Original Article

Journal of Human Hypertension (2007) 21, 717–728; doi:10.1038/sj.jhh.1002212; published online 19 April 2007

Increased consumption of fruit and vegetables is related to a reduced risk of coronary heart disease: meta-analysis of cohort studies

F J He1, C A Nowson2, M Lucas2 and G A MacGregor1

  1. 1Blood Pressure Unit, Cardiac and Vascular Sciences, St George's University of London, London, UK
  2. 2Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Australia

Correspondence: Dr FJ He, Blood Pressure Unit, Cardiac and Vascular Sciences, St George's University of London, Cranmer Terrace, London SW17 0RE, UK. E-mail: fhe@sgul.ac.uk

Received 26 January 2007; Revised 24 March 2007; Accepted 25 March 2007; Published online 19 April 2007.

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Abstract

Increased consumption of fruit and vegetables has been shown to be associated with a reduced risk of coronary heart disease (CHD) in many epidemiological studies, however, the extent of the association is uncertain. We quantitatively assessed the relation between fruit and vegetable intake and incidence of CHD by carrying out a meta-analysis of cohort studies. Studies were included if they reported relative risks (RRs) and corresponding 95% confidence interval (CI) of CHD with respect to frequency of fruit and vegetable intake. Twelve studies, consisting of 13 independent cohorts, met the inclusion criteria. There were 278 459 individuals (9143 CHD events) with a median follow-up of 11 years. Compared with individuals who had less than 3 servings/day of fruit and vegetables, the pooled RR of CHD was 0.93 (95% CI: 0.86–1.00, P=0.06) for those with 3–5 servings/day and 0.83 (0.77–0.89, P<0.0001) for those with more than 5 servings/day. Subgroup analyses showed that both fruits and vegetables had a significant protective effect on CHD. Our meta-analysis of prospective cohort studies demonstrates that increased consumption of fruit and vegetables from less than 3 to more than 5 servings/day is related to a 17% reduction in CHD risk, whereas increased intake to 3–5 servings/day is associated with a smaller and borderline significant reduction in CHD risk. These results provide strong support for the recommendations to consume more than 5 servings/day of fruit and vegetables.

Keywords:

fruit and vegetables, coronary disease, prospective cohort studies, meta-analysis

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