 266-272 ◽  
Author(s):  
LM Bermejo ◽  
A Aparicio ◽  
P Andrés ◽  
AM López-Sobaler ◽  
RM Ortega
Keyword(s):  
Nutritional Status ◽  
Elderly People ◽  
Fruits And Vegetables ◽  
Vegetable Intake ◽  
Plasma Homocysteine ◽  
Fruit And Vegetables ◽  
Fruit And Vegetable Intake ◽  
Vitamin B ◽  
Fruit And Vegetable ◽  
Erythrocyte Folate

AbstractObjectiveTo determine the difference in the nutritional status of elderly people depending on their consumption of fruits and vegetables, and to study the possible association between the consumption of these foods and different cardiovascular risk factors, especially total plasma homocysteine (t-Hcys) levels.Design, setting and subjectsA cross-sectional study in 152 institutionalised older people from Madrid aged ≥ 65 years. Food and nutrient intakes were recorded over 7 days using the ‘precise individual weighing’ method. The weight, height, and waist and hip circumferences of all subjects were recorded, as were their α-erythrocyte glutathione reductase, serum B6, B12and folate levels, erythrocyte folate levels, t-Hcys levels, serum lipids and blood pressure. The experimental population was then divided into tertiles depending on the serving intake of fruit and vegetables (T1, < 2.29 servings day− 1; T2, 2.29–2.79 servings day− 1; and T3, >2.79 servings day− 1).ResultsCompared with T1 subjects, T3 subjects showed consumptions of cereals, pulses, meat, fish and eggs closer to those recommended (P < 0.05). In addition, the contribution of their diet towards covering the recommended daily intake of vitamin B1, niacin, vitamin B6, folic acid, vitamin C, B12, vitamin A, and P, Mg, Zn and Fe was higher. The intake of fibre increased with consumption of fruit and vegetables (r = 0.6839,P < 0.001). T3 subjects also had better serum and erythrocyte folate levels than T1 and T2 subjects (P < 0.05). A positive correlation was found between the consumption of fruit and vegetables and serum folate (r = 0.2665,P < 0.01) and with erythrocyte folate levels (r = 0.2034,P < 0.05), and a negative correlation with t-Hcys (r = − 0.2493,P < 0.01).ConclusionsGreater consumption of fruit and vegetables is associated with better food habits, increased vitamin and mineral intakes and lower t-Hcys levels. Considering that the fruit and vegetable intake in Spanish elderly people is very low, it is recommended that the consumption of fruits and vegetables by elderly people be increased.

scholarly journals Does the Royal Horticultural Society Campaign for School Gardening increase intake of fruit and vegetables in children? Results from two randomised controlled trials

2014 ◽  
Vol 2 (4) ◽  
pp. 1-162 ◽  
Author(s):  
Meaghan S Christian ◽  
Charlotte EL Evans ◽  
Janet E Cade
Keyword(s):  
Health Research ◽  
Vegetable Intake ◽  
Public Health Research ◽  
Fruit And Vegetables ◽  
Fruit And Vegetable Intake ◽  
Controlled Trials ◽  
Fruit And Vegetable ◽  
School Gardening ◽  
Randomised Controlled

BackgroundChildren’s fruit and vegetable intake in the UK is low. Changing intake is challenging. Gardening in schools might be a vehicle for facilitating fruit and vegetable intake.ObjectivesTo undertake the first clustered randomised controlled trials (RCTs) of a gardening intervention. To evaluate the impact of a school gardening programme, the Royal Horticultural Society (RHS) Campaign for School Gardening, on children’s fruit and vegetable intake.MethodsPrimary school children aged 8–11 years from eight London boroughs were included in one of two related RCTs. Trial 1 consisted of 23 schools, randomised to receive either a RHS-led or teacher-led intervention. Trial 2 consisted of 31 schools, randomised to either the teacher-led intervention or a comparison group. A 24-hour food diary [the Child And Diet Evaluation Tool (CADET)] collected baseline and follow-up dietary intake. Questionnaires measured children’s knowledge and attitudes towards fruit and vegetables and assessed intervention implementation. Data were collected by fieldworkers who were blind to the original allocation of the school. The primary outcome was change in fruit and vegetable intake analysed using a random effects model, based on intention to treat.ResultsTotal sample size at baseline for both trials (2529 children) was lower than the original aim of 2900 children. The final sample size was 1557, with 641 children completing trial 1 (RHS-led,n = 312; teacher-led,n = 329) and 916 children completing trial 2 (teacher-led,n = 488; control,n = 428). The response rate at follow-up for the two combined was 62%.Baseline analysis of children’s fruit and vegetable intake showed that eating a family meal together, cutting up fruit and vegetables, and parental modelling of fruit and vegetable intakes were all associated with higher intakes of fruit and vegetables in children.The primary trial outcome, combined fruit and vegetable intake, showed that in trial 1 the teacher-led group had a mean change in intake of 8 g [95% confidence interval (CI) –19 to 36 g], compared with a mean of –32 g (95% CI –60 to –3 g) in the RHS-led group. However, this difference was not significant (intervention effect –43 g, 95% CI –88 to 1 g;p = 0.06). In trial 2, the teacher-led group consumed 15 g (95% CI –36 to 148 g) more fruit and vegetables than the comparison group; this difference was not significant. No change was found in children’s knowledge and attitudes. However, if schools improved their RHS gardening score by three levels, children had a higher intake of 81 g of fruit and vegetables (95% CI 0 to 163 g;p = 0.05) compared with schools with no change in gardening score.ConclusionResults from these trials provide little evidence that school gardening alone can improve children’s fruit and vegetable intake. In both trials, gardening levels increased across all groups from baseline to follow-up, with no statistically significant difference between groups in terms of improvement in gardening level. This lack of differentiation between groups is likely to have influenced the primary outcome. However, when the gardening intervention was implemented at the highest intensities there was a suggestion that it could improve children’s fruit and vegetable intake by a portion. Analysis of the baseline data showed that family support for fruit and vegetable intakes was associated with higher intakes of fruit and vegetables in children. This study highlights the need for more sophisticated and accurate tools to evaluate diet in children. Future intervention designs should include a greater level of parental involvement in school interventions, along with related components such as cooking, to substantially improve children’s fruit and vegetable intake. In addition, the home environment has been demonstrated to be an important focus for intervention.Trial registrationCurrent Controlled Trials ISRCTN11396528.FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 2, No. 4. See the NIHR Journals Library website for further project information.

scholarly journals Fruit and vegetable intake and risk of frailty in women 60 years old or older

2020 ◽  
Vol 112 (6) ◽  
pp. 1540-1546 ◽  
Author(s):  
Teresa T Fung ◽  
Ellen A Struijk ◽  
Fernando Rodriguez-Artalejo ◽  
Walter C Willett ◽  
Esther Lopez-Garcia
Keyword(s):  
Lower Risk ◽  
Fruits And Vegetables ◽  
Vegetable Intake ◽  
Fruit And Vegetable Intake ◽  
Health Study ◽  
Inverse Association ◽  
Fruit And Vegetable ◽  
Cox Models ◽  
Physically Active

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.

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