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Intakes of fruits, vegetables and carbohydrate and the risk of CVD.
Public Health Nutr. 2009 Jan; 12(1):115-21.PH

Abstract

BACKGROUND

Low-carbohydrate diets could lead to reduced fruit and vegetable intake, which may be protective against CVD. The role of carbohydrate intake in modifying the association between fruits and vegetables and CVD has not been evaluated.

OBJECTIVE

To evaluate whether carbohydrate intake affects the association between fruits and vegetables and CVD.

DESIGN

We included participants from two large prospective studies, the Nurses' Health Study (NHS) and the Health Professionals' Follow-Up Study (HPFS). We followed 70 870 eligible NHS females for 16 years and 38 918 eligible HPFS males for 14 years. Diet was assessed from an FFQ updated every 4 years. Our primary outcome was ischaemic CVD (fatal and non-fatal myocardial infarction and ischaemic stroke). We used Cox proportional hazards models to evaluate the relationship between fruits and vegetables and ischaemic CVD within groups with low, moderate or high carbohydrate intake.

RESULTS

Fruit intake was strongly related with carbohydrate intake, but vegetables showed a very small correlation. Vegetable intake showed stronger associations with ischaemic CVD among the low carbohydrate group (multivariate risk ratio (RR) = 0.82 for an increment of 3 servings/d; 95 % CI 0.68, 0.99); green leafy vegetables and carotene-rich fruits and vegetables followed a similar pattern. Total fruit intake was associated with a lower risk of ischaemic CVD only among participants with moderate carbohydrate intake (RR = 0.81 comparing extreme quintiles; 95 % CI 0.70, 0.94).

CONCLUSIONS

Total vegetables, green leafy vegetables and carotene-rich fruits and vegetables showed stronger associations with ischaemic CVD among the low carbohydrate group. No consistent trends were observed for fruit intake.

Authors+Show Affiliations

Center for Clinical Research and Health Promotion, University of Puerto Rico, Medical Sciences Campus, School of Dentistry Office A-107, PO Box 365067, San Juan, Puerto Rico PR00936. kjoshipura@rcm.upr.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18410704

Citation

Joshipura, Kaumudi J., et al. "Intakes of Fruits, Vegetables and Carbohydrate and the Risk of CVD." Public Health Nutrition, vol. 12, no. 1, 2009, pp. 115-21.
Joshipura KJ, Hung HC, Li TY, et al. Intakes of fruits, vegetables and carbohydrate and the risk of CVD. Public Health Nutr. 2009;12(1):115-21.
Joshipura, K. J., Hung, H. C., Li, T. Y., Hu, F. B., Rimm, E. B., Stampfer, M. J., Colditz, G., & Willett, W. C. (2009). Intakes of fruits, vegetables and carbohydrate and the risk of CVD. Public Health Nutrition, 12(1), 115-21. https://doi.org/10.1017/S1368980008002036
Joshipura KJ, et al. Intakes of Fruits, Vegetables and Carbohydrate and the Risk of CVD. Public Health Nutr. 2009;12(1):115-21. PubMed PMID: 18410704.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intakes of fruits, vegetables and carbohydrate and the risk of CVD. AU - Joshipura,Kaumudi J, AU - Hung,Hsin-Chia, AU - Li,Tricia Y, AU - Hu,Frank B, AU - Rimm,Eric B, AU - Stampfer,Meir J, AU - Colditz,Graham, AU - Willett,Walter C, Y1 - 2008/04/15/ PY - 2008/4/16/entrez PY - 2008/4/16/pubmed PY - 2009/2/14/medline SP - 115 EP - 21 JF - Public health nutrition JO - Public Health Nutr VL - 12 IS - 1 N2 - BACKGROUND: Low-carbohydrate diets could lead to reduced fruit and vegetable intake, which may be protective against CVD. The role of carbohydrate intake in modifying the association between fruits and vegetables and CVD has not been evaluated. OBJECTIVE: To evaluate whether carbohydrate intake affects the association between fruits and vegetables and CVD. DESIGN: We included participants from two large prospective studies, the Nurses' Health Study (NHS) and the Health Professionals' Follow-Up Study (HPFS). We followed 70 870 eligible NHS females for 16 years and 38 918 eligible HPFS males for 14 years. Diet was assessed from an FFQ updated every 4 years. Our primary outcome was ischaemic CVD (fatal and non-fatal myocardial infarction and ischaemic stroke). We used Cox proportional hazards models to evaluate the relationship between fruits and vegetables and ischaemic CVD within groups with low, moderate or high carbohydrate intake. RESULTS: Fruit intake was strongly related with carbohydrate intake, but vegetables showed a very small correlation. Vegetable intake showed stronger associations with ischaemic CVD among the low carbohydrate group (multivariate risk ratio (RR) = 0.82 for an increment of 3 servings/d; 95 % CI 0.68, 0.99); green leafy vegetables and carotene-rich fruits and vegetables followed a similar pattern. Total fruit intake was associated with a lower risk of ischaemic CVD only among participants with moderate carbohydrate intake (RR = 0.81 comparing extreme quintiles; 95 % CI 0.70, 0.94). CONCLUSIONS: Total vegetables, green leafy vegetables and carotene-rich fruits and vegetables showed stronger associations with ischaemic CVD among the low carbohydrate group. No consistent trends were observed for fruit intake. SN - 1368-9800 UR - https://www.unboundmedicine.com/medline/citation/18410704/Intakes_of_fruits_vegetables_and_carbohydrate_and_the_risk_of_CVD_ L2 - https://www.cambridge.org/core/product/identifier/S1368980008002036/type/journal_article DB - PRIME DP - Unbound Medicine ER -