Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka5650871, Japan.
Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba3058575, Japan.
Br J Nutr. 2020 Nov 14;124(9):952-959. doi: 10.1017/S0007114520001993. Epub 2020 Jun 9.
Although the association between fruit consumption and CHD risk has been well studied, few studies have focused on flavonoid-rich fruits (FRF), in particular strawberries and grapes. We aimed to verify the association of total and specific FRF consumption with risk of CHD by a large prospective cohort study. A total of 87 177 men and women aged 44-75 years who were free of CVD and cancer at study baseline were eligible for the present analysis. FRF consumption was assessed using a FFQ. Cox proportional hazards regression models were used to estimate the hazard ratios (HR) of CHD in relation to FRF consumption with adjustment for potential risk factors and confounders. During a mean follow-up of 13·2 years, we identified 1156 incident CHD cases. After full adjustment for covariates including demographics, lifestyles and dietary factors, the HR were 0·93 (95 % CI 0·77, 1·11), 0·91 (95 % CI 0·75, 1·11), 0·84 (95 % CI 0·67, 1·04) and 0·78 (95 % CI 0·62, 0·99) for the second, third, fourth and fifth quintiles compared with the lowest quintile of FRF consumption. Regarding specific fruits, we observed a significant inverse association for citrus fruit consumption and a borderline inverse association for strawberry consumption, while no association was observed for apple/pear or grape consumption. Although the associations appeared to be stronger in women, they were not significantly modified by sex. Higher consumption of FRF, in particular, citrus fruits, may be associated with a lower risk of developing CHD.
尽管水果摄入与 CHD 风险之间的关联已得到充分研究，但很少有研究关注富含类黄酮的水果（FRF），尤其是草莓和葡萄。我们旨在通过一项大型前瞻性队列研究验证总摄入量和特定 FRF 摄入量与 CHD 风险之间的关联。共有 87177 名年龄在 44-75 岁、基线时无 CVD 和癌症的男女符合本分析条件。使用 FFQ 评估 FRF 摄入量。使用 Cox 比例风险回归模型估计 FRF 摄入量与 CHD 之间的风险比（HR），并调整潜在的风险因素和混杂因素。在平均 13.2 年的随访期间，我们确定了 1156 例 CHD 病例。在充分调整包括人口统计学、生活方式和饮食因素等协变量后，HR 分别为 0.93（95%CI 0.77, 1.11）、0.91（95%CI 0.75, 1.11）、0.84（95%CI 0.67, 1.04）和 0.78（95%CI 0.62, 0.99），与 FRF 摄入量最低五分位组相比，第二、三、四和五分位组的 HR 分别为 0.93（95%CI 0.77, 1.11）、0.91（95%CI 0.75, 1.11）、0.84（95%CI 0.67, 1.04）和 0.78（95%CI 0.62, 0.99）。关于特定水果，我们观察到柑橘类水果摄入量与 CHD 呈显著负相关，草莓摄入量与 CHD 呈边缘负相关，而苹果/梨或葡萄摄入量与 CHD 无关。尽管女性中的关联似乎更强，但性别并未显著改变这种关联。FRF，尤其是柑橘类水果的较高摄入量可能与 CHD 发病风险降低有关。
