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Fruit and vegetable intake and cause-specific mortality in the EPIC study

Leenders, Max; Boshuizen, Hendriek C.; Ferrari, Pietro; Siersema, Peter D.; Overvad, Kim; Tjonneland, Anne; Olsen, Anja; Boutron-Ruault, Marie-Christine; Dossus, Laure and Dartois, Laureen, et al. (2014) In European Journal of Epidemiology 29(9). p.639-652
Abstract
Consumption of fruits and vegetables is associated with a lower overall mortality. The aim of this study was to identify causes of death through which this association is established. More than 450,000 participants from the European Prospective Investigation into Cancer and Nutrition study were included, of which 25,682 were reported deceased after 13 years of follow-up. Information on lifestyle, diet and vital status was collected through questionnaires and population registries. Hazard ratios (HR) with 95 % confidence intervals (95 % CI) for death from specific causes were calculated from Cox regression models, adjusted for potential confounders. Participants reporting consumption of more than 569 g/day of fruits and vegetables had lower... (More)
Consumption of fruits and vegetables is associated with a lower overall mortality. The aim of this study was to identify causes of death through which this association is established. More than 450,000 participants from the European Prospective Investigation into Cancer and Nutrition study were included, of which 25,682 were reported deceased after 13 years of follow-up. Information on lifestyle, diet and vital status was collected through questionnaires and population registries. Hazard ratios (HR) with 95 % confidence intervals (95 % CI) for death from specific causes were calculated from Cox regression models, adjusted for potential confounders. Participants reporting consumption of more than 569 g/day of fruits and vegetables had lower risks of death from diseases of the circulatory (HR for upper fourth 0.85, 95 % CI 0.77-0.93), respiratory (HR for upper fourth 0.73, 95 % CI 0.59-0.91) and digestive system (HR for upper fourth 0.60, 95 % CI 0.46-0.79) when compared with participants consuming less than 249 g/day. In contrast, a positive association with death from diseases of the nervous system was observed. Inverse associations were generally observed for vegetable, but not for fruit consumption. Associations were more pronounced for raw vegetable consumption, when compared with cooked vegetable consumption. Raw vegetable consumption was additionally inversely associated with death from neoplasms and mental and behavioral disorders. The lower risk of death associated with a higher consumption of fruits and vegetables may be derived from inverse associations with diseases of the circulatory, respiratory and digestive system, and may depend on the preparation of vegetables and lifestyle factors. (Less)
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keywords
Fruits and vegetables, Mortality, Nutrition, Cancer, Cardiovascular, disease, Respiratory disease
in
European Journal of Epidemiology
volume
29
issue
9
pages
639 - 652
publisher
Springer
external identifiers
  • wos:000341914800006
  • scopus:84908476586
ISSN
1573-7284
DOI
10.1007/s10654-014-9945-9
language
English
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yes
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78d5b6ad-f0b6-4819-8e7c-3a9fb8217948 (old id 4706665)
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2014-11-03 07:19:26
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@article{78d5b6ad-f0b6-4819-8e7c-3a9fb8217948,
  abstract     = {Consumption of fruits and vegetables is associated with a lower overall mortality. The aim of this study was to identify causes of death through which this association is established. More than 450,000 participants from the European Prospective Investigation into Cancer and Nutrition study were included, of which 25,682 were reported deceased after 13 years of follow-up. Information on lifestyle, diet and vital status was collected through questionnaires and population registries. Hazard ratios (HR) with 95 % confidence intervals (95 % CI) for death from specific causes were calculated from Cox regression models, adjusted for potential confounders. Participants reporting consumption of more than 569 g/day of fruits and vegetables had lower risks of death from diseases of the circulatory (HR for upper fourth 0.85, 95 % CI 0.77-0.93), respiratory (HR for upper fourth 0.73, 95 % CI 0.59-0.91) and digestive system (HR for upper fourth 0.60, 95 % CI 0.46-0.79) when compared with participants consuming less than 249 g/day. In contrast, a positive association with death from diseases of the nervous system was observed. Inverse associations were generally observed for vegetable, but not for fruit consumption. Associations were more pronounced for raw vegetable consumption, when compared with cooked vegetable consumption. Raw vegetable consumption was additionally inversely associated with death from neoplasms and mental and behavioral disorders. The lower risk of death associated with a higher consumption of fruits and vegetables may be derived from inverse associations with diseases of the circulatory, respiratory and digestive system, and may depend on the preparation of vegetables and lifestyle factors.},
  author       = {Leenders, Max and Boshuizen, Hendriek C. and Ferrari, Pietro and Siersema, Peter D. and Overvad, Kim and Tjonneland, Anne and Olsen, Anja and Boutron-Ruault, Marie-Christine and Dossus, Laure and Dartois, Laureen and Kaaks, Rudolf and Li, Kuanrong and Boeing, Heiner and Bergmann, Manuela M. and Trichopoulou, Antonia and Lagiou, Pagona and Trichopoulos, Dimitrios and Palli, Domenico and Krogh, Vittorio and Panico, Salvatore and Tumino, Rosario and Vineis, Paolo and Peeters, Petra H. M. and Weiderpass, Elisabete and Engeset, Dagrun and Braaten, Tonje and Luisa Redondo, Maria and Agudo, Antonio and Sanchez, Maria-Jose and Amiano, Pilar and Huerta, Jose-Maria and Ardanaz, Eva and Drake, Isabel and Sonestedt, Emily and Johansson, Ingegerd and Winkvist, Anna and Khaw, Kay-Tee and Wareham, Nick J. and Key, Timothy J. and Bradbury, Kathryn E. and Johansson, Mattias and Licaj, Idlir and Gunter, Marc J. and Murphy, Neil and Riboli, Elio and Bueno-de-Mesquita, H. Bas},
  issn         = {1573-7284},
  keyword      = {Fruits and vegetables,Mortality,Nutrition,Cancer,Cardiovascular,disease,Respiratory disease},
  language     = {eng},
  number       = {9},
  pages        = {639--652},
  publisher    = {Springer},
  series       = {European Journal of Epidemiology},
  title        = {Fruit and vegetable intake and cause-specific mortality in the EPIC study},
  url          = {http://dx.doi.org/10.1007/s10654-014-9945-9},
  volume       = {29},
  year         = {2014},
}