Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies

By Xia Wang, Yingying Ouyang, Jun Liu, Minmin Zhu, Gang Zhao, W. Bao, F. B. Hu. British medical journal, 2014

1,528 citations recorded by the source corpus.

Objective To examine and quantify the potential dose-response relation between fruit and vegetable consumption and risk of all cause, cardiovascular, and cancer mortality. Data sources Medline, Embase, and the Cochrane library searched up to 30 August 2013 without language restrictions. Reference lists of retrieved articles. Study selection Prospective cohort studies that reported risk estimates for all cause, cardiovascular, and cancer mortality by levels of fruit and vegetable consumption. Data synthesis Random effects models were used to calculate pooled hazard ratios and 95% confidence intervals and to incorporate variation between studies. The linear and non-linear dose-response relations were evaluated with data from categories of fruit and vegetable consumption in each study. Results Sixteen prospective cohort studies were eligible in this meta-analysis. During follow-up periods ranging from 4.6 to 26 years there were 56 423 deaths (11 512 from cardiovascular disease and 16 817 from cancer) among 833 234 participants. Higher consumption of fruit and vegetables was significantly associated with a lower risk of all cause mortality. Pooled hazard ratios of all cause mortality were 0.95 (95% confidence interval 0.92 to 0.98) for an increment of one serving a day of fruit and vegetables (P=0.001), 0.94 (0.90 to 0.98) for fruit (P=0.002), and 0.95 (0.92 to 0.99) for vegetables (P=0.006). There was a threshold around five servings of fruit and vegetables a day, after which the risk of all cause mortality did not reduce further. A significant inverse association was observed for cardiovascular mortality (hazard ratio for each additional serving a day of fruit and vegetables 0.96, 95% confidence interval 0.92 to 0.99), while higher consumption of fruit and vegetables was not appreciably associated with risk of cancer mortality. Conclusions This meta-analysis provides further evidence that a higher consumption of fruit and vegetables is associated with a lower risk of all cause mortality, particularly cardiovascular mortality.

Subfields: Cancer Research, Health, Toxicology and Mutagenesis, Public Health, Environmental and Occupational Health

View Paper: https://www.semanticscholar.org/paper/481b29f7e9e42d4ab03581e62fda749c805b37df

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Citations in the corpus

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 (2017, background): “In addition, we found significant inverse associations with overall cancer risk, which is consistent with data for some individual cancer sites, but in contrast to the previous meta-analysis which may have had limited power to detect a weak association.(41) An interesting finding in the present meta”
Epigenetic clock analysis of diet, exercise, education, and lifestyle factors (2017, positive): “This is in agreement with the wide range of literature supporting the protective effects of high fruit and vegetable intake against age-related diseases CHD [77, 78], stroke [79], type-2 diabetes [80], breast cancer[81], and all-cause mortality [82].”
2016 European Guidelines on cardiovascular disease prevention in clinical practice (2016, background): “99)] in CV mortality for each additional serving of fruits (equivalent to 77 g) and vegetables (equivalent to 80 g) per day, while all-cause mortality did not reduce further with intakes of more than five servings.(325) A meta-analysis reported a risk reduction for stroke of 11% [RR 0.”
2016 European Guidelines on cardiovascular disease prevention in clinical practice (2017, positive): “99)] in CV mortality for each additional serving of fruits (equivalent to 77 g) and vegetables (equivalent to 80 g) per day,while all-causemortality did not reduce further with intakes of more than five servings [325].”
Reducing the Global Burden of Cardiovascular Disease, Part 1: The Epidemiology and Risk Factors. (2017, background): “Most of these data are from North America or Europe, with sparse data from LICs and MICs.72 Recent data from China indicate that consumption of even 1 fruit serving per day confers substantial protection from CVDrelated death, but the large effect size (a 40% relative risk reduction with consumption”
ESPEN guidelines on nutrition in cancer patients. (2017, background): “On the other hand, there is reliable evidence that a diet rich in vegetables and fruits is associated with a decreased risk of cardiovascular and overall mortality [441].”
2016 European Guidelines on cardiovascular disease prevention in clinical practice. (2016, background): “99)] in CV mortality for each additional serving of fruits (equivalent to 77 g) and vegetables (equivalent to 80 g) per day, while all-cause mortality did not reduce further with intakes of more than five servings.(325) A meta-analysis reported a risk reduction for stroke of 11% [RR 0.”