Department of Social Medicine, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou 310058, China.
The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Int J Environ Res Public Health. 2021 Jan 5;18(1):342. doi: 10.3390/ijerph18010342.
This study was to investigate the association of long-term fruit and vegetable (FV) intake with all-cause mortality. We utilized data from the China Health and Nutrition Survey (CHNS), a prospective cohort study conducted in China. The sample population included 19,542 adult respondents with complete mortality data up to 31 December 2011. Cumulative FV intake was assessed by 3 day 24 h dietary recalls. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality. Covariates included sociodemographic characteristics, lifestyle factors, health-related factors, and urban index. A total of 1409 deaths were observed during follow-up (median: 14 years). In the fully adjusted model, vegetable intake of the fourth quintile (327~408 g/day) had the greatest negative association with death compared to the lowest quintile (HR = 0.63, 95% CI: 0.53-0.76). Fruit intake of the fifth quintile (more than 126 g/day) had the highest negative association (HR = 0.24, 95% CI: 0.15-0.40) and increasing general FV intake were also negatively associated with all-cause mortality which demonstrated the greatest negative association in the amount of fourth quintile (HR = 0.59, 95% CI: 0.49-0.70) compared to the lowest quintile. To conclude, greater FV intake is associated with a reduced risk of total mortality for Chinese adults. High intake of fruit has a stronger negative association with mortality than differences in intake of vegetables. Our findings support recommendations to increase the intake of FV to promote overall longevity.
本研究旨在探讨长期摄入水果和蔬菜（FV）与全因死亡率的关系。我们利用了中国健康与营养调查（CHNS）的数据，这是一项在中国进行的前瞻性队列研究。样本人群包括 19542 名有完整死亡率数据的成年受访者，随访时间截至 2011 年 12 月 31 日。通过 3 天 24 小时膳食回忆来评估 FV 的累积摄入量。使用 Cox 比例风险回归来估计全因死亡率的危险比（HR）和 95%置信区间（CI）。协变量包括社会人口统计学特征、生活方式因素、健康相关因素和城市指数。在随访期间共观察到 1409 例死亡（中位数：14 年）。在完全调整的模型中，与最低五分位组相比，第四五分位组（327408 克/天）的蔬菜摄入量与死亡的负相关最大（HR=0.63，95%CI：0.530.76）。第五五分位组（每天超过 126 克）的水果摄入量与死亡的负相关最高（HR=0.24，95%CI：0.150.40），并且增加一般 FV 的摄入量也与全因死亡率呈负相关，与最低五分位组相比，第四五分位组（HR=0.59，95%CI：0.490.70）的负相关最大。总之，中国成年人摄入更多的 FV 与全因死亡率降低相关。高水果摄入量与死亡率的负相关比蔬菜摄入量的差异更强。我们的研究结果支持增加 FV 摄入量以促进整体长寿的建议。
