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Cited by 1,368Nutritional Studies and DietCardiovascular Health and Risk FactorsPhytochemicals and Antioxidant Activities

Fruit and vegetables, and cardiovascular disease: A review

Ness, A. R., Powles, J. W.·1997·International Journal of Epidemiology
DOI 10.1093/ije/26.1.1
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Abstract

BACKGROUND: Increased interest in the potential cardio-protective effects of fruit and vegetables is currently unsupported by systematic reviews of the reported associations of these foods with risk. METHOD: All ecological, case-control, cohort studies and unconfounded trials in humans were eligible for inclusion. Eligible outcomes were symptomatic coronary heart disease, stroke and total circulatory disease. Only studies of diet that reported on fresh fruit and vegetables or a nutrient which could serve as a proxy (reversing the usual direction of inference) were included. MEDLINE (1966-1995) and EMBASE (1980-1995) were searched using the terms cerebrovascular disorder, coronary heart disease, fruit(s) and vegetable(s) as keywords. Personal bibliographies, books and reviews were also searched, as were citations in located reports. RESULTS: For coronary heart disease nine of ten ecological studies, two of three case-control studies and six of 16 cohort studies found a significant protective association with consumption of fruit and vegetables or surrogate nutrients. For stroke three of five ecological studies, none (of one) case-control study and six of eight cohort studies found a significant protective association with consumption of fruit and vegetables or surrogate nutrients. For total circulatory disease, one of two cohort studies reported a significant protective association. No attempt was made to arrive at a summary measure of the association because of the differences in study type, study quality and the different exposure measures used. CONCLUSIONS: Although null findings may be underreported the results are consistent with a strong protective effect of fruit and vegetables for stroke and a weaker protective effect on coronary heart disease. Greater use of food-based hypotheses and analyses, would complement existing nutrient-based analyses and help guide the search for underlying causes.

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  • Increased consumption of fruits and vegetables is associated with reduced risk of cardiovascular disease.

    “Increased consumption of fruits and vegetables is associated with a reduction of the risk of cardiovascular disease [72,73,74].”

    From NO-Rich Diet for Lifestyle-Related Diseases (2015) · cites this paper as [72]

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Research works printed but not linked: 8

  1. Report of the Cardiovascular Review Group Committee on Medical Aspects of Food Policy. Nutritional Aspects of Cardiovascular Disease. London: HMSO, 1994.
  2. Byington R, Dyer A R, Garside D et al. Recent trends of major coronary risk factors and CHD mortality in the United States and other industrialised countries. In: Proceedings of the Conference on the decline of coronary heart disease mortality. Washington: NIH publication No 79-1610., US Department of Health, 1979.
  3. Ikeda M, Kasahara M, Koizumi A, Watanabe T. Correlation of cerebrovascular disease standardised mortality ratios with dietary sodium and the sodium/potassium ratio among the Japanese population. Prev Med 1986; 15: 46-59.
  4. Georgieva L M, Powles J, Ness A R, Penev B, Dragoichev T, Popova S. Negative association of fruit and vegetable consumption with ischaemic heart disease: a case control study from Sofia, Bulgaria. Poster at conference: IEA regional meeting in The Hague in August 1995.
  5. Manson J E, Stampfer M J, Willett W et al. A prospective study of vitamin C and incidence of coronary heart disease in women. Circulation 1992; 85: 865.
  6. Knekt P, Reunanen A, Jarvinen R, Seppanen R, Hellovaara M, Aromaa A. Antioxidant vitamin intake and coronary mortality in a longitudinal study. Am J Epidemiol 1994; 139: 180-89.
  7. Manson J E, Willett W C, Stampfer M J, Colditz G A, Speizer F E, Hennekens C H. Vegetable and fruit consumption and incidence of stroke in women. Circulation 1994; 89: 932 (Abstract).
  8. Rowe P M. Beta-carotene takes a collective beating. Lancet 1996; 347: 249.

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Authors
Ness, A. R., & Powles, J. W.
Affiliations
University of Cambridge (GB)
ORCID
Venue
International Journal of Epidemiology
Publisher
Oxford University Press (OUP)
Published
1997-02-01
Volume
26
Issue
1
Pages
1-13
ISSN
  • 0300-5771 (ISSN-L)
  • 1464-3685
DOI
10.1093/ije/26.1.1
OpenAlex
W2147201798
Cited by
1,368
References
57
Citations by year
2026: 5 · 2025: 8 · 2024: 11 · 2023: 27 · 2022: 13 · 2021: 21 · 2020: 27 · 2019: 31 · 2018: 38 · 2017: 34 · 2016: 42 · 2015: 58 · 2014: 55 · 2013: 78 · 2012: 93
FWCI
8.10
Type
journal article
Language
en
Open access
closed
Locations
  • International Journal of Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Wellcome Trust
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 disease, coronary artery disease, stroke, circulatory diseases, cardioprotection, dietary risk factors
MeSH terms
Cardiovascular Diseases, Cerebrovascular Disorders, Clinical Trials as Topic, Female, Fruit, Humans, Male, Prospective Studies, Vegetables, Cohort Studies, Incidence, Case-Control Studies, MEDLINE

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