Dietary intake of fruits and vegetables and risk of cardiovascular disease

Abstract

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in the United States and worldwide. In this review, we examine the scientific evidence in support of current dietary recommendations to increase fruit and vegetable intake for CVD prevention. Available evidence indicates that persons who consume more fruits and vegetables often have lower prevalence of important risk factors for CVD, including hypertension, obesity, and type 2 diabetes mellitus. Recent large, prospective studies also show a direct inverse association between fruit and vegetable intake and the development of CVD incidents such as coronary heart disease and stroke. However, the biologic mechanisms whereby fruits and vegetables may exert their effects are not entirely clear and are likely to be multiple. Many nutrients and phytochemicals in fruits and vegetables, including fiber, potassium, and folate, could be independently or jointly responsible for the apparent reduction in CVD risk. Functional aspects of fruits and vegetables, such as their low dietary glycemic load and energy density, may also play a significant role. Although it is important to continue our quest for mechanistic insights, given the great potential for benefits already known, greater efforts and resources are needed to support dietary changes that encourage increased fruit and vegetable intake.

Improvement in blood pressure after short-term inorganic nitrate supplementation is attenuated in cigarette smokers compared to non-smoking controls

“…It is also important to stress that, although the findings of this study suggest that cigarette smokers might not improve blood pressure if they increase dietary NO 3 -intake, increased NO 3 --rich vegetable consumption will provide other nutrients that can benefit human health [2,3]. Moreover, it is possible that increased NO 3 -intake might have improved aspects of health in smokers that were not investigated in this study or that cigarette smokers might need to consume a greater NO 3 -dose to lower blood pressure compared to their nonsmoking counterparts.…”

“…There was a group × treatment interaction effect for salivary [NO 3 Figure 2). However, there were no differences between smokers and nonsmokers in any of the experimental conditions (P>0.05).…”

“…As such, interventions that can lower cardiovascular disease morbidity will be of epidemiological and economic importance. It has long been appreciated that a diet rich in fruit and vegetables lowers the risk of developing cardiovascular diseases and the incidence of adverse cardiovascular events such as stroke, heart failure and coronary heart disease [2,3]. Consequently, there are numerous government-driven initiatives to increase fruit and vegetable consumption including the Dietary Approaches to Stop Hypertension (DASH) diet in the United States of America [4], the 5-A-Day diet in the United Kingdom [5] and variations of this latter diet in countries within the European Union [6].…”

The use of predefined diet quality scores in the context of CVD risk during urbanization in the South African Prospective Urban and Rural Epidemiological (PURE) study

“…In this population, fruit and vegetable intake was less than half the recommended 400 g of fruit and vegetables per day, even in the urban group. Fruit and vegetables are good sources of dietary fibre, K, folate, antioxidants and minerals such as Mg (43) and a low intake has been shown to contribute to CVD such as IHD and ischaemic stroke (44) . On the other hand, for the other micronutrients, the urban group had median intakes above 100 % of the EAR/AI.…”

Selenium and antioxidant vitamin status of elderly German women

“…However, results of randomized clinical trials do not support a protective role of antioxidants in CAD (Hennekens et al, 1996;Rapola et al, 1997;Duffield-Lillico et al, 2003) or cancer (ATBC, 1994;Omenn et al, 1996;Albanes et al, 2000;Malila et al, 2002). Thus, it is concluded that the antioxidant status is only a marker of a diet rich in fruit and vegetables whereas the underlying mechanisms are likely to be multiple (Bazzano et al, 2003).…”