By how much does fruit and vegetable consumption reduce the risk of ischaemic heart disease?

Abstract

Objective: To quantify the relationship between fruit and vegetable consumption and the incidence of ischaemic heart disease. Design: A meta-analysis of cohort studies of the relationship between ischaemic heart disease and markers of fruit and vegetable consumption, namely dietary intake of fruit, vegetables, carotenoids, vitamin C, fruit ®bre and vegetable ®bre, and serum concentration of carotenoids and vitamin C, adjusted for other risk factors. Main outcome measures: Risk of ischaemic heart disease at the 90th centile of consumption relative to that at the 10th, equivalent to about a four-fold difference in fruit consumption and a doubling of vegetable consumption.Results: The association with ischaemic heart disease was of similar magnitude for all six dietary markers of fruit and vegetable consumption. The median of the six estimates was that risk was 15% (range 12±19%) lower at the 90th centile of consumption than at the 10th. The estimates were generally adjusted for the possible confounding effect of other heart disease risk factors. The serum studies of vitamin C were consistent with this; those of carotenoids suggested a larger difference (43%) but were not adjusted for the important confounding effect of smoking. The substances in fruit and vegetables responsible for the protective effect on heart disease are uncertain but the effect is commensurate with the estimated protective effects of the potassium and folate in fruit and vegetables. Beta-carotene or vitamin E are not likely to be important because randomised trials of these vitamins in large doses have shown no reduction in heart disease mortality. Conclusions: The risk of ischaemic heart disease is about 15% lower at the 90th than the 10th centile of fruit and vegetable consumption.

Diet in relation to socioeconomic status in patients with coronary heart disease

“…Fruits and vegetables contain ®bre and micronutrients that can reduce the risk of CHD (Rimm et al, 1996;Law & Morris, 1998) and may account for some of the health inequalities between socioeconomic classes, in addition to the traditional nutritional risk factors in¯uen-cing lipid metabolism and thereby the risk of CHD. The intakes of carbohydrate and ®bre were lower in men with high education than in men with low or middle education.…”

Influence of habitual diet on antioxidant status: a study in a population of vegetarians and omnivores

“…This has led to some researchers questioning the efficacy of antioxidants per se in reducing chronic disease risk and suggesting that antioxidants could merely be acting as a marker of the body status of 'other' entities, which might ultimately be responsible for the associations observed in epidemiological studies. At the same time, increased intakes of foods, also rich in antioxidants such as fruits and vegetables (Ness and Powles, 1997;Law and Morris, 1998;Genkinger et al, 2004;La Vecchia, 2004), and whole grain cereals (Slavin, 2003;Seal, 2006) have been associated with a decrease in the risk of chronic diseases including cancer and cardiovascular diseases.…”

Effects of enhanced consumption of fruit and vegetables on plasma antioxidant status and oxidative resistance of LDL in smokers supplemented with fish oil

“…There is considerable epidemiological evidence that a diet rich in fruit and vegetables may be protective against coronary heart disease ( Ness & Powles, 1997;Law & Morris, 1998). There is also increasing experimental evidence that oxidative stress, particularly oxidation of low-density lipoproteins (LDL) plays a significant role in the pathogenic pathway of atherosclerosis, the primary cause of coronary heart disease (Reaven & Witztum, 1996).…”