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Cited by 917Nutritional Studies and DietCardiovascular Health and Risk FactorsPhytochemicals and Antioxidant Activities

Fruit and vegetable intake and risk of cardiovascular disease: The women’s health study

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Liu, Simin, Manson, JoAnn E, Lee, I-Min, Cole, Stephen R, Hennekens, Charles H, Willett, Walter C, Buring, Julie E·2000·The American Journal of Clinical Nutrition
DOI 10.1093/ajcn/72.4.922
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Abstract

Background Prospective data relating fruit and vegetable intake to cardiovascular disease (CVD) risk are sparse, particularly for women.Objective In a large, prospective cohort of women, we examined the hypothesis that higher fruit and vegetable intake reduces CVD risk.Design In 1993 we assessed fruit and vegetable intake among 39876 female health professionals with no previous history of CVD or cancer by use of a detailed food-frequency questionnaire. We subsequently followed these women for an average of 5 y for incidence of nonfatal myocardial infarction (MI), stroke, percutaneous transluminal coronary angioplasty, coronary artery bypass graft, or death due to CVD.Results During 195647 person-years of follow-up, we documented 418 incident cases of CVD including 126 MIs. After adjustment for age, randomized treatment status, and smoking, we observed a significant inverse association between fruit and vegetable intake and CVD risk. For increasing quintiles of total fruit and vegetable intake (median servings/d: 2. 6, 4.1, 5.5, 7.1, and 10.2), the corresponding relative risks (RRs) were 1.0 (reference), 0.78, 0.72, 0.68, and 0.68 (95% CI comparing the 2 extreme quintiles: 0.51, 0.92; P: for trend = 0.01). An inverse, though not statistically significant, trend remained after additional adjustment for other known CVD risk factors, with RRs of 1.0, 0.75, 0.83, 0.80, and 0.85 (95% CI for extreme quintiles: 0.61, 1.17). After excluding participants with a self-reported history of diabetes, hypertension, or high cholesterol at baseline, the multivariate-adjusted RR was 0.45 when extreme quintiles were compared (95% CI: 0.22, 0.91; P: for trend = 0.09). Higher fruit and vegetable intake was also associated with a lower risk of MI, with an adjusted RR of 0.62 for extreme quintiles (95% CI: 0.37, 1.04; P: for trend = 0.07).Conclusion These data suggest that higher intake of fruit and vegetables may be protective against CVD and support current dietary guidelines to increase fruit and vegetable intake.

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  • Green leafy vegetables are protective against coronary heart disease, hypertension, and ischemic stroke.

    “Recent prospective and epidemiologic studies have shown that among the various foods, green leafy vegetables are undoubtedly protective against coronary heart disease, hypertension [3,4,5,6], and ischemic stroke [7].”

    From NO-Rich Diet for Lifestyle-Related Diseases (2015) · cites this paper as [3]

  • A number of epidemiological studies have shown preventive effects of fruits and vegetables on coronary heart disease.

    “On the other hand, a number of epidemiological studies have shown the preventive effects of fruits and vegetables on coronary heart disease [3,4,5,6,106].”

    From NO-Rich Diet for Lifestyle-Related Diseases (2015) · cites this paper as [3]

  • Consumption of fruits and vegetables has been correlated with decreased risks of cardiovascular disease.

    “Consumption of fruits and vegetables has been correlated with decreased risks of cardiovascular disease (CVD).”

    From Berries: emerging impact on cardiovascular health (2010) · cites this paper as [17]

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Authors
Liu, S., Manson, J. E., Lee, I.-M., Cole, S. R., Hennekens, C. H., Willett, W. C., & Buring, J. E.
Affiliations
Brigham and Women's Hospital (US)
Corresponding author
Liu, Simin
ORCID
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2000-10
Volume
72
Issue
4
Pages
922-928
ISSN
0002-9165 (ISSN-L)
DOI
10.1093/ajcn/72.4.922
OpenAlex
W1963215827
Cited by
917
References
25
Citations by year
2026: 3 · 2025: 11 · 2024: 17 · 2023: 13 · 2022: 21 · 2021: 25 · 2020: 21 · 2019: 26 · 2018: 29 · 2017: 28 · 2016: 28 · 2015: 56 · 2014: 42 · 2013: 51 · 2012: 65
FWCI
39.07
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • PubMed (publishedVersion)
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 › Phytochemicals and Antioxidant Activities
Keywords
fruit and vegetable intake, cardiovascular risk, myocardial infarction, stroke, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, cardiovascular mortality, women, female health workers, dietary risk factors, Women's Health Study, prospective cohort, hypertension, hypercholesterolemia, cardiovascular risk factors
MeSH terms
Age Factors, Aged, Alcohol Drinking, Cardiovascular Diseases, Diet, Female, Fruit, Humans, Middle Aged, Myocardial Infarction, Prospective Studies, Surveys and Questionnaires, Risk Factors, Smoking, Vegetables, Cohort Studies, Exercise, Body Mass Index, Proportional Hazards Models, Randomized Controlled Trials as Topic, Dietary Supplements

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