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Fruit and vegetable intake and mortality from ischaemic heart disease: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study

Francesca L. Crowe, Andrew W. Roddam, Timothy J. Key, Paul N. Appleby, Kim Overvad, Marianne U. Jakobsen, Anne Tjønneland, Louise Hansen, Heiner Boeing, Cornelia Weikert, Jakob Linseisen, Rudolf Kaaks, Antonia Trichopoulou, Gesthimani Misirli, Pagona Lagiou, Carlotta Sacerdote, Valeria Pala, Domenico Palli, Rosario Tumino, Salvatore Panico, H. Bas Bueno-de-Mesquita, Jolanda Boer, Carla H. van Gils, Joline W.J. Beulens, Aurelio Barricarte, Laudina Rodríguez, Nerea Larrañaga, Maria-José Sánchez, María-José Tormo, Genevieve Buckland, Eiliv Lund, Bo Hedblad, Olle Melander, Jan-Håkan Jansson, Patrik Wennberg, Nicholas J. Wareham, Nadia Slimani, Isabelle Romieu, Mazda Jenab, John Danesh, Valentina Gallo, Teresa Norat, Elio Riboli
DOI: http://dx.doi.org/10.1093/eurheartj/ehq465 ehq465 First published online: 18 January 2011


Aims A higher intake of fruits and vegetables has been associated with a lower risk of ischaemic heart disease (IHD), but there is some uncertainty about the interpretation of this association. The objective was to assess the relation between fruit and vegetable intake and risk of mortality from IHD in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study.

Methods and results After an average of 8.4 years of follow-up, there were 1636 deaths from IHD among 313 074 men and women without previous myocardial infarction or stroke from eight European countries. Participants consuming at least eight portions (80 g each) of fruits and vegetables a day had a 22% lower risk of fatal IHD [relative risk (RR) = 0.78, 95% confidence interval (CI): 0.65–0.95] compared with those consuming fewer than three portions a day. After calibration of fruit and vegetable intake to account for differences in dietary assessment between the participating centres, a one portion (80 g) increment in fruit and vegetable intake was associated with a 4% lower risk of fatal IHD (RR = 0.96, 95% CI: 0.92–1.00, P for trend = 0.033).

Conclusion Results from this large observational study suggest that a higher intake of fruits and vegetables is associated with a reduced risk of IHD mortality. Whether this association is causal and, if so, the biological mechanism(s) by which fruits and vegetables operate to lower IHD risks remains unclear.

  • Fruits
  • Vegetables
  • Coronary disease
  • Prospective cohort studies
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