Fruits and Vegetables Help to Lower Risk of Heart Disease Later in Life

Washington, DC—Previous studies of middle-aged adults whose diet consists of a high proportion of fruits and vegetables showed reduced rates of coronary artery disease (CAD). Now, long-term follow-up from the ongoing CARDIA [Coronary Artery Risk Development in Young Adults] study found that a higher intake of fruits and vegetables during young adulthood was associated with a lower prevalence of coronary artery calcium (CAC) in middle-aged women but was not observed in men. Michael Miedema, MD, MPH, cardiologist, Minneapolis Heart Institute, Minnesota, presented the findings at the ACC meeting.

Because the relationship between intake of fruits and vegetables during young adulthood and CAD later in life is unclear, Dr. Miedema and colleagues evaluated the association between dietary intake of fruits and vegetables in young adulthood and the presence of CAC 20 years later. The study began in 1985 with a group of 2646 men and women 18 to 30 years of age to evaluate the development of cardiovascular risk factors and cardiovascular disease. Participants with extreme levels of energy intake (<800 kcal/day or >4500 kcal/day) or those missing CAC scores or other variables were excluded.

Intake of fruits and vegetables at baseline (1985-1986) was assessed using a semi-quantitative interview administered food-frequency questionnaire. According to participant responses, the researchers calculated the average number of servings of fruits and vegetables per day and adjusted them to a 2000 calorie per day diet. Participants were categorized as having a high, moderate, or low fruit and vegetable intake. CAC was measured at year 20 (2005-2006) using electron-beam computed tomography. Researchers also used logistic regression to estimate the adjusted odds ratio and 95% confidence interval across energy-adjusted tertiles of total servings of fruit and vegetables per day.

After 20 years of follow-up, there was a significant trend toward a lower risk of CAC prevalence (10.1%) with an increased consumption of fruits and vegetables in women. For men, however, a similar reduction in CAC prevalence (28.1%) was not observed across the tertiles, according to Dr. Miedema. Specifically, women who reported consuming 8 to 9 servings of fruits and vegetables per day were 40% less likely to have any calcified plaque in the arteries after 20 years of follow-up compared with women who ate the least amount (3-4 servings/day) during the same timeframe. Dr. Miedema said the results were independent of age and other lifestyle factors. Furthermore, adjusting for other dietary factors only minimally attenuated the association. Yet, the same benefit was not found in men, which experts believe warrants further investigation.

“Two prior studies have suggested less benefit from fruit and vegetable intake in men,” said Dr. Miedema, adding that the current study only had 1038 men and may have been underpowered. He noted that other studies of fruit and vegetable intake have suggested cardiovascular benefit as well as reduced risk of cancer and all-cause mortality for men.—Eileen Koutnik-Fotopoulos