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Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies

International journal of epidemiology, 2017-06, Vol.46 (3), p.1029-1056 [Peer Reviewed Journal]

The Author 2017. Published by Oxford University Press on behalf of the International Epidemiological Association ;The Author 2017. Published by Oxford University Press on behalf of the International Epidemiological Association 2017 ;ISSN: 0300-5771 ;EISSN: 1464-3685 ;DOI: 10.1093/ije/dyw319 ;PMID: 28338764

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  • Title:
    Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies
  • Author: Aune, Dagfinn ; Giovannucci, Edward ; Boffetta, Paolo ; Fadnes, Lars T ; Keum, NaNa ; Norat, Teresa ; Greenwood, Darren C ; Riboli, Elio ; Vatten, Lars J ; Tonstad, Serena
  • Subjects: Cardiovascular Diseases - mortality ; Diet ; Fruit ; Humans ; Miscellaneous ; Mortality ; Neoplasms - mortality ; Prospective Studies ; Risk Reduction Behavior ; Vegetables
  • Is Part Of: International journal of epidemiology, 2017-06, Vol.46 (3), p.1029-1056
  • Description: Questions remain about the strength and shape of the dose-response relationship between fruit and vegetable intake and risk of cardiovascular disease, cancer and mortality, and the effects of specific types of fruit and vegetables. We conducted a systematic review and meta-analysis to clarify these associations. PubMed and Embase were searched up to 29 September 2016. Prospective studies of fruit and vegetable intake and cardiovascular disease, total cancer and all-cause mortality were included. Summary relative risks (RRs) were calculated using a random effects model, and the mortality burden globally was estimated; 95 studies (142 publications) were included. For fruits and vegetables combined, the summary RR per 200 g/day was 0.92 [95% confidence interval (CI): 0.90-0.94, I 2  = 0%, n  = 15] for coronary heart disease, 0.84 (95% CI: 0.76-0.92, I 2  = 73%, n  = 10) for stroke, 0.92 (95% CI: 0.90-0.95, I 2  = 31%, n  = 13) for cardiovascular disease, 0.97 (95% CI: 0.95-0.99, I 2  = 49%, n  = 12) for total cancer and 0.90 (95% CI: 0.87-0.93, I 2  = 83%, n  = 15) for all-cause mortality. Similar associations were observed for fruits and vegetables separately. Reductions in risk were observed up to 800 g/day for all outcomes except cancer (600 g/day). Inverse associations were observed between the intake of apples and pears, citrus fruits, green leafy vegetables, cruciferous vegetables, and salads and cardiovascular disease and all-cause mortality, and between the intake of green-yellow vegetables and cruciferous vegetables and total cancer risk. An estimated 5.6 and 7.8 million premature deaths worldwide in 2013 may be attributable to a fruit and vegetable intake below 500 and 800 g/day, respectively, if the observed associations are causal. Fruit and vegetable intakes were associated with reduced risk of cardiovascular disease, cancer and all-cause mortality. These results support public health recommendations to increase fruit and vegetable intake for the prevention of cardiovascular disease, cancer, and premature mortality.
  • Publisher: England: Oxford University Press
  • Language: English
  • Identifier: ISSN: 0300-5771
    EISSN: 1464-3685
    DOI: 10.1093/ije/dyw319
    PMID: 28338764
  • Source: GFMER Free Medical Journals
    MEDLINE
    Alma/SFX Local Collection
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