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Quantity and variety in fruit and vegetable intake and risk of coronary heart disease.
Am J Clin Nutr 2013; 98(6):1514-23AJ

Abstract

BACKGROUND

Dietary guidelines recommend increasing fruit and vegetable intake and, most recently, have also suggested increasing variety.

OBJECTIVE

We prospectively examined the independent roles of quantity and variety in fruit and vegetable intake in relation to incident coronary heart disease (CHD).

DESIGN

We prospectively followed 71,141 women from the Nurses' Health Study (1984-2008) and 42,135 men from the Health Professionals Follow-Up Study (1986-2008) who were free of diabetes, cardiovascular diseases, and cancer at baseline. Diet was assessed by using a validated questionnaire and updated every 4 y. Variety was defined as the number of unique fruit and vegetables consumed at least once per week. Potatoes, legumes, and fruit juices were not included in our definition of fruit and vegetables.

RESULTS

During follow-up, we documented 2582 CHD cases in women and 3607 cases in men. In multivariable analyses, after adjustment for dietary and nondietary covariates, those in the highest quintile of fruit and vegetable intake had a 17% lower risk (95% CI: 9%, 24%) of CHD. A higher consumption of citrus fruit, green leafy vegetables, and β-carotene- and vitamin C-rich fruit and vegetables was associated with a lower CHD risk. Conversely, quantity-adjusted variety was not associated with CHD.

CONCLUSIONS

Our data suggest that absolute quantity, rather than variety, in fruit and vegetable intake is associated with a significantly lower risk of CHD. Nevertheless, consumption of specific fruit and vegetable subgroups was associated with a lower CHD risk.

Authors+Show Affiliations

Department of Nutrition, Harvard School of Public Health, Boston, MA (SNB, NMW, WCW, and FBH); Saw Swee Hock School of Public Health and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (AP); the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (JEM and KMR); the Department of Epidemiology, Harvard School of Public Health, Boston, MA (JEM, WCW, EBR, and FBH); and the Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW, EBR, and FBH).No 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

24088718

Citation

Bhupathiraju, Shilpa N., et al. "Quantity and Variety in Fruit and Vegetable Intake and Risk of Coronary Heart Disease." The American Journal of Clinical Nutrition, vol. 98, no. 6, 2013, pp. 1514-23.
Bhupathiraju SN, Wedick NM, Pan A, et al. Quantity and variety in fruit and vegetable intake and risk of coronary heart disease. Am J Clin Nutr. 2013;98(6):1514-23.
Bhupathiraju, S. N., Wedick, N. M., Pan, A., Manson, J. E., Rexrode, K. M., Willett, W. C., ... Hu, F. B. (2013). Quantity and variety in fruit and vegetable intake and risk of coronary heart disease. The American Journal of Clinical Nutrition, 98(6), pp. 1514-23. doi:10.3945/ajcn.113.066381.
Bhupathiraju SN, et al. Quantity and Variety in Fruit and Vegetable Intake and Risk of Coronary Heart Disease. Am J Clin Nutr. 2013;98(6):1514-23. PubMed PMID: 24088718.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quantity and variety in fruit and vegetable intake and risk of coronary heart disease. AU - Bhupathiraju,Shilpa N, AU - Wedick,Nicole M, AU - Pan,An, AU - Manson,JoAnn E, AU - Rexrode,Kathyrn M, AU - Willett,Walter C, AU - Rimm,Eric B, AU - Hu,Frank B, Y1 - 2013/10/02/ PY - 2013/10/4/entrez PY - 2013/10/4/pubmed PY - 2014/4/8/medline SP - 1514 EP - 23 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 98 IS - 6 N2 - BACKGROUND: Dietary guidelines recommend increasing fruit and vegetable intake and, most recently, have also suggested increasing variety. OBJECTIVE: We prospectively examined the independent roles of quantity and variety in fruit and vegetable intake in relation to incident coronary heart disease (CHD). DESIGN: We prospectively followed 71,141 women from the Nurses' Health Study (1984-2008) and 42,135 men from the Health Professionals Follow-Up Study (1986-2008) who were free of diabetes, cardiovascular diseases, and cancer at baseline. Diet was assessed by using a validated questionnaire and updated every 4 y. Variety was defined as the number of unique fruit and vegetables consumed at least once per week. Potatoes, legumes, and fruit juices were not included in our definition of fruit and vegetables. RESULTS: During follow-up, we documented 2582 CHD cases in women and 3607 cases in men. In multivariable analyses, after adjustment for dietary and nondietary covariates, those in the highest quintile of fruit and vegetable intake had a 17% lower risk (95% CI: 9%, 24%) of CHD. A higher consumption of citrus fruit, green leafy vegetables, and β-carotene- and vitamin C-rich fruit and vegetables was associated with a lower CHD risk. Conversely, quantity-adjusted variety was not associated with CHD. CONCLUSIONS: Our data suggest that absolute quantity, rather than variety, in fruit and vegetable intake is associated with a significantly lower risk of CHD. Nevertheless, consumption of specific fruit and vegetable subgroups was associated with a lower CHD risk. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/24088718/Quantity_and_variety_in_fruit_and_vegetable_intake_and_risk_of_coronary_heart_disease_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.113.066381 DB - PRIME DP - Unbound Medicine ER -