Fruit and vegetable consumption and all-cause mortality: a dose-response analysis

Bellavia, Andrea; Larsson, Susanna C.; Bottai, Matteo; Wolk, Alicja; Orsini, Nicola

doi:10.3945/ajcn.112.056119

Cited by 138 publications

(113 citation statements)

References 23 publications

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“…Experiencing any barrier to meet the vegetable guideline had only marginal impact on the association between level of education and adherence to the vegetable guideline (c′) and this mediation effect was not statistically significant. When we adjusted the associations between the SES indicators and adherence to the guidelines for the statistically significant mediators (path c′ = column (4) and column (5) in Tables 6, 7 and 8), the observed associations diminished and became non-significant, which confirms the statistically significant mediation effects that we showed. Exclusion of the barriers 'dislike fruit' and 'fish is expensive' from the composed barriers 'perceiving any barrier to meet the fruit/ fish guideline' did not change the mediation results.…”

Section: Potential Mediatorssupporting

confidence: 76%

The role of perceived barriers in explaining socio-economic status differences in adherence to the fruit, vegetable and fish guidelines in older adults: a mediation study

Dijkstra

Neter

Stralen

et al. 2014

Public Health Nutr.

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Objective: We aimed to identify barriers for meeting the fruit, vegetable and fish guidelines in older Dutch adults and to investigate socio-economic status (SES) differences in these barriers. Furthermore, we examined the mediating role of these barriers in the association between SES and adherence to these guidelines. Design: Cross-sectional. Setting: Longitudinal Aging Study Amsterdam (LASA), the Netherlands. Subjects: We used data from 1057 community-dwelling adults, aged 55-85 years. SES was measured by level of education and household income. An FFQ was used to assess dietary intake and barriers were measured with a self-reported lifestyle questionnaire. Results: Overall, 48·9 % of the respondents perceived a barrier to adhere to the fruit guideline, 40·0 % for the vegetable and 51·1 % for the fish guideline. The most frequently perceived barriers to meet the guidelines were the high price of fruit and fish and a poor appetite for vegetables. Lower-SES groups met the guidelines less often and perceived more barriers. The association between income and adherence to the fruit guideline was mediated by 'perceiving any barrier to meet the fruit guideline' and the barrier 'dislike fruit'. The association between income and adherence to the fish guideline was mediated by 'perceiving any barrier to meet the fish guideline' and the barrier 'fish is expensive'. Conclusions: Perceived barriers for meeting the dietary guidelines are common in older adults, especially in lower-SES groups. These barriers and in particular disliking and cost concerns explained the lower adherence to the guidelines for fruit and fish in lower-income groups in older adults.

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Section: Potential Mediatorssupporting

confidence: 76%

The role of perceived barriers in explaining socio-economic status differences in adherence to the fruit, vegetable and fish guidelines in older adults: a mediation study

Dijkstra

Neter

Stralen

et al. 2014

Public Health Nutr.

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“…As shareholders' average pre-CSA consumption was four servings per day, this extra serving puts them at or near what researchers believe is a critical produce consumption threshold for positive long-term health outcomes. Public health researchers associate vegetable consumption, especially five servings or more per day, with decreased risks of cardiac disease, cancer, stroke, and other chronic diseases [18][19][20]. Other researchers [5,10] noted similar changes in vegetable servings, though these studies considered shareholder groups with longer-term involvement in the CSA model.…”

Section: Discussionmentioning

confidence: 99%

“…CSA programs represent a promising option for wellness programming as they focus directly on increasing vegetable consumption in participants. As increased vegetable consumption is associated with decreased risk of cardiac disease, cancer, stroke, and other chronic diseases [18][19][20], the potential health impacts of employer CSA programs are compelling. Additionally, CSA participation is linked to broader behavior changes in how shareholders relate to their own health and consumption patterns [8].…”

Section: Introductionmentioning

confidence: 99%

Impacts of a Community Supported Agriculture (CSA) Voucher Program on Food Lifestyle Behaviors: Evidence from an Employer-Sponsored Pilot Program

