Fruit and vegetable intake and mortality from ischaemic heart disease: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study
Open accessAbstract
AIMS: A higher intake of fruits and vegetables has been associated with a lower risk of ischaemic heart disease (IHD), but there is some uncertainty about the interpretation of this association. The objective was to assess the relation between fruit and vegetable intake and risk of mortality from IHD in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study. METHODS AND RESULTS: After an average of 8.4 years of follow-up, there were 1636 deaths from IHD among 313 074 men and women without previous myocardial infarction or stroke from eight European countries. Participants consuming at least eight portions (80 g each) of fruits and vegetables a day had a 22% lower risk of fatal IHD [relative risk (RR) = 0.78, 95% confidence interval (CI): 0.65-0.95] compared with those consuming fewer than three portions a day. After calibration of fruit and vegetable intake to account for differences in dietary assessment between the participating centres, a one portion (80 g) increment in fruit and vegetable intake was associated with a 4% lower risk of fatal IHD (RR = 0.96, 95% CI: 0.92-1.00, P for trend = 0.033). CONCLUSION: Results from this large observational study suggest that a higher intake of fruits and vegetables is associated with a reduced risk of IHD mortality. Whether this association is causal and, if so, the biological mechanism(s) by which fruits and vegetables operate to lower IHD risks remains unclear.
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The HRs for ischaemic heart disease mortality (per 80 g/day) were 0.97 (95% CI: 0.95-0.99) without correction and 0.95 (95% CI: 0.91-0.99) with correction for measurement error in the EPIC study.
“and the corresponding HRs for ischaemic heart disease mortality (per 80 g/day) were 0.97 (95% CI: 0.95–0.99) and 0.95 (95% CI: 0.91–0.99),23 respectively, in the EPIC study.”
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- Authors
- Crowe, F. L., Roddam, A. W., Key, T. J., Appleby, P. N., Overvad, K., Jakobsen, M. U., Tjonneland, A., Hansen, L., Boeing, H., Weikert, C., Linseisen, J., Kaaks, R., Trichopoulou, A., Misirli, G., Lagiou, P., Sacerdote, C., Pala, V., Palli, D., Tumino, R., Panico, S., Bueno-de-Mesquita, H. B., Boer, J., van Gils, C. H., Beulens, J. W. J., Barricarte, A., Rodriguez, L., Larranaga, N., Sanchez, M.-J., Tormo, M.-J., Buckland, G., Lund, E., Hedblad, B., Melander, O., Jansson, J.-H., Wennberg, P., Wareham, N. J., Slimani, N., Romieu, I., Jenab, M., Danesh, J., Gallo, V., Norat, T., Riboli, E., & Collaborators, E. P. I. I. C. A. N. (.-H. S.
- Affiliations
- University of Oxford (GB)
- Aarhus University (DK)
- Aalborg University Hospital (DK)
- Danish Cancer Society (DK)
- German Institute of Human Nutrition (DE)
- German Cancer Research Center (DE)
- National and Kapodistrian University of Athens (GR)
- Italian institute for Genomic Medicine (IT)
- Fondazione IRCCS Istituto Nazionale dei Tumori (IT)
- Istituto per lo Studio e la Prevenzione Oncologica (IT)
- Azienda Usl 8 Arezzo (IT)
- Federico II University Hospital (IT)
- University Medical Center Utrecht (NL)
- National Institute for Public Health and the Environment (NL)
- Instituto de Salud Pública de Navarra (ES)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (ES)
- Institut d'Investigació Biomédica de Bellvitge (ES)
- UiT The Arctic University of Norway (NO)
- Lund University (SE)
- Skellefteå Hospital (SE)
- Umeå University (SE)
- Addenbrooke's Hospital (GB)
- Centre international de recherche sur le cancer (FR)
- University of Cambridge (GB)
- Imperial College London (GB)
- Corresponding author
- Crowe, F. L.
- ORCID
- Crowe, F. L.
- Roddam, A. W.
- Overvad, K.
- Jakobsen, M. U.
- Hansen, L.
- Boeing, H.
- Weikert, C.
- Linseisen, J.
- Kaaks, R.
- Trichopoulou, A.
- Sacerdote, C.
- Pala, V.
- Palli, D.
- Tumino, R.
- Panico, S.
- Boer, J.
- Beulens, J. W. J.
- Barricarte, A.
- Buckland, G.
- Lund, E.
- Melander, O.
- Jansson, J.-H.
- Wennberg, P.
- Wareham, N. J.
- Slimani, N.
- Jenab, M.
- Danesh, J.
- Gallo, V.
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-01-18
- Volume
- 32
- Issue
- 10
- Pages
- 1235-1243
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- PMC
- PMC3094548
- OpenAlex
- W2164513470
- Cited by
- 263
- References
- 39
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 4 · 2023: 8 · 2022: 16 · 2021: 14 · 2020: 18 · 2019: 12 · 2018: 15 · 2017: 22 · 2016: 28 · 2015: 23 · 2014: 28 · 2013: 27 · 2012: 27
- FWCI
- 29.88
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Heart Journal (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
- Lund University Publications (Lund University) (submittedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (submittedVersion)
- Rivm (National Institute for Public Health and the Environment) (submittedVersion)
- OPUS (Augsburg University) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- Compagnia di San Paolo
- Deutsches Krebsforschungszentrum
- Wellcome Trust
- Cancer Research UK
- National Institute for Health and Care Research
- British Heart Foundation (RG/08/014/24067)
- European Commission
- Institut National de la Santé et de la Recherche Médicale
- Bundesministerium für Bildung und Forschung
- Cancerfonden
- Ligue Contre le Cancer
- Stavros Niarchos Foundation
- Vetenskapsrådet
- Associazione Italiana per la Ricerca sul Cancro
- Norges Forskningsråd
- Deutsche Krebshilfe
- Mutuelle Générale de l'Education Nationale
- Hellenic Health Foundation
- Medical Research Council
- World Cancer Research Fund
- Instituto de Salud Carlos III (C03/09)
- 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, ischemic heart disease, cardiovascular mortality, dietary intake, cardiovascular risk factors
- MeSH terms
- Diet, Europe, Female, Fruit, Humans, Life Style, Male, Middle Aged, Prospective Studies, Risk Factors, Vegetables, Myocardial Ischemia
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