Fruit and Vegetable Consumption is Inversely Associated with Mortality

by | Apr 28, 2021 | 2021, Fruits and Vegetables, Longevity

Written by Joyce Smith, BS. Results of two prospective cohort studies and a meta-analysis of 26 cohort studies provide evidence of an inverse association between fruit and vegetable consumption and mortality.

fruits and vegetablesInadequate consumption of fruit and vegetables is a high dietary contributor to disease burden and premature death in the United States 1 and worldwide 2. US dietary guidelines have recommended an increase in fruit and vegetable intake of 3-5 daily servings 3 which is well above the current average intake among U.S. adults of only one serving of fruit and 1.5 servings of vegetables per day 4. Guidelines vary from the World Health Organization’s recommendation of 5 servings of fruit and vegetables per day to Denmark’s 6 servings per day and Australia’s 8.5 servings per day 5,6.

Wang and colleagues 7, hypothesizing an association between higher fruit and vegetable consumption and lower mortality, analyzed the impact of fruit and vegetable consumption on mortality risk of 66,719 women from the Nurses’ Health Study (NHS) from 1984 to 2014 and 42,016 men from the Health Professionals Follow-up Study (HPFS) from 1986 to 2014, who were free from cardiovascular disease, cancer, and diabetes at baseline. Participant diets were assessed via a validated semiquantitative food frequency questionnaire that was administered at baseline and updated every 2 to 4 years for a follow up of 30 years. The final dose-response meta-analysis included results from both NHS and HPFS cohorts and 24 additional prospective cohort studies.

Wang and team found that 33,898 deaths due to cancer, cardiovascular disease and respiratory disease occurred during the 30 -year follow up and were inversely associated with fruit and vegetable consumption (Pnonlinear<0.001). Compared to those who consumed two daily servings of fruits and vegetables, participants who consumed five daily servings of fruits and vegetables had the lowest mortality risk. Of the five daily servings, two daily servings of fruit and three daily servings of vegetables provided the greatest longevity. Higher levels of consumption provided no additional risk reductions. Compared to two servings of fruit and vegetables per day, five servings of fruits and vegetables a day provided a 13% lower risk of death from all causes; a 12% lower risk of death from cardiovascular disease, including heart disease and stroke; a 10% lower risk of death from cancer; and a 35% lower risk of death from respiratory disease, such as chronic obstructive pulmonary disease.

In addition, the final updated meta-analysis of the NHS and HPFS studies and the 24 prospective cohort studies which had 14,5015 deaths in 189,2885 participants, revealed similar results, Pnonlinear<0.001). Although current dietary recommendations usually attribute the same health benefit to all types of fruits and vegetables, researchers found that not all fruits and vegetables offered the same degree of benefit. In the updated analysis, higher intakes of most subgroups of fruits and vegetables were associated with lower mortality, with the exception of starchy vegetables, particularly peas and corn, while consumption of fruit juices and potatoes were not associated with mortality. The higher glycemic load in starchy vegetables has been linked to an elevated risk of major chronic diseases 8. Peas and corn can have significantly reduced antioxidant values when processed by canning. 9.

Study limitations include the inconsistencies in the definitions of fruit and vegetables and their serving sizes among the studies in the meta-analysis. Study results support the current dietary recommendations to increase fruit and vegetable consumption but not fruit juices and potatoes.

Source: Wang, Dong D., Yanping Li, Shilpa N. Bhupathiraju, Bernard A. Rosner, Qi Sun, Edward L. Giovannucci, Eric B. Rimm et al. “Fruit and Vegetable Intake and Mortality: Results From 2 Prospective Cohort Studies of US Men and Women and a Meta-Analysis of 26 Cohort Studies.” Circulation (2021).

© 2021 American Heart Association, Inc.

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Posted April 28, 2021.

Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from  the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.

References:

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