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Fresh Fruit Consumption and Major Cardiovascular Disease in China
Open accessAbstract
BACKGROUND: In Western populations, a higher level of fruit consumption has been associated with a lower risk of cardiovascular disease, but little is known about such associations in China, where the consumption level is low and rates of stroke are high. METHODS: Between 2004 and 2008, we recruited 512,891 adults, 30 to 79 years of age, from 10 diverse localities in China. During 3.2 million person-years of follow-up, 5173 deaths from cardiovascular disease, 2551 incident major coronary events (fatal or nonfatal), 14,579 ischemic strokes, and 3523 intracerebral hemorrhages were recorded among the 451,665 participants who did not have a history of cardiovascular disease or antihypertensive treatments at baseline. Cox regression yielded adjusted hazard ratios relating fresh fruit consumption to disease rates. RESULTS: Overall, 18.0% of participants reported consuming fresh fruit daily. As compared with participants who never or rarely consumed fresh fruit (the "nonconsumption" category), those who ate fresh fruit daily had lower systolic blood pressure (by 4.0 mm Hg) and blood glucose levels (by 0.5 mmol per liter [9.0 mg per deciliter]) (P<0.001 for trend for both comparisons). The adjusted hazard ratios for daily consumption versus nonconsumption were 0.60 (95% confidence interval [CI], 0.54 to 0.67) for cardiovascular death, and 0.66 (95% CI, 0.58 to 0.75), 0.75 (95% CI, 0.72 to 0.79), and 0.64 (95% CI, 0.56 to 0.74), respectively, for incident major coronary events, ischemic stroke, and hemorrhagic stroke. There was a strong log-linear dose-response relationship between the incidence of each outcome and the amount of fresh fruit consumed. These associations were similar across the 10 study regions and in subgroups of participants defined by baseline characteristics. CONCLUSIONS: Among Chinese adults, a higher level of fruit consumption was associated with lower blood pressure and blood glucose levels and, largely independent of these and other dietary and nondietary factors, with significantly lower risks of major cardiovascular diseases. (Funded by the Wellcome Trust and others.).
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“In the China Kadoorie Cohort Study the HR of cardiovascular death with one daily portion of fresh fruit intake was 0.77 (95% CI: 0.72–0.83) before and 0.63 (95% CI: 0.56–0.72) after correction for regression dilution.”
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Metadata
- Authors
- Du, H., Li, L., Bennett, D., Guo, Y., Key, T. J., Bian, Z., Sherliker, P., Gao, H., Chen, Y., Yang, L., Chen, J., Wang, S., Du, R., Su, H., Collins, R., Peto, R., & Chen, Z.
- Affiliations
- Peking University (CN)
- Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2016-04-07
- Volume
- 374
- Issue
- 14
- Pages
- 1332-1343
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC4896382
- OpenAlex
- W2314578140
- Cited by
- 281
- References
- 35
- Citations by year
- 2026: 5 · 2025: 14 · 2024: 22 · 2023: 24 · 2022: 38 · 2021: 41 · 2020: 39 · 2019: 30 · 2018: 28 · 2017: 26 · 2016: 13
- FWCI
- 32.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Pure (Coventry University) (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Wellcome Trust (104085, 088158)
- Cancer Research UK (A8760, 16491)
- British Heart Foundation
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Biochemistry (medical) › Phytochemicals and Antioxidant Activities
- Keywords
- fresh fruit consumption, cardiovascular disease, ischemic stroke, intracerebral hemorrhage, coronary events, cardiovascular mortality, blood pressure, blood glucose, dose-response relationship, Chinese adults, diet and cardiovascular risk
- MeSH terms
- Adult, Aged, Blood Glucose, Blood Pressure, Cardiovascular Diseases, China, Diet, Diet Surveys, Female, Follow-Up Studies, Fruit, Humans, Hyperglycemia, Hypertension, Male, Middle Aged, Risk Factors, Body Mass Index, Proportional Hazards Models
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