Department of Health Data Science, Graduate School of Data Science, Yokohama City University, Yokohama, Japan.
Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan.
J Nutr. 2022 Oct 6;152(10):2245-2254. doi: 10.1093/jn/nxac136.
A dose-response and nonlinear association between fruit and vegetable intake and mortality has been reported in Europe and the United States, but little is known about this association in Asia.
This study aimed to evaluate the association of fruit and vegetable intake with all-cause, cancer, cardiovascular, and respiratory disease mortality in a Japanese cohort.
In the Japan Public Health Center-based prospective study, we included 94,658 participants (mean age: 56.4; 46.0% male) without cancer and cardiovascular disease at baseline. Information on fruit and vegetable intake was collected using a validated FFQ. The Cox proportional hazard model was used to estimate HRs and 95% CIs of each quintile of fruit and vegetable intake, separately, in relation to all-cause and cause-specific mortality using the first quintile as a reference. Nonlinear associations were evaluated using a likelihood ratio test, comparing a linear model with a restricted cubic spline model.
During a median of 20.9 follow-up years (IQR: 19.6-23.8 y), 23,687 all-cause deaths were documented. After adjusting for age, sex, and potential confounding factors, fruit and vegetable intake was nonlinearly and significantly associated with lower all-cause mortality, with the fourth and fifth quintiles having comparable HRs (fruit: fourth quintile HR: 0.91; 95% CI: 0.87, 0.95 and fifth quintile HR: 0.92; 95% CI: 0.88, 0.96; P-nonlinearity < 0.001; vegetable: fourth quintile HR: 0.92; 95% CI: 0.88, 0.97 and fifth quintile HR: 0.93; 95% CI: 0.89, 0.98; P-nonlinearity = 0.002). Fruit intake was significantly associated with lower cardiovascular mortality (HR in the fifth quintile: 0.91; 95% CI: 0.83, 0.99; P-nonlinearity = 0.01).
In the Japanese population, higher intake of fruits and vegetables was nonlinearly associated with decreased all-cause mortality. These findings may contribute to the establishment of dietary recommendations for enhancing life expectancy in Asia.
在欧洲和美国，水果和蔬菜摄入量与死亡率之间存在剂量反应和非线性关联，但亚洲对此关联的了解甚少。
本研究旨在评估日本队列中水果和蔬菜摄入量与全因、癌症、心血管和呼吸系统疾病死亡率之间的关系。
在日本公共卫生中心前瞻性研究中，我们纳入了 94658 名参与者（平均年龄：56.4 岁；46.0%为男性），基线时无癌症和心血管疾病。使用经过验证的 FFQ 收集水果和蔬菜摄入量的信息。使用 Cox 比例风险模型分别估计每个五分位组水果和蔬菜摄入量与全因和特定原因死亡率的 HR 和 95%CI，以第一五分位组为参考。使用似然比检验评估非线性关联，比较线性模型与限制立方样条模型。
在中位数为 20.9 年（IQR：19.6-23.8 年）的随访期间，记录了 23687 例全因死亡。在校正年龄、性别和潜在混杂因素后，水果和蔬菜的摄入量与较低的全因死亡率呈非线性显著相关，第四和第五五分位组的 HR 相当（水果：第四五分位 HR：0.91；95%CI：0.87，0.95 和第五五分位 HR：0.92；95%CI：0.88，0.96；P-非线性<0.001；蔬菜：第四五分位 HR：0.92；95%CI：0.88，0.97 和第五五分位 HR：0.93；95%CI：0.89，0.98；P-非线性=0.002）。水果摄入量与较低的心血管死亡率显著相关（第五五分位 HR：0.91；95%CI：0.83，0.99；P-非线性=0.01）。
在日本人群中，较高的水果和蔬菜摄入量与全因死亡率降低呈非线性相关。这些发现可能有助于制定亚洲地区提高预期寿命的饮食建议。
