Prospective Analysis of Vegetable Amount and Variety on the Risk of All-Cause and Cause-Specific Mortality among US Adults, 1999⁻2011.

Zach Conrad,Lisa Jahns,Jessica Thomson

doi:10.3390/nu10101377

Abstract

The Dietary Guidelines for Americans 2015–2020 (DGA) provides recommendations for consuming a specific amount and variety of vegetables, but no studies have assessed the relationship between DGA-recommended vegetable variety and risk of mortality. We prospectively assessed the relationship between vegetable amount and variety and the risk of mortality using nationally-representative survey data (n = 29,133). Hazard ratios were estimated using survey-weighted, multivariate, Cox-proportional hazards models. Mean follow-up time was 6.5 years (12.8 years maximum). Total deaths from all causes were 2861, which included 829 deaths from cardiometabolic disease (556 coronary heart disease, 170 stroke, and 103 diabetes). Compared to individuals who reported consuming the greatest amount of vegetables daily, those with the least intake had a 78% greater risk of mortality from all causes (HR: 1.78, 95% CI: 1.29–2.47), a 68% greater risk of death from cardiovascular disease (1.68, 1.08–2.62), and an 80% greater risk of death from coronary heart disease (1.80, 1.09–2.08). No relationships were observed between vegetable variety and risk of all-cause or cause-specific mortality. Greater vegetable amount, but not variety, was associated with a reduced risk of mortality from all causes, cardiovascular disease, and coronary heart disease. Additional large-scale longitudinal studies with repeated measures of dietary exposure are needed.

Highlights

IntroductionGreater vegetable intake is associated with a reduced risk of cardiometabolic disease (CMD) [1,2,3,4]
Greater vegetable intake is associated with a reduced risk of cardiometabolic disease (CMD) [1,2,3,4].This etiology is largely driven by the bioactive compounds found in vegetables [5], such as carotenoids, polyphenols, folate, and potassium, which are associated with reduced blood pressure, inhibited platelet aggregation, improvement of lipoprotein profiles, increased insulin sensitivity, and reduced oxidant stress and inflammation [6,7,8,9]
Compared to individuals who reported consuming the greatest amount of vegetables daily, those with the least intake had a 78% greater risk of mortality from all causes (HR: 1.78, 95% CI: 1.29–2.47), a 68% greater risk of death from cardiovascular disease (1.68, 1.08–2.62), and an 80% greater risk of death from coronary heart disease (1.80, 1.09–2.08)

Summary

Introduction

Greater vegetable intake is associated with a reduced risk of cardiometabolic disease (CMD) [1,2,3,4]. This etiology is largely driven by the bioactive compounds found in vegetables [5], such as carotenoids, polyphenols, folate, and potassium, which are associated with reduced blood pressure, inhibited platelet aggregation, improvement of lipoprotein profiles, increased insulin sensitivity, and reduced oxidant stress and inflammation [6,7,8,9]. (DGA) provides specific recommendations for consuming a variety of vegetables [11], in order to increase the likelihood that individuals consume adequate amounts of a wide array of health-promoting bioactive compounds. Bhupathiraju, et al reported that the number of distinct fruits and vegetables consumed is not associated with a reduced risk of incident coronary heart disease (CHD) [12], yet recently, Nutrients 2018, 10, 1377; doi:10.3390/nu10101377 www.mdpi.com/journal/nutrients

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