Fruit and vegetable intake and risk of cardiovascular disease in US adults: the first National Health and Nutrition

Examination Survey Epidemiologic Follow-up Study

Carolina Agurto Daniela Hernandez Ignacio Quintana Mnica Vargas Guillermo Vsquez

Objective of this research

The objective was to examine the relation between fruit and vegetable intake and the risk of cardiovascular disease.

Kind of study
Prospective cohort study
Study population: participants in the first National Health and Nutrition Examination Survey (NHANES) aged 25-74 years.

Methodology (1)
Baseline data:
Study population : cohort of 9608 participants (applying exclusion criteria).
Medical history Standardized medical examination Dietary assessment Laboratory tests Anthropometric measurements

Blood pressure , body weight and height were obtained with the use of standard protocols.

Methodology (2)
Education level, physical activity and alcohol consumption were obtained by Intervieweradministered questionnaires. Smoking status was obtained by questions on lifetime smoking history at follow-up interviews in 1982 through 1984 or later.

Methodology (3)
Food-frequency questionnaire
3 items referring to fruit and vegetable intake. Frequency of consumption of fruit and vegetables was coded into categories ranging from never to 8 times/day. Frequency of consumption of meat, poultry and of fish and shellfish.

Total energy intakes were calculated for each participant by the National Center for Health Statistics.

Observations to the methodology that could affect the results and conclusions of the study
They did not exclude overweight participants, Frequency of consumption of junk food was not included in the Food-frequency questionnaire.

We can see that: people with less frequency in intake of fruit and vegetable practice quantity low physical activity. They show more current cigarette smoking, etc

While they consume less fruit and vegetable in their diet ,they have more blood pressure ,hypertension (%), serum total cholesterol, diabetes (%) and BMI (Kg/m ^2).

We can see that : the intake of fruit and vegetable is a protect factor of ischemic heart disease, stroke, cardiovascular disease.

The frequency of fruit and vegetable in the intake is directly proportional to level of protection for these diseases.

The connection between frecuency and disease , is more evident while more age has the partcipant of the research.

FIGURE 1. Age-adjusted cumulative mortality from stroke, ischemic heart disease, cardiovascular disease, and all causes according to frequency of fruit and vegetable intake in 9608 participants in the research.

This study shows a correlation between consumption of fruit and vegetables and the incidence of ischemic heart disease?
This study shows that the intake of fruit and vegetables 3 times/d compared with < 1 time/d was associated with a 24% lower mortality from ischemic heart disease. Also, recent prospective studies reported an inverse association between fruit and vegetables intake and the risk of ischemic stroke and ischemic heart disease. Accordingly with the results this study, increased fruit and vegetables intakes have been recommended to prevent morbidity and mortality from cardiovascular diseases.

How do the articles authors try to explain in the discussion the answer to the question above?
Fruit and vegetables have abundant individual nutrients, including potassium, antioxidants, and folic acid may contribute to inverse association of the intake of these foods with the risk of stroke and mortality from cardiovascular disease.

Although each of these nutrients may play a protective role in the prevention of cardiovascular disease, their effect in combination with those of other components in whole foods may have a greater effect.

What limitations do you find to the conclusions of this study?

The most important limitation of this study is the no contemplation of the environmental factors and the quality of life of the people; it includes depression and psychological factors, because those factors are related to highest levels of heart problems and heart disease.

What limitations do you find to the conclusions of this study?

Other limitations that we found were the absence of relations between some particular vitamin or substance in the fruits or vegetables or even some reaction between this nutrients with the cause the results presented. We didnt find in this study the cause of the lower risk of cardiovascular disease, it can be considered as a limitation.

What limitations do you find to the conclusions of this study?

The last limitation that we found was the absence of blood and urine exams, its important because the researchers can exclude to persona with drug abuse, renal failure or some medical condition can disturb this study. Other factor is the stress level of the person of this study and use of medication for other disease that can affect the final results.

Which additional studies would you make in order to complement the material presented in this article?
The most important complementary study would be the blood analysis searching some component responsible of results exposed in this study. Other complementary studies may include regular blood pressure control in a close relation with the intake of fruits and vegetables. Analysis of the most important fruits and vegetables for the cardiovascular disease risk