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Fruit and vegetable intake and cause-specific mortality in the EPIC study.
Eur J Epidemiol 2014; 29(9):639-52EJ

Abstract

Consumption of fruits and vegetables is associated with a lower overall mortality. The aim of this study was to identify causes of death through which this association is established. More than 450,000 participants from the European Prospective Investigation into Cancer and Nutrition study were included, of which 25,682 were reported deceased after 13 years of follow-up. Information on lifestyle, diet and vital status was collected through questionnaires and population registries. Hazard ratios (HR) with 95% confidence intervals (95% CI) for death from specific causes were calculated from Cox regression models, adjusted for potential confounders. Participants reporting consumption of more than 569 g/day of fruits and vegetables had lower risks of death from diseases of the circulatory (HR for upper fourth 0.85, 95% CI 0.77-0.93), respiratory (HR for upper fourth 0.73, 95% CI 0.59-0.91) and digestive system (HR for upper fourth 0.60, 95% CI 0.46-0.79) when compared with participants consuming less than 249 g/day. In contrast, a positive association with death from diseases of the nervous system was observed. Inverse associations were generally observed for vegetable, but not for fruit consumption. Associations were more pronounced for raw vegetable consumption, when compared with cooked vegetable consumption. Raw vegetable consumption was additionally inversely associated with death from neoplasms and mental and behavioral disorders. The lower risk of death associated with a higher consumption of fruits and vegetables may be derived from inverse associations with diseases of the circulatory, respiratory and digestive system, and may depend on the preparation of vegetables and lifestyle factors.

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands, m.b.leenders@uu.nl.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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, Non-U.S. Gov't

Language

eng

PubMed ID

25154553

Citation

Leenders, Max, et al. "Fruit and Vegetable Intake and Cause-specific Mortality in the EPIC Study." European Journal of Epidemiology, vol. 29, no. 9, 2014, pp. 639-52.
Leenders M, Boshuizen HC, Ferrari P, et al. Fruit and vegetable intake and cause-specific mortality in the EPIC study. Eur J Epidemiol. 2014;29(9):639-52.
Leenders, M., Boshuizen, H. C., Ferrari, P., Siersema, P. D., Overvad, K., Tjønneland, A., ... Bueno-de-Mesquita, H. B. (2014). Fruit and vegetable intake and cause-specific mortality in the EPIC study. European Journal of Epidemiology, 29(9), pp. 639-52. doi:10.1007/s10654-014-9945-9.
Leenders M, et al. Fruit and Vegetable Intake and Cause-specific Mortality in the EPIC Study. Eur J Epidemiol. 2014;29(9):639-52. PubMed PMID: 25154553.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fruit and vegetable intake and cause-specific mortality in the EPIC study. AU - Leenders,Max, AU - Boshuizen,Hendriek C, AU - Ferrari,Pietro, AU - Siersema,Peter D, AU - Overvad,Kim, AU - Tjønneland,Anne, AU - Olsen,Anja, AU - Boutron-Ruault,Marie-Christine, AU - Dossus,Laure, AU - Dartois,Laureen, AU - Kaaks,Rudolf, AU - Li,Kuanrong, AU - Boeing,Heiner, AU - Bergmann,Manuela M, AU - Trichopoulou,Antonia, AU - Lagiou,Pagona, AU - Trichopoulos,Dimitrios, AU - Palli,Domenico, AU - Krogh,Vittorio, AU - Panico,Salvatore, AU - Tumino,Rosario, AU - Vineis,Paolo, AU - Peeters,Petra H M, AU - Weiderpass,Elisabete, AU - Engeset,Dagrun, AU - Braaten,Tonje, AU - Redondo,Maria Luisa, AU - Agudo,Antonio, AU - Sánchez,María-José, AU - Amiano,Pilar, AU - Huerta,José-María, AU - Ardanaz,Eva, AU - Drake,Isabel, AU - Sonestedt,Emily, AU - Johansson,Ingegerd, AU - Winkvist,Anna, AU - Khaw,Kay-Tee, AU - Wareham,Nick J, AU - Key,Timothy J, AU - Bradbury,Kathryn E, AU - Johansson,Mattias, AU - Licaj,Idlir, AU - Gunter,Marc J, AU - Murphy,Neil, AU - Riboli,Elio, AU - Bueno-de-Mesquita,H Bas, Y1 - 2014/08/26/ PY - 2014/04/08/received PY - 2014/08/12/accepted PY - 2014/8/27/entrez PY - 2014/8/27/pubmed PY - 2014/11/6/medline SP - 639 EP - 52 JF - European journal of epidemiology JO - Eur. J. Epidemiol. VL - 29 IS - 9 N2 - Consumption of fruits and vegetables is associated with a lower overall mortality. The aim of this study was to identify causes of death through which this association is established. More than 450,000 participants from the European Prospective Investigation into Cancer and Nutrition study were included, of which 25,682 were reported deceased after 13 years of follow-up. Information on lifestyle, diet and vital status was collected through questionnaires and population registries. Hazard ratios (HR) with 95% confidence intervals (95% CI) for death from specific causes were calculated from Cox regression models, adjusted for potential confounders. Participants reporting consumption of more than 569 g/day of fruits and vegetables had lower risks of death from diseases of the circulatory (HR for upper fourth 0.85, 95% CI 0.77-0.93), respiratory (HR for upper fourth 0.73, 95% CI 0.59-0.91) and digestive system (HR for upper fourth 0.60, 95% CI 0.46-0.79) when compared with participants consuming less than 249 g/day. In contrast, a positive association with death from diseases of the nervous system was observed. Inverse associations were generally observed for vegetable, but not for fruit consumption. Associations were more pronounced for raw vegetable consumption, when compared with cooked vegetable consumption. Raw vegetable consumption was additionally inversely associated with death from neoplasms and mental and behavioral disorders. The lower risk of death associated with a higher consumption of fruits and vegetables may be derived from inverse associations with diseases of the circulatory, respiratory and digestive system, and may depend on the preparation of vegetables and lifestyle factors. SN - 1573-7284 UR - https://www.unboundmedicine.com/medline/citation/25154553/Fruit_and_vegetable_intake_and_cause_specific_mortality_in_the_EPIC_study_ L2 - https://doi.org/10.1007/s10654-014-9945-9 DB - PRIME DP - Unbound Medicine ER -