Original Article
European Journal of Clinical Nutrition (2009) 63, 1345–1352; doi:10.1038/ejcn.2009.61; published online 22 July 2009
The association of fruits, vegetables, antioxidant vitamins and fibre intake with high-sensitivity C-reactive protein: sex and body mass index interactions
A Oliveira1,2,3, F Rodríguez-Artalejo4 and C Lopes1,2,3
- 1Department of Hygiene and Epidemiology of the University of Porto Medical School, Porto, Portugal
- 2Cardiovascular Research and Development Unit of the University of Porto Medical School, Porto, Portugal
- 3Public Health Institute of the Porto University, Porto, Portugal
- 4Department of Preventive Medicine and Public Health, School of Medicine, CIBER of Epidemiology and Public Health (CIBERESP), Universidad Autónoma de Madrid, Madrid, Spain.
Correspondence: Dr A Oliveira, Department of Hygiene and Epidemiology, University of Porto Medical School, Porto Alameda Professor Hernâni Monteiro 4200-319, Portugal. E-mail: acmatos@med.up.pt
Received 30 October 2008; Revised 25 May 2009; Accepted 29 May 2009; Published online 22 July 2009.
Abstract
Objective:
To study the associations of fruits, vegetables, antioxidant vitamins and fibre intake with high-sensitivity C-reactive protein (hs-CRP). Existing literature on these associations is scarce and has rendered conflicting results.
Methods:
Cross-sectional study of 1060 individuals (675 women, 385 men), representative of the non-institutionalized population, aged 
18 years, in Porto, Portugal (70% participation rate). Diet over the previous year was assessed with a validated food frequency questionnaire. Associations between diet and hs-CRP (categorized into <1, 1–3, >3 to 
10 mg/l) were obtained from ordinal logistic regression models (odds ratio, 95% confidence intervals-OR, 95% CI) adjusted for sociodemographic and behavioural variables.
Results:
In normal weight men (body mass index (BMI) <25.0 kg/m2), for each 100 g increase in fruit and vegetable intake, there was 30% less probability of changing of hs-CRP category (no risk to moderate risk, or moderate to high risk). Protective associations were also observed between hs-CRP and fruits (OR=0.73, 95% CI 0.56–0.96 per 100 g/day), vegetables (OR=0.55, 95% CI 0.35–0.86 per 100 g/day), vitamin C (OR=0.34, 95% CI 0.14–0.80 per 10 mg/day) and vitamin E (OR=0.14, 95% CI 0.02–0.88 per 1000 retinol equivalents per day). Overall, associations tended to be weaker in overweight participants. In men (BMI 25.0 kg/m2), fibre was also negatively associated with hs-CRP. In women, no significant associations were found between dietary variables and hs-CRP. A significant modification effect of the evaluated associations was found by sex for fruits and vegetables, vitamin C and fibre, but not by BMI.
Conclusion:
Intake of fruits and vegetables, vitamin C, E and fibre were negatively associated with hs-CRP in men.
Keywords:
fruits, vegetables, dietary fibre, antioxidants, C-reactive protein, effect modifier epidemiology
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