Abstract
This study was to investigate the association of long-term fruit and vegetable (FV) intake with all-cause mortality. We utilized data from the China Health and Nutrition Survey (CHNS), a prospective cohort study conducted in China. The sample population included 19,542 adult respondents with complete mortality data up to 31 December 2011. Cumulative FV intake was assessed by 3 day 24 h dietary recalls. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality. Covariates included sociodemographic characteristics, lifestyle factors, health-related factors, and urban index. A total of 1409 deaths were observed during follow-up (median: 14 years). In the fully adjusted model, vegetable intake of the fourth quintile (327~408 g/day) had the greatest negative association with death compared to the lowest quintile (HR = 0.63, 95% CI: 0.53–0.76). Fruit intake of the fifth quintile (more than 126 g/day) had the highest negative association (HR = 0.24, 95% CI: 0.15–0.40) and increasing general FV intake were also negatively associated with all-cause mortality which demonstrated the greatest negative association in the amount of fourth quintile (HR = 0.59, 95% CI: 0.49–0.70) compared to the lowest quintile. To conclude, greater FV intake is associated with a reduced risk of total mortality for Chinese adults. High intake of fruit has a stronger negative association with mortality than differences in intake of vegetables. Our findings support recommendations to increase the intake of FV to promote overall longevity.
Highlights
Fruit and vegetable (FV) intake has been recognized as an important component of a healthy diet and has become a key component of multiple national dietary guidelines, including those in China [1,2]
This study aimed to examine the association of combined FV intakes and separate fruit and vegetable intake with all-cause mortality utilizing data from a nationwide longitudinal sample
In the fully adjusted model, vegetable intake between 327 and 408 g/day was most inversely associated with all-cause mortality (HR = 0.63, 95% confidence intervals (CIs): 0.53–0.76); intake of fruits in the fifth quintile was most inversely associated with all-cause mortality, at more than 126 g/day (HR = 0.24, 95% CI: 0.15–0.40)
Summary
Fruit and vegetable (FV) intake has been recognized as an important component of a healthy diet and has become a key component of multiple national dietary guidelines, including those in China [1,2]. Chinese dietary guidelines recommend that vegetables consumption should be 300~500 g/day, and that fruits consumption should be 200~350 g/day [4]. According to the results of a sample of residents from 2010 to 2012, the average daily intake of vegetables and fruits for urban and rural residents in China is 269.7 g and 40.7 g, respectively [5]. Half of the Chinese population meet the criteria of fruit and vegetable intake recommended by the Chinese dietary guidelines [6]. Past research on the relationship between food and human health has observed inadequate intake of fruits and vegetables to be among the top ten risk factors of death
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