2017

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Community supported agriculture (CSA) programs have recently received attention for their potential to influence food lifestyle behaviors and health outcomes. We build on and expand inquiries into the relationship between CSA participation and behavior change by presenting the results from a controlled pilot study of first-time CSA shareholders. We offered 95 first-time shareholders a $200 voucher to participate in a CSA. Prior to and immediately following CSA participation, these shareholders completed a survey on food lifestyle behaviors. Using econometric analyses, we measured shareholder behavior changes against an 82 person control group. All participants were drawn from a pool of individuals involved in a university wellness program. From these analyses, we identified potential benefits and changes to shareholders in four unique categories: (1) fresh versus processed food consumption; (2) food prepared at home versus away from home; (3) food purchasing behavior and interest in nutrition; and (4) self-reported health outcomes. Changes within these categories and differences between test and control were more strongly realized in shareholders who reported lower than average health prior to the CSA. We conclude with a discussion about the potential of incentivized CSAs to serve as a novel preventative health intervention.

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“…Observational studies suggest an inverse relation between intakes of vegetables and fruit (V/F) and cardiovascular disease (1-3), type 2 diabetes (4), some cancers (5), and all-cause mortality (6). The 2010 Dietary Guidelines for Americans recommends increased consumption of V/F, with specific guidelines for dark-green and red and orange vegetables (7).…”

Section: Introductionmentioning

confidence: 99%

Skin and plasma carotenoid response to a provided intervention diet high in vegetables and fruit: uptake and depletion kinetics , , ,

Jahns

Johnson

Mayne

et al. 2014

The American Journal of Clinical Nutrition

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Background: Objective biomarkers are needed to assess adherence to vegetable and fruit intervention trials. Blood carotenoids are considered the best biomarker of vegetable and fruit intake, but collecting blood is invasive and the analyses are relatively expensive for population studies. Resonance Raman spectroscopy (RRS) is an innovative method for assessing carotenoids in skin noninvasively. Objective: Our objective was to compare blood carotenoid concentrations with skin carotenoid assessments by RRS during a controlled feeding intervention. Design: Twenty-nine participants consumed low-carotenoid diets (6 wk, phases 1 and 3), a provided diet containing 6-cup equivalents (1046 g/d) of vegetables and fruit (8 wk, phase 2), and usual diet (final 8 wk, phase 4). Results: At baseline, skin and plasma total carotenoid values were correlated (r = 0.61, P , 0.001). Skin and plasma carotenoid values decreased (P , 0.001) 36% and 30%, respectively, from baseline to the end of phase 1 and then increased (P , 0.001) by .200% at the end of phase 2. Plasma carotenoids returned to baseline concentrations by the middle of phase 3 and skin carotenoid concentrations by the middle of phase 4. Skin carotenoid status predicted plasma values by using a mixed linear model including all time points (r = 0.72, P , 0.001), which indicates that changes in skin carotenoid status closely follow changes in plasma across a broad range of intakes. At the individual level, skin carotenoids predicted plasma values (r = 0.70, P , 0.001) over all time points. Conclusion: Skin carotenoid status assessed by resonance Raman spectroscopy is a noninvasive, objective biomarker of changes in vegetable and fruit intake. This trial was registered at clinicaltrials.gov as NCT01403844.Am J Clin Nutr 2014;100:930-7.

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Fruit and vegetable consumption and all-cause mortality: a dose-response analysis

Cited by 138 publications

References 23 publications

The role of perceived barriers in explaining socio-economic status differences in adherence to the fruit, vegetable and fish guidelines in older adults: a mediation study

The role of perceived barriers in explaining socio-economic status differences in adherence to the fruit, vegetable and fish guidelines in older adults: a mediation study

Impacts of a Community Supported Agriculture (CSA) Voucher Program on Food Lifestyle Behaviors: Evidence from an Employer-Sponsored Pilot Program

Skin and plasma carotenoid response to a provided intervention diet high in vegetables and fruit: uptake and depletion kinetics , , ,

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