The following paper has just been published online by the European Heart
Journal (http://eurheartj.oxfordjournals.org). An accompanying
editorial by Michael Marmot of University College London concludes that
"moving to a diet that emphasizes fruit and vegetables is of great
importance to public health".
Fruit and vegetable intake and mortality from ischaemic heart disease:
results from the European Prospective Investigation into Cancer and
Nutrition (EPIC)-Heart study.
Crowe FL, Roddam AW, Key TJ, Appleby PN, Overvad K, Jakobsen MU,
Tjønneland A, Hansen L, Boeing H, Weikert C, Linseisen J, Kaaks R,
Trichopoulou A, Misirli G, Lagiou P, Sacerdote C, Pala V, Palli D,
Tumino R, Panico S, Bueno-de-Mesquita HB, Boer J, van Gils CH, Beulens
JW, Barricarte A, Rodríguez L, Larrañaga N, Sánchez MJ, Tormo MJ,
Buckland G, Lund E, Hedblad B, Melander O, Jansson JH, Wennberg P,
Wareham NJ, Slimani N, Romieu I, Jenab M, Danesh J, Gallo V, Norat T,
Riboli E; European Prospective Investigation into Cancer and Nutrition
(EPIC)-Heart Study Collaborators.
Aims A higher intake of fruits and vegetables has been associated with a
lower risk of ischaemic heart disease (IHD), but there is some
uncertainty about the interpretation of this association. The objective
was to assess the relation between fruit and vegetable intake and risk
of mortality from IHD in the European Prospective Investigation into
Cancer and Nutrition (EPIC)-Heart study.
Methods and results After an average of 8.4 years of follow-up, there
were 1636 deaths from IHD among 313 074 men and women without previous
myocardial infarction or stroke from eight European countries.
Participants consuming at least eight portions (80 g each) of fruits and
vegetables a day had a 22% lower risk of fatal IHD [relative risk (RR) =
0.78, 95% confidence interval (CI): 0.65-0.95] compared with those
consuming fewer than three portions a day. After calibration of fruit
and vegetable intake to account for differences in dietary assessment
between the participating centres, a one portion (80 g) increment in
fruit and vegetable intake was associated with a 4% lower risk of fatal
IHD (RR = 0.96, 95% CI: 0.92-1.00, P for trend = 0.033).
Conclusion Results from this large observational study suggest that a
higher intake of fruits and vegetables is associated with a reduced risk
of IHD mortality. Whether this association is causal and, if so, the
biological mechanism(s) by which fruits and vegetables operate to lower
IHD risks remains unclear.