蔬果摄入量与农药残留状况和冠心病风险的关系。
Association between intake of fruits and vegetables by pesticide residue status and coronary heart disease risk.
机构信息
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz, CIBERESP, Madrid, Spain.
出版信息
Environ Int. 2019 Nov;132:105113. doi: 10.1016/j.envint.2019.105113. Epub 2019 Aug 29.
BACKGROUND
Fruit and vegetable (FV) intake is recommended for the prevention of coronary heart disease (CHD). FVs are also an important source of exposure to pesticide residues. Whether the relations of FV intake with CHD differ according to pesticide residue status is unknown.
OBJECTIVE
To examine the associations of high- and low-pesticide-residue FVs with the risk of CHD.
METHODS
We followed 145,789 women and 24,353 men free of cardiovascular disease and cancer (excluding non-melanoma skin cancer) at baseline and participating in three ongoing prospective cohorts: the Nurses' Health Study (NHS: 1998-2012), the NHS-II (1999-2013), and the Health Professionals Follow-up Study (HPFS: 1998-2012). FV intake was assessed via food frequency questionnaires. We categorized FVs as having high- or low-pesticide-residues using a validated method based on pesticide surveillance data from the US Department of Agriculture. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95%CI) of CHD in relation to high- and low-pesticide-residue FV intake.
RESULTS
A total of 3707 incident CHD events were identified during 2,241,977 person-years of follow-up. In multivariable-adjusted models, a greater intake of low-pesticide-residue FVs was associated with a lower risk of CHD whereas high-pesticide-residue FV intake was unrelated to CHD risk. Specifically, compared with individuals consuming <1 serving/day of low-pesticide-residue FVs, those consuming ≥4 servings/day had 20% (95CI: 4%, 33%) lower risk of CHD. The corresponding HR (comparing ≥4 servings/day to <1 serving/day) for high-pesticide-residue FV intake and CHD was 0.97 (95%CI: 0.72, 1.30).
CONCLUSIONS
Our data suggested exposure to pesticide residues through FV intake may modify some cardiovascular benefits of FV consumption. Further confirmation of these findings, especially using biomarkers for assessment of pesticide exposure, is needed.
背景
水果和蔬菜（FV）的摄入被推荐用于预防冠心病（CHD）。FV 也是接触农药残留的重要来源。FV 摄入与 CHD 的关系是否因农药残留状况而异尚不清楚。
目的
研究高、低农药残留 FV 与 CHD 风险的关系。
方法
我们在基线时对 145789 名女性和 24353 名男性进行了随访，这些人没有心血管疾病和癌症（不包括非黑色素瘤皮肤癌），并参加了三个正在进行的前瞻性队列：护士健康研究（NHS：1998-2012）、NHS-II（1999-2013）和健康专业人员随访研究（HPFS：1998-2012）。FV 摄入量通过食物频率问卷进行评估。我们使用基于美国农业部农药监测数据的验证方法将 FV 分为高或低农药残留。多变量 Cox 比例风险模型用于估计与高、低农药残留 FV 摄入相关的 CHD 的风险比（HR）和 95%置信区间（95%CI）。
结果
在 2241977 人年的随访期间，共确定了 3707 例新发 CHD 事件。在多变量调整模型中，低农药残留 FV 的摄入量越大，CHD 的风险越低，而高农药残留 FV 的摄入量与 CHD 风险无关。具体来说，与每天摄入<1 份低农药残留 FV 的人相比，每天摄入≥4 份低农药残留 FV 的人 CHD 风险降低 20%（95%CI：4%，33%）。高农药残留 FV 摄入和 CHD 的相应 HR（比较≥4 份/天与<1 份/天）为 0.97（95%CI：0.72，1.30）。
结论
我们的数据表明，通过 FV 摄入接触农药残留可能会改变 FV 摄入对心血管的一些益处。需要进一步证实这些发现，特别是使用生物标志物评估农药暴露情况。
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