Skip to main content
    • Aa
    • Aa
  • Access
  • Cited by 59
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Buil-Cosiales, Pilar Toledo, Estefania Salas-Salvadó, Jordi Zazpe, Itziar Farràs, Marta Basterra-Gortari, Francisco Javier Diez-Espino, Javier Estruch, Ramon Corella, Dolores Ros, Emilio Marti, Amelia Gómez-Gracia, Enrique Ortega-Calvo, Manuel Arós, Fernando Moñino, Manuel Serra-Majem, Lluis Pintó, Xavier Lamuela-Raventós, Rosa Maria Babio, Nancy Gonzalez, Jose I. Fitó, Montserrat and Martínez-González, Miguel A. 2016. Association between dietary fibre intake and fruit, vegetable or whole-grain consumption and the risk of CVD: results from the PREvención con DIeta MEDiterránea (PREDIMED) trial. British Journal of Nutrition, Vol. 116, Issue. 03, p. 534.

    Golzarand, Mahdieh Bahadoran, Zahra Mirmiran, Parvin Zadeh-Vakili, Azita and Azizi, Fereidoun 2016. Consumption of nitrate-containing vegetables is inversely associated with hypertension in adults: a prospective investigation from the Tehran Lipid and Glucose Study. Journal of Nephrology, Vol. 29, Issue. 3, p. 377.

    Guo, Xiaohui Tresserra-Rimbau, Anna Estruch, Ramón Martínez-González, Miguel A. Medina-Remón, Alexander Castañer, Olga Corella, Dolores Salas-Salvadó, Jordi and Lamuela-Raventós, Rosa M. 2016. Effects of Polyphenol, Measured by a Biomarker of Total Polyphenols in Urine, on Cardiovascular Risk Factors After a Long-Term Follow-Up in the PREDIMED Study. Oxidative Medicine and Cellular Longevity, Vol. 2016, p. 1.

    Kamran, Aziz Shekarchi, Ali Akbar Sharifian, Elham and Heydari, Heshmatolah 2016. The Comparison of Dietary Behaviors among Rural Controlled and Uncontrolled Hypertensive Patients. Advances in Preventive Medicine, Vol. 2016, p. 1.

    Gouveri, Evanthia Drakopanagiotakis, Fotios and Diamantopoulos, Emmanuel 2015. Nutritional Intervention in Metabolic Syndrome.

    Leske, Stuart Strodl, Esben Harper, Catherine Clemens, Susan and Hou, Xiang-Yu 2015. Psychological distress may affect nutrition indicators in Australian adults. Appetite, Vol. 90, p. 144.

    Niknam, Mahdieh Saadatnia, Mohammad Shakeri, Forough Keshteli, Ammar Hassanzadeh Saneei, Parvane and Esmaillzadeh, Ahmad 2015. Adherence to a DASH-Style Diet in Relation to Stroke: A Case-Control Study. Journal of the American College of Nutrition, Vol. 34, Issue. 5, p. 408.

    Perona, Javier 2015. Nutritional Intervention in Metabolic Syndrome.

    Randhawa, Muhammad Atif Khan, Ammar Ahmad Javed, Muhammad Sameem and Sajid, Muhammad Wasim 2015. Handbook of Fertility.

    Widmer, R. Jay Flammer, Andreas J. Lerman, Lilach O. and Lerman, Amir 2015. The Mediterranean Diet, its Components, and Cardiovascular Disease. The American Journal of Medicine, Vol. 128, Issue. 3, p. 229.

    Fuentes, Eduardo and Palomo, Iván 2014. Mechanisms of endothelial cell protection by hydroxycinnamic acids. Vascular Pharmacology, Vol. 63, Issue. 3, p. 155.

    Kooshki, Akram and Hoseini, BiBi Leila 2014. Phytochemicals and Hypertension. Shiraz E-Medical Journal, Vol. 15, Issue. 1,

    Medina-Remón, Alexander Tresserra-Rimbau, Anna Valderas-Martinez, Palmira Estruch, Ramon and Lamuela-Raventos, Rosa Maria 2014. Polyphenols in Human Health and Disease.

