Fruit and Vegetable Consumption and Mortality
Open accessAbstract
In this study, the relation between fruit and vegetable consumption and mortality was investigated within the European Prospective Investigation Into Cancer and Nutrition. Survival analyses were performed, including 451,151 participants from 10 European countries, recruited between 1992 and 2000 and followed until 2010. Hazard ratios, rate advancement periods, and preventable proportions to respectively compare risk of death between quartiles of consumption, to estimate the period by which the risk of death was postponed among high consumers, and to estimate proportions of deaths that could be prevented if all participants would shift their consumption 1 quartile upward. Consumption of fruits and vegetables was inversely associated with all-cause mortality (for the highest quartile, hazard ratio = 0.90, 95% confidence interval (CI): 0.86, 0.94), with a rate advancement period of 1.12 years (95% CI: 0.70, 1.54), and with a preventable proportion of 2.95%. This association was driven mainly by cardiovascular disease mortality (for the highest quartile, hazard ratio = 0.85, 95% CI: 0.77, 0.93). Stronger inverse associations were observed for participants with high alcohol consumption or high body mass index and suggested in smokers. Inverse associations were stronger for raw than for cooked vegetable consumption. These results support the evidence that fruit and vegetable consumption is associated with a lower risk of death.
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The HR for all-cause mortality was 0.97 (95% CI: 0.96-0.98) per 200 g/day of fruit and vegetable intake without correction for measurement error compared with 0.94 (95% CI: 0.91-0.96) with correction for measurement error in the EPIC study.
“The HR for all-cause mortality was 0.97 (95% CI: 0.96–0.98) per 200 g/day of fruit and vegetable intake without correction for measurement error compared with 0.94 (95% CI: 0.91–0.96) with correction for measurement error,75”
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- Authors
- Leenders, M., Sluijs, I., Ros, M. M., Boshuizen, H. C., Siersema, P. D., Ferrari, P., Weikert, C., Tjønneland, A., Olsen, A., Boutron-Ruault, M.-C., Clavel-Chapelon, F., Nailler, L., Teucher, B., Li, K., Boeing, H., Bergmann, M. M., Trichopoulou, A., Lagiou, P., Trichopoulos, D., Palli, D., Pala, V., Panico, S., Tumino, R., Sacerdote, C., Peeters, P. H. M., van Gils, C. H., Lund, E., Engeset, D., Redondo, M. L., Agudo, A., Sánchez, M. J., Navarro, C., Ardanaz, E., Sonestedt, E., Ericson, U., Nilsson, L. M., Khaw, K.-T., Wareham, N. J., Key, T. J., Crowe, F. L., Romieu, I., Gunter, M. J., Gallo, V., Overvad, K., Riboli, E., & Bueno-de-Mesquita, H. B.
- Affiliations
- University Medical Center Groningen (NL)
- Utrecht University (NL)
- University Medical Center Utrecht (NL)
- Radboud University Nijmegen (NL)
- Université Paris-Sud (FR)
- German Cancer Research Center (DE)
- Inserm (FR)
- Aarhus University (DK)
- National and Kapodistrian University of Athens (GR)
- University of Cambridge (GB)
- Lund University (SE)
- Aalborg University Hospital (DK)
- Corresponding author
- Leenders, Max
- ORCID
- Sluijs, Ivonne
- Boshuizen, Hendriek C.
- Siersema, Peter D.
- Ferrari, Pietro
- Weikert, Cornelia
- Tjønneland, Anne
- Olsen, Anja
- Li, Kuanrong
- Boeing, Heiner
- Bergmann, Manuela M.
- Trichopoulou, Antonia
- Palli, Domenico
- Pala, Valeria
- Panico, Salvatore
- Tumino, Rosario
- Sacerdote, Carlotta
- Peeters, Petra H. M.
- Lund, Eiliv
- Engeset, Dagrun
- Agudo, Antonio
- Navarro, Carmen
- Sonestedt, Emily
- Ericson, Ulrika
- Nilsson, Lena Maria
- Khaw, Kay-Tee
- Wareham, Nicholas J.
- Key, Timothy J.
- Crowe, Francesca L.
- Gunter, Marc J.
- Gallo, Valentina
- Overvad, Kim
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-04-18
- Volume
- 178
- Issue
- 4
- Pages
- 590-602
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- OpenAlex
- W2118381611
- Cited by
- 163
- References
- 42
- Citations by year
- 2025: 3 · 2024: 10 · 2023: 9 · 2022: 15 · 2021: 16 · 2020: 10 · 2019: 9 · 2018: 11 · 2017: 18 · 2016: 17 · 2015: 21 · 2014: 19 · 2013: 5
- FWCI
- 21.08
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Socio-Environmental Systems Modeling (acceptedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- VBN Forskningsportal (Aalborg Universitet) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Rivm (National Institute for Public Health and the Environment) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Kræftens Bekæmpelse
- Deutsches Krebsforschungszentrum (RD06/0020)
- Centre International de Recherche sur le Cancer (RD06/0020)
- Wellcome Trust
- Cancer Research UK (14136)
- National Institute for Health and Care Research
- British Heart Foundation
- European Commission (RD06/0020)
- Institut National de la Santé et de la Recherche Médicale (RD06/0020)
- Bundesministerium für Bildung und Forschung (RD06/0020)
- Cancerfonden
- Ligue Contre le Cancer (RD06/0020)
- Stavros Niarchos Foundation (RD06/0020)
- NordForsk
- Associazione Italiana per la Ricerca sul Cancro (RD06/0020)
- Deutsche Krebshilfe (RD06/0020)
- Institut Gustave-Roussy (RD06/0020)
- Mutuelle Générale de l'Education Nationale (RD06/0020)
- Hellenic Health Foundation (RD06/0020)
- Medical Research Council (RD06/0020)
- World Cancer Research Fund (ERC-2009-AdG 232997, RD06/0020)
- Instituto de Salud Carlos III (RD06/0020)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Biochemistry › Phytochemicals and Antioxidant Activities
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- fruit consumption, vegetable consumption, all-cause mortality, cardiovascular mortality, preventable deaths, alcohol consumption, body mass index, smoking, dietary risk factors
- MeSH terms
- Adult, Aged, Cause of Death, Diet Surveys, Europe, Female, Fruit, Humans, Male, Middle Aged, Neoplasms, Prospective Studies, Vegetables, Proportional Hazards Models, Survival Analysis
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