Department of Nutrition, Harvard School of Public Health, Boston, MA (SNB, NMW, WCW, and FBH); Saw Swee Hock School of Public Health and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (AP); the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (JEM and KMR); the Department of Epidemiology, Harvard School of Public Health, Boston, MA (JEM, WCW, EBR, and FBH); and the Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW, EBR, and FBH).
Am J Clin Nutr. 2013 Dec;98(6):1514-23. doi: 10.3945/ajcn.113.066381. Epub 2013 Oct 2.
Dietary guidelines recommend increasing fruit and vegetable intake and, most recently, have also suggested increasing variety.
We prospectively examined the independent roles of quantity and variety in fruit and vegetable intake in relation to incident coronary heart disease (CHD).
We prospectively followed 71,141 women from the Nurses' Health Study (1984-2008) and 42,135 men from the Health Professionals Follow-Up Study (1986-2008) who were free of diabetes, cardiovascular diseases, and cancer at baseline. Diet was assessed by using a validated questionnaire and updated every 4 y. Variety was defined as the number of unique fruit and vegetables consumed at least once per week. Potatoes, legumes, and fruit juices were not included in our definition of fruit and vegetables.
During follow-up, we documented 2582 CHD cases in women and 3607 cases in men. In multivariable analyses, after adjustment for dietary and nondietary covariates, those in the highest quintile of fruit and vegetable intake had a 17% lower risk (95% CI: 9%, 24%) of CHD. A higher consumption of citrus fruit, green leafy vegetables, and β-carotene- and vitamin C-rich fruit and vegetables was associated with a lower CHD risk. Conversely, quantity-adjusted variety was not associated with CHD.
Our data suggest that absolute quantity, rather than variety, in fruit and vegetable intake is associated with a significantly lower risk of CHD. Nevertheless, consumption of specific fruit and vegetable subgroups was associated with a lower CHD risk.
饮食指南建议增加水果和蔬菜的摄入量，最近还建议增加种类。
我们前瞻性地研究了水果和蔬菜摄入量的数量和种类与冠心病（CHD）发病风险的独立关系。
我们前瞻性地随访了 71141 名来自护士健康研究（1984-2008 年）的女性和 42135 名来自健康专业人员随访研究（1986-2008 年）的男性，他们在基线时无糖尿病、心血管疾病和癌症。饮食通过使用经过验证的问卷进行评估，并每 4 年更新一次。种类定义为每周至少食用一次的不同水果和蔬菜的数量。土豆、豆类和果汁不在我们对水果和蔬菜的定义中。
在随访期间，我们记录了女性 2582 例和男性 3607 例 CHD 病例。在多变量分析中，调整饮食和非饮食因素后，水果和蔬菜摄入量最高五分位数的人患 CHD 的风险降低了 17%（95%CI：9%，24%）。柑橘类水果、绿叶蔬菜以及富含β-胡萝卜素和维生素 C 的水果和蔬菜的摄入量较高与 CHD 风险降低相关。相反，调整后的种类与 CHD 无关。
我们的数据表明，水果和蔬菜摄入量的绝对数量，而不是种类，与 CHD 风险显著降低相关。然而，特定水果和蔬菜亚组的消费与较低的 CHD 风险相关。
