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Fruit, vegetable, and fish consumption and heart rate variability: the Veterans Administration Normative Aging Study

¹ From the Departments of Environmental Health Sciences (SKP, MSO, and HH) and Epidemiology (MSO), University of Michigan School of Public Health, Ann Arbor, MI; the Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (KLT); the VA Normative Aging Study, Veterans Affairs Boston Healthcare System, Boston, MA (DS and PSV); the Department of Medicine, Boston University School of Medicine, Boston, MA (DS and PSV); the Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School (DS, HH, and JS) and the Department of Environmental Health, Harvard School of Public Health (HH and JS), Boston, MA.

² Supported by the US Environmental Protection Agency (grants EPA R827353 and R832416) and the National Institute of Environment Health Sciences (grants RO1-ES015172, ES00002, ES05257, ES10798, P01-ES009825, and P42-ES05947). The VA Normative Aging Study is supported by the Cooperative Studies Program/Epidemiology Research and Information Center of the US Department of Veterans Affairs and is a component of the Massachusetts Veterans Epidemiology Research and Information Center, Boston, MA.

³ Reprints not available. Address correspondence to SK Park, SPH II-M6240, Department of Environmental Health Sciences, University of Michigan School of Public Health, 109 South Observatory Street, Ann Arbor, MI 48109. E-mail: sungkyun{at}umich.edu.

Background: Higher intakes of fruit, vegetables, and dark fish may prevent sudden cardiac death and arrhythmias, but the exact mechanisms are not fully understood.

Objective: We examined whether high consumption of fruit, vegetables, and dark fish would be associated with beneficial changes in heart rate variability (HRV).

Design: HRV variables were measured among 586 older men with 928 total observations from November 2000 to June 2007 in the Normative Aging Study, a community-based longitudinal study of aging. Dietary intake was evaluated with a self-administered semiquantitative food-frequency questionnaire and categorized into quartiles.

Results: After controlling for potential confounders, intake of green leafy vegetables was positively associated with normalized high-frequency power and inversely associated with normalized low-frequency power (P for trend < 0.05). These significant associations were retained after further adjustment for healthy lifestyle factors, such as physical activity and use of multivitamins. No significant association was seen between HRV measures and intakes of other fruit and vegetables, vitamin C, carotenoids, tuna and dark-meat fish, or n–3 (omega-3) fatty acids. An effect modification of intake of noncitrus fruit by obesity and of total vegetables and cruciferous vegetables by cigarette smoking was seen, which warrants further investigation.

Conclusion: These findings suggest that higher intake of green leafy vegetables may reduce the risk of cardiovascular disease through favorable changes in cardiac autonomic function.