Abstract
Stroke is the first leading cause of death in China, and low fruit intake is suggested to be one of the most important risk factors for stroke mortality. However, the trends of stroke mortality attributable to low fruit intake remain unclear in China. Therefore, this study aimed to investigate the long-term trends of stroke mortality attributable to low fruit intake by sex in China during 1990–2017. Data were obtained from the Global Burden of Disease 2017 study; the annual percentage change (APC) and average annual percentage change (AAPC) were estimated by joinpoint regression analysis, and the net age, period, and cohort effects were estimated using the age–period–cohort model with an intrinsic estimator algorithm (APC-IE). The crude mortality rates (CMRs) increased for males and decreased for females from 1990 to 2017. The age-standardized mortality rates (ASMRs) for both males and females showed consecutive significant declines from 1990 to 2017. By APC analysis, substantially increasing age effects were presented from 25 to 79 years for both sexes. The independent period and cohort effects progressively decreased during the entire period for both sexes, with a faster decrease for females than for males. Males and elder groups were the high-risk population for stroke mortality caused by low fruit intake. Although the mortality risk showed a decreasing trend, the fruit intake was still low for the Chinese population. Therefore, effective strategies and global awareness are essential to improve the current situation of low fruit intake, thereby preventing and reducing the stroke mortality risk caused by low fruit intake in China.
Highlights
As one of the non-communicable diseases (NCDs), stroke has become the second leading cause of death globally, which has been identified by the World Health Organization (WHO) and the United Nations as one of the priorities for actions to reduce the burden of NCDs (Feigin et al, 2015; GBD Collaborators, 2019)
We can observe that crude mortality rates (CMRs) and age-standardized mortality rates (ASMRs) of stroke attributable to low fruit intake for males were both higher than that for females
The main potential mechanisms for fruit decreasing stroke mortality risk are that some fruits have antioxidant and free radical scavenging functions, such as grapes, blueberries, pomegranates, apples, hawthorns, and avocados (Brasil et al, 2014; Zhao et al, 2017)
Summary
As one of the non-communicable diseases (NCDs), stroke has become the second leading cause of death globally, which has been identified by the World Health Organization (WHO) and the United Nations as one of the priorities for actions to reduce the burden of NCDs (Feigin et al, 2015; GBD Collaborators, 2019). The United Kingdom women’s cohort study indicated that each 80-g per day intake of fruit could reduce 6–7% mortality risk of cardiovascular and coronary heart disease (Lai et al, 2015). The age-standardized stroke mortality attributable to low fruit intake in 2017 in China (21.34 per 10,000) was much higher than that in the United States (3.71 per 10,000) (GBD Collaborative Network Network, 2018). It was significant to estimate the stroke burden attributable to low fruit intake in China
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