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Raw and processed fruit and vegetable consumption and 10-year stroke incidence in a population-based cohort study in the Netherlands

European Journal of Clinical Nutrition volume 65, pages 791–799 (2011)Cite this article

Subjects

Abstract

Background/Objectives:

Prospective cohort studies have shown that high fruit and vegetable consumption is related to a lower risk of stroke. Whether food processing affects this association is unknown. We evaluated the associations of raw and processed fruit and vegetable consumption independently from each other with 10-year stroke incidence and stroke subtypes in a prospective population-based cohort study in the Netherlands.

Subjects/Methods:

We used data of 20 069 men and women aged 20–65 years and free of cardiovascular diseases at baseline who were enrolled from 1993 to 1997. Diet was assessed using a validated 178-item food frequency questionnaire. Hazard ratios (HRs) were calculated for total, ischemic and hemorrhagic stroke incidence using multivariable Cox proportional hazards models.

Results:

During a mean follow-up time of 10.3 years, 233 incident stroke cases were documented. Total and processed fruit and vegetable intake were not related to incident stroke. Total stroke incidence was 30% lower for participants with a high intake of raw fruit and vegetables (Q4: >262 g/day; HR: 0.70; 95% confidence intervals (95% CIs): 0.47–1.03) compared with those with a low intake (Q1: ⩽92 g/day) and the trend was borderline significant (P for trend=0.07). Raw vegetable intake was significantly inversely associated with ischemic stroke (>27 vs ⩽27 g/day; HR: 0.50; 95% CI: 0.34–0.73), and raw fruit borderline significantly with hemorrhagic stroke (>120 vs ⩽120 g/day; HR: 0.53; 95% CI: 0.28–1.01).

Conclusions:

High intake of raw fruit and vegetables may protect against stroke. No association was found between processed fruit and vegetable consumption and incident stroke.

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Acknowledgements

Dr Geleijnse obtained an unrestricted grant (13281) from the Product Board for Horticulture, Zoetermeer, the Netherlands to cover the costs of data analysis for the present study. The other authors did not report financial disclosures. The Monitoring Project on Risk Factors and Chronic Diseases in the Netherlands (MORGEN) Study was supported by the Ministry of Health, Welfare and Sport of the Netherlands, the National Institute of Public Health and the Environment, Bilthoven, the Netherlands and the Europe against Cancer Program of the European Union. The sponsors did not participate in the design or conduct of the study; in the collection, analysis or interpretation of the data; or in the preparation, review or approval of the manuscript.

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Authors and Affiliations

  1. Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands

    LM Oude Griep, D Kromhout & J M Geleijnse

  2. Center for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands

    W M M Verschuren

  3. Center for Nutrition and Health, National Institute for Public Health and the Environment, Bilthoven, The Netherlands

    M C Ocké

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  1. LM Oude Griep
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Correspondence to LM Oude Griep.

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The authors declare no conflict of interest.

Additional information

Contributors: LMOG, DK and JMG contributed to study concept and design, and data analysis and interpretation; WMMV and MCO contributed to data acquisition; LMOG contributed to drafting of the manuscript; WMMV, DK, MCO and JMG contributed to critical revision of the manuscript for important intellectual content; LMOG contributed to statistical analysis; WMMV and JMG obtained funding; WMMV and JMG provided administrative, technical or material support; WMMV, DK and JMG done study supervision.

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Oude Griep, L., Verschuren, W., Kromhout, D. et al. Raw and processed fruit and vegetable consumption and 10-year stroke incidence in a population-based cohort study in the Netherlands. Eur J Clin Nutr 65, 791–799 (2011). https://doi.org/10.1038/ejcn.2011.36

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