Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies

被引：1544

作者：

Aune, Dagfinn ^{[1
,2
,3
]}

Giovannucci, Edward ^{[4
,5
,6
,7
]}

Boffetta, Paolo ^{[8
]}

Fadnes, Lars T. ^{[9
,10
]}

Keum, NaNa ^{[6
,7
]}

Norat, Teresa ^{[2
]}

Greenwood, Darren C. ^{[11
]}

Riboli, Elio ^{[2
]}

Vatten, Lars J. ^{[1
]}

Tonstad, Serena ^{[12
]}

机构：

[1] Norwegian Univ Sci & Technol, Dept Publ Hlth & Gen Practice, Trondheim, Norway

[2] Imperial Coll London, Dept Epidemiol & Biostat, London, England

[3] Bjorknes Univ Coll, Oslo, Norway

[4] Brigham & Womens Hosp, Channing Div Network Med, 75 Francis St, Boston, MA 02115 USA

[5] Harvard Med Sch, Boston, MA USA

[6] Harvard T Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA

[7] Harvard T Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA

[8] Icahn Sch Med Mt Sinai, Tisch Canc Inst, New York, NY 10029 USA

[9] Univ Bergen, Dept Global Publ Hlth & Primary Care, Bergen, Norway

[10] Univ Bergen, Dept Clin Dent, Bergen, Norway

[11] Univ Leeds, Biostat Unit, Leeds, W Yorkshire, England

[12] Univ Oslo, Hosp Ulleval, Dept Prevent Cardiol, Oslo, Norway

来源：

INTERNATIONAL JOURNAL OF EPIDEMIOLOGY | 2017年 / 46卷 / 03期

关键词：

Fruit and vegetables; diet; nutrition; cardiovascular disease; cancer; all-cause mortality; cohort; global assessment; CORONARY-HEART-DISEASE; LIFE-STYLE FACTORS; OBSTRUCTIVE PULMONARY-DISEASE; DIETARY FLAVONOID INTAKE; MIDDLE-AGED MEN; MEDITERRANEAN DIET; VITAMIN-C; MYOCARDIAL-INFARCTION; ISCHEMIC-STROKE; FIBER INTAKE;

D O I：

10.1093/ije/dyw319

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background: Questions remain about the strength and shape of the dose-response relationship between fruit and vegetable intake and risk of cardiovascular disease, cancer and mortality, and the effects of specific types of fruit and vegetables. We conducted a systematic review and meta-analysis to clarify these associations. Methods: PubMed and Embase were searched up to 29 September 2016. Prospective studies of fruit and vegetable intake and cardiovascular disease, total cancer and all-cause mortality were included. Summary relative risks (RRs) were calculated using a random effects model, and the mortality burden globally was estimated; 95 studies (142 publications) were included. Results: For fruits and vegetables combined, the summary RR per 200 g/day was 0.92 [95% confidence interval (CI): 0.90-0.94, I-2 - 0%, n - 15] for coronary heart disease, 0.84 (95% CI: 0.76-0.92, I-2 = 73%, n = 10) for stroke, 0.92 (95% CI: 0.90-0.95, I-2 = 31%, n = 13) for cardiovascular disease, 0.97 (95% CI: 0.95-0.99, I-2 = 49%, n = 12) for total cancer and 0.90 (95% CI: 0.87-0.93, I-2 = 83%, n = 15) for all-cause mortality. Similar associations were observed for fruits and vegetables separately. Reductions in risk were observed up to 800 g/day for all outcomes except cancer (600 g/day). Inverse associations were observed between the intake of apples and pears, citrus fruits, green leafy vegetables, cruciferous vegetables, and salads and cardiovascular disease and all-cause mortality, and between the intake of green-yellow vegetables and cruciferous vegetables and total cancer risk. An estimated 5.6 and 7.8 million premature deaths worldwide in 2013 may be attributable to a fruit and vegetable intake below 500 and 800 g/day, respectively, if the observed associations are causal. Conclusions: Fruit and vegetable intakes were associated with reduced risk of cardiovascular disease, cancer and all-cause mortality. These results support public health recommendations to increase fruit and vegetable intake for the prevention of cardiovascular disease, cancer, and premature mortality.

引用

页码：1029 / 1056

页数：28

共 194 条

[41] Bias in meta-analysis detected by a simple, graphical test [J].