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Fruit and vegetable intake and cause-specific mortality in the EPIC study.

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.

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  • Authors+Show Affiliations

    ,

    Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands, m.b.leenders@uu.nl.

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    Source

    European journal of epidemiology 29:9 2014 Sep pg 639-52

    MeSH

    Adult
    Aged
    Cardiovascular Diseases
    Cause of Death
    Diet
    Diet Surveys
    Europe
    Feeding Behavior
    Female
    Fruit
    Humans
    Incidence
    Life Style
    Male
    Middle Aged
    Neoplasms
    Proportional Hazards Models
    Prospective Studies
    Risk Factors
    Surveys and Questionnaires
    Vegetables

    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 -