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Original Research Communication |
1 From the Departments of Epidemiology (LAB, JH, SV, and PKW) and Biostatistics (LGO and LM), Tulane University School of Public Health and Tropical Medicine, New Orleans, and the National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD (CML).
Background: Epidemiologic studies report inconsistent findings on the association of fruit and vegetable intake with the risk of cardiovascular disease.
Objective: The objective was to examine the relation between fruit and vegetable intake and the risk of cardiovascular disease.
Design: We studied 9608 adults aged 25–74 y participating in the first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study and free of cardiovascular disease at the time of their baseline examination between 1971 and 1975. Fruit and vegetable intake at baseline was measured with a food-frequency questionnaire. The incidence of and mortality from cardiovascular disease were obtained from medical records and death certificates.
Results: Over an average of 19 y, 888 strokes (218 fatal), 1786 ischemic heart disease events (639 fatal), 1145 cardiovascular disease deaths, and 2530 all-cause deaths were documented. Consuming fruit and vegetables 
3 times/d compared with <1 time/d was associated with a 27% lower stroke incidence [relative risk (RR): 0.73; 95% CI: 0.57, 0.95; P for trend = 0.01), a 42% lower stroke mortality (0.58; 0.33, 1.02; P for trend = 0.05), a 24% lower ischemic heart disease mortality (0.76; 0.56, 1.03; P for trend = 0.07), a 27% lower cardiovascular disease mortality (0.73; 0.58, 0.92; P for trend = 0.008), and a 15% lower all-cause mortality (0.85; 0.72, 1.00; P for trend = 0.02) after adjustment for established cardiovascular disease risk factors.
Conclusion: We showed an inverse association of fruit and vegetable intake with the risk of cardiovascular disease and all-cause mortality in the general US population.
Key Words: Fruit • vegetables • ischemic heart disease • cerebrovascular disorders • mortality • cohort studies • NHANES I • National Health and Nutrition Examination Survey • cardiovascular disease
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