Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, 100037, China.
Sci China Life Sci. 2022 Jan;65(1):119-128. doi: 10.1007/s11427-020-1896-x. Epub 2021 Apr 20.
Evidence about the response patterns of fruit and vegetable consumption with the risk of cardiovascular disease (CVD) and all-cause mortality was inconsistent. These associations were examined using a large-scale, population-based Chinese cohort comprising 100,728 participants. A food-frequency questionnaire was used to assess fruit and vegetable consumption. Outcomes were ascertained by interviewing individuals or their proxies and checking hospital records or death certificates. Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). At the 736,668 person-years of follow-up, 3,677 CVD cases and 5,466 deaths were identified. The multivariable-adjusted HRs for CVD across increasing quartiles of total fruit and vegetable consumption were 1 (reference), 0.94 (95%CI=0.85-1.04), 0.89 (95%CI=0.80-0.98), and 0.85 (95% CI=0.11-0.95). Moreover, participants in the highest quartile displayed a 13% lower risk of all-cause mortality (HR=0.81; 95% CI=0.80-0.95). A nonlinear dose-response relation was found for CVD, without additional benefits beyond a consumption of 600 g d, whereas the all-cause mortality risk decreased along with higher consumption, with a linear trend. These associations remained significant for fruit consumption but not for vegetable consumption. Our findings indicated that greater fruit and vegetable consumption was significantly associated with a lower risk of CVD and all cause mortality. Increasing fruit and vegetable consumption, especially fruit, in the general population would prevent CVD and premature mortality.
关于水果和蔬菜摄入量与心血管疾病 (CVD) 和全因死亡率风险之间的反应模式的证据不一致。使用包含 100728 名参与者的大规模人群队列研究来检查这些关联。使用食物频率问卷评估水果和蔬菜的摄入量。通过访谈个人或其代理人、检查医院记录或死亡证明来确定结局。使用 Cox 比例风险回归计算风险比 (HR) 及其 95%置信区间 (CI)。在 736668 人年的随访中，确定了 3677 例 CVD 病例和 5466 例死亡。总水果和蔬菜摄入量递增四分位区间的 CVD 多变量调整 HR 分别为 1（参考）、0.94（95%CI=0.85-1.04）、0.89（95%CI=0.80-0.98）和 0.85（95%CI=0.11-0.95）。此外，最高四分位组的全因死亡率风险降低了 13%（HR=0.81；95%CI=0.80-0.95）。发现 CVD 存在非线性剂量反应关系，在摄入 600 克/天以上时没有额外的益处，而全因死亡率风险随着摄入量的增加而降低，呈线性趋势。这些关联在水果摄入量上仍然显著，但在蔬菜摄入量上则不显著。我们的研究结果表明，更多地摄入水果和蔬菜与降低 CVD 和全因死亡率的风险显著相关。增加水果和蔬菜的摄入，尤其是水果的摄入，将有助于预防 CVD 和过早死亡。
