Abstract
BACKGROUND: The association between fruit and vegetable (FV) consumption and overall mortality has seldom been investigated in large cohort studies. Findings from the few available studies are inconsistent. OBJECTIVE: The objective was to examine the dose-response relation between FV consumption and mortality, in terms of both time and rate, in a large prospective cohort of Swedish men and women. DESIGN: FV consumption was assessed through a self-administrated questionnaire in a population-based cohort of 71,706 participants (38,221 men and 33,485 women) aged 45-83 y. We performed a dose-response analysis to evaluate 10th survival percentile differences (PDs) by using Laplace regression and estimated HRs by using Cox regression. RESULTS: During 13 y of follow-up, 11,439 deaths (6803 men and 4636 women) occurred in the cohort. In comparison with 5 servings FV/d, a lower consumption was progressively associated with shorter survival and higher mortality rates. Those who never consumed FV lived 3 y shorter (PD: -37 mo; 95% CI: -58, -16 mo) and had a 53% higher mortality rate (HR: 1.53; 95% CI: 1.19, 1.99) than did those who consumed 5 servings FV/d. Consideration of fruit and vegetables separately showed that those who never consumed fruit lived 19 mo shorter (PD: -19 mo; 95% CI: -29, -10 mo) than did those who ate 1 fruit/d. Participants who consumed 3 vegetables/d lived 32 mo longer than did those who never consumed vegetables (PD: 32 mo; 96% CI: 13, 51 mo). CONCLUSION: FV consumption <5 servings/d is associated with progressively shorter survival and higher mortality rates. The Swedish Mammography Cohort and the Cohort of Swedish Men were registered at clinicaltrials.gov as NCT01127698 and NCT01127711, respectively.
Generated Summary
This study, published in the American Journal of Clinical Nutrition, investigates the relationship between fruit and vegetable (FV) consumption and all-cause mortality in a large prospective cohort of Swedish men and women. The research employed a dose-response analysis to examine how different levels of FV intake correlate with mortality, measured in terms of both time and rate. The study included 71,706 participants aged 45-83 years, with data collected through a self-administered questionnaire. The primary methodology involved assessing FV consumption and analyzing survival differences using Laplace regression and Cox regression models over a 13-year follow-up period.
Key Findings & Statistics
- The study followed 71,706 participants (38,221 men and 33,485 women).
- During the 13-year follow-up period, 11,439 deaths occurred (6803 men and 4636 women).
- Compared to those consuming 5 servings of FV per day, individuals who never consumed FV experienced a 3-year shorter lifespan (PD: -37 months; 95% CI: -58, -16 months).
- Those who never consumed FV had a 53% higher mortality rate (HR: 1.53; 95% CI: 1.19, 1.99) compared to those consuming 5 servings FV/d.
- Participants who never consumed fruit lived 19 months shorter (PD: -19 months; 95% CI: -29, -10 months) compared to those who ate 1 fruit per day.
- Those consuming 3 vegetables per day lived 32 months longer (PD: 32 months; 96% CI: 13, 51 months) compared to those who never consumed vegetables.
Other Important Findings
- The study found a dose-response relationship between FV consumption and all-cause mortality, indicating that higher FV intake is associated with lower mortality rates.
- Separate analyses of fruit and vegetable consumption revealed independent protective effects on survival.
- The study highlights the importance of FV consumption in promoting longevity.
Limitations Noted in the Document
- The study relies on self-reported dietary data, which is subject to recall bias and may not accurately reflect actual FV consumption.
- The study population is limited to Swedish men and women, and the findings may not be generalizable to other populations.
- The study did not account for potential confounding factors that could influence the relationship between FV consumption and mortality.
- The study focuses on all-cause mortality, which may not capture specific health benefits of FV consumption.
Conclusion
The study strongly supports the benefits of fruit and vegetable consumption for longevity, showing a clear dose-response relationship between intake and all-cause mortality. The findings underscore the importance of integrating FV into daily diets for promoting overall health and potentially extending lifespan. The substantial differences in survival observed between those consuming varying amounts of FV highlight the significance of dietary choices in health outcomes. It shows those who never consumed FV lived 3 y shorter and had a 53% higher mortality rate than those who consumed 5 servings FV/d. The conclusion emphasizes that FV consumption is linked with progressively shorter survival and higher mortality rates. These findings are significant to guide public health recommendations and personalized dietary advice. The Swedish Mammography Cohort and the Cohort of Swedish Men were registered at clinicaltrials.gov as NCT01127698 and NCT01127711, respectively. Future research should address the limitations of this study by incorporating more objective dietary assessment methods and considering the effects of other factors in depth to gain more insights in this field.