Fruits and Vegetables Directly Linked to Reduced Mortality Rates

A recent study published in BMJ has combined Medline, Embase, and Cochrane library searches to examine and quantify the potential “dose-response relation between fruit and vegetable consumption and risk of all cause, cardiovascular, and cancer mortality.” The team searched up to August 30, 2013 to compose a reference list of retrieved articles, without language restriction.

The meta-analysis turned up 16 eligible prospective cohort studies, going back to 1950. The oft-cited five servings per day of fruits and vegetables was the optimal amount for limiting overall and cardiovascular mortality, though not cancer mortality. The researchers found that the more fruits and vegetables people consumed each day (up to five total servings), the lower the risk for all-cause mortality.

Specifically,  among 833,234 participants, during follow-up periods ranging from 4.6 to 26 years there were 56,423 deaths, 11,512 from cardiovascular disease and 16,817 from cancer. There was a threshold around five servings of fruit and vegetables a day, after which the risk of all cause mortality did not reduce further. For consumption of five servings versus no servings daily, the hazard ratio was 0.74 for all-cause mortality. Two servings of fruit and three of vegetables appeared to provide optimal benefits. In addition, each fruit or vegetable serving was associated with a 4% reduction in cardiovascular mortality.  A significant inverse association was observed for cardiovascular mortality, while higher consumption of fruit and vegetables was not appreciably associated with risk of cancer mortality. A serving was defined as roughly 80 g, or 2.8 oz., of fruit or vegetable.

The study provides further evidence that a higher consumption of fruit and vegetables is associated with a lower risk of all cause mortality, particularly cardiovascular mortality.

In April a study in the Journal of Epidemiology and Community Health reported similar results. 65,000 U.K. adults completed annual health surveys over an eight-year period. During nearly eight years of follow-up, seven percent of the sample died. Compared with participants who reported eating less than one serving of fruits and veggies daily, those who ate one to three servings had a 12 percent reduction in all-cause mortality. As consumption increased, so did the risk reduction, and unlike the more recent study which capped out benefit at five daily servings, those eating seven or more servings daily continued to increase benefit, experiencing a 33 percent risk reduction. Significant reductions in cancer- and cardiovascular-related mortality were also seen with three or more servings daily.

BMJ, 2014, 349:g4490, http://www.bmj.com/content/349/bmj.g4490

J Epidemiol Community Health, 2014, 68:856-862, doi:10.1136/jech-2013-203500, http://jech.bmj.com/content/68/9/856

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