Intakes of fruits, vegetables and carbohydrate and the risk of CVD

Center for Clinical Research and Health Promotion, University of Puerto Rico, Medical Sciences Campus, School of Dentistry Office A-107, PO Box 365067, San Juan, Puerto Rico PR00936.
Public Health Nutrition (Impact Factor: 2.68). 05/2008; 12(1):115-21. DOI: 10.1017/S1368980008002036
Source: PubMed


Low-carbohydrate diets could lead to reduced fruit and vegetable intake, which may be protective against CVD. The role of carbohydrate intake in modifying the association between fruits and vegetables and CVD has not been evaluated.
To evaluate whether carbohydrate intake affects the association between fruits and vegetables and CVD.
We included participants from two large prospective studies, the Nurses' Health Study (NHS) and the Health Professionals' Follow-Up Study (HPFS). We followed 70 870 eligible NHS females for 16 years and 38 918 eligible HPFS males for 14 years. Diet was assessed from an FFQ updated every 4 years. Our primary outcome was ischaemic CVD (fatal and non-fatal myocardial infarction and ischaemic stroke). We used Cox proportional hazards models to evaluate the relationship between fruits and vegetables and ischaemic CVD within groups with low, moderate or high carbohydrate intake.
Fruit intake was strongly related with carbohydrate intake, but vegetables showed a very small correlation. Vegetable intake showed stronger associations with ischaemic CVD among the low carbohydrate group (multivariate risk ratio (RR) = 0.82 for an increment of 3 servings/d; 95 % CI 0.68, 0.99); green leafy vegetables and carotene-rich fruits and vegetables followed a similar pattern. Total fruit intake was associated with a lower risk of ischaemic CVD only among participants with moderate carbohydrate intake (RR = 0.81 comparing extreme quintiles; 95 % CI 0.70, 0.94).
Total vegetables, green leafy vegetables and carotene-rich fruits and vegetables showed stronger associations with ischaemic CVD among the low carbohydrate group. No consistent trends were observed for fruit intake.

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Available from: Kaumudi J Joshipura, Jun 03, 2014
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    • "Another classification focuses on antioxidant content, e.g. vitamin C [9,13,15], folate [13] and carotene [13,15], which are implicated in the etiology of diseases such as CVD and cancer, and may contribute substantially to health inequality [4]. Finally, particular attention can be paid to the dietary variety of FV, as only a varied diet can provide the broad range of nutrients needed to achieve protection against chronic diseases [12,16,17]. "
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    ABSTRACT: We investigated whether socioeconomic differences affect fruit and vegetable (FV) consumption with respect to total intake and intake of various FV subgroups. Our study included 6667 adults aged 40-64 years who completed a dietary survey in the fourth Korean NHANES (2007-2009). FV intake was estimated from 24-hour recalls and food frequency questionnaires. Differences in FV consumption related to educational attainment were analyzed according to different nutritional categories of FV. Both men and women in the low-education group had the lowest intake of total FV and total fruits, and women also had the lowest intake of total vegetables. Also lowest in this group was consumption of mushrooms and vegetables (excluding kimchi) among men, and cruciferous and allium vegetables (excluding Chinese cabbage and radish) among women, while kimchi consumption was the highest in this group. Additionally, an association between educational level and intake of citrus fruits was evident among men. Adults in the low-education group consumed less carotene-rich FV, red fruit and/or vegetables, and dark-green leafy vegetables, fewer total vegetable dishes, and fewer types of fruit than in other groups. Men in this group had the lowest intake of yellow/orange fruit and/or vegetables, and women consumed the least folate-rich FV. There is a clear association between educational attainment and FV intake with regard to total intake, and to specific nutrients, bioactive compounds, colors, and variety.
    Nutrition research and practice 06/2012; 6(3):263-9. DOI:10.4162/nrp.2012.6.3.263 · 1.44 Impact Factor
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    • "Adequate consumption of fruits and vegetables may reduce risks for cardiovascular disease [1], obesity [2], and diabetes [3] among adults. African American and Hispanic/Latino adults present with higher rates of heart disease [4], obesity [5], and diabetes [6] compared with their white peers. "
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    Journal of obesity 05/2012; 2012(4):737891. DOI:10.1155/2012/737891
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    • "Modifiable lifestyle risk factors such as dietary intake could be related to the risk of stroke [3]. These include an inverse relationship between intake of fruits and vegetables and stroke risk [4-7]. Meta-analyses of cohort studies show that increased intake of fruits and vegetables is associated with a reduced risk of stroke, and provides support for the recommendation to consume more than five servings of fruits and vegetables per day, which is likely to cause a major reduction in stroke [4]. "
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    ABSTRACT: Consumption of vegetables and fruits is associated with a reduced risk of stroke, but it is unclear whether their protective effects are due to antioxidant vitamins or folate and metabolically related B vitamins. The purpose of the study was to test the hypothesis that intake of fruits and vegetables, which are major sources of antioxidant and vitamin B complex vitamins, reduces the risk of stroke. Cases consisted of patients diagnosed with first event of stroke (n = 69). Controls (n = 69) were age-, sex-, and body mass index-matched to cases. Multivariable-adjusted regression analysis showed that subjects who ate four to six servings of vegetable per day had a 32% reduction in the risk of stroke, and those with more than six servings per day had a reduction of 69% after adjusting for age, sex, BMI, and family history of stroke. Intakes of total fat, plant fat, calcium, potassium, vitamin B(1), vitamin B(2), vitamin B(6), niacin, and folate were significantly and negatively associated with the risk of stroke. Although the trend was not significant, stroke risk was reduced in the second quartile (1.21-2.66 servings per week) of fish intake. However, intake of fruits (average daily intake of 1.0 serving) and antioxidant vitamins such as carotene, vitamin C, and vitamin E was not associated with the risk of stroke. In conclusion, our observational study suggests that intake of fat and vegetables, rich sources of vitamin B complex, calcium, and potassium may protect against stroke.
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