    Rodrigo, Ramón and González, Jaime 2014. Role of Oxidative Stress in Chronic Diseases.

    Song, Hong Ji Paek, Yu Jin Choi, Min Kyu and Lee, Hae-Jeung 2014. Gender differences in the relationship between risk of hypertension and fruit intake. Preventive Medicine, Vol. 67, p. 154.

    Davila, E.P. Quintero, M.A. Orrego, M.L. Ford, E.S. Walke, H. Arenas, M.M. and Pratt, M. 2013. Prevalence and risk factors for metabolic syndrome in Medellin and surrounding municipalities, Colombia, 2008–2010. Preventive Medicine, Vol. 56, Issue. 1, p. 30.

    García-Hernández, V. M. Gallar, M. Sánchez-Soriano, J. Micol, V. Roche, E. and García-García, E. 2013. Effect of omega-3 dietary supplements with different oxidation levels in the lipidic profile of women: a randomized controlled trial. International Journal of Food Sciences and Nutrition, Vol. 64, Issue. 8, p. 993.

    Medina-Remón, A. Vallverdú-Queralt, A. Arranz, S. Ros, E. Martínez-González, M.A. Sacanella, E. Covas, M.I. Corella, D. Salas-Salvadó, J. Gómez-Gracia, E. Ruiz-Gutiérrez, V. Lapetra, J. García-Valdueza, M. Arós, F. Saez, G.T. Serra-Majem, L. Pinto, X. Vinyoles, E. Estruch, R. and Lamuela-Raventos, R.M. 2013. Gazpacho consumption is associated with lower blood pressure and reduced hypertension in a high cardiovascular risk cohort. Cross-sectional study of the PREDIMED trial. Nutrition, Metabolism and Cardiovascular Diseases, Vol. 23, Issue. 10, p. 944.

    Salehi-Abargouei, Amin Maghsoudi, Zahra Shirani, Fatemeh and Azadbakht, Leila 2013. Effects of Dietary Approaches to Stop Hypertension (DASH)-style diet on fatal or nonfatal cardiovascular diseases—Incidence: A systematic review and meta-analysis on observational prospective studies. Nutrition, Vol. 29, Issue. 4, p. 611.

    de Paula, Tatiana Pedroso Steemburgo, Thais de Almeida, Jussara Carnevale Dall'Alba, Valesca Gross, Jorge Luiz and de Azevedo, Mirela Jobim 2012. The role of Dietary Approaches to Stop Hypertension (DASH) diet food groups in blood pressure in type 2 diabetes. British Journal of Nutrition, Vol. 108, Issue. 01, p. 155.


Fruit and vegetable consumption is inversely associated with blood pressure in a Mediterranean population with a high vegetable-fat intake: the Seguimiento Universidad de Navarra (SUN) Study

  • Alvaro Alonso (a1) (a2), Carmen de la Fuente (a1), Ana M. Martín-Arnau (a1), Jokin de Irala (a1), J. Alfredo Martínez (a3) and Miguel Ángel Martínez-González (a1)
  • DOI:
  • Published online: 01 March 2007

There is evidence that a diet rich in fruit and vegetables reduces blood pressure (BP). Characteristically, the Mediterranean diet is rich in plant-derived foods and also in fat, but studies conducted in Mediterranean countries to relate diet to BP are scarce. We studied the association between fruit and vegetable consumption and BP in a cross-sectional analysis of 4393 participants in the Seguimiento Universidad de Navarra (SUN) Study, an ongoing dynamic cohort study in Spain. Diet was measured using a food-frequency questionnaire previously validated in Spain. Fat represented more than 37% total energy intake. Subjects were considered to have undiagnosed hypertension if they reported systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, and not a medical diagnosis of hypertension. The adjusted prevalence odds ratio of undiagnosed hypertension (upper v. lowest quintile) was 0·58 (95% CI 0·36, 0·91; P for trend 0·01) for vegetable consumption and 0·68 (95% CI 0·43, 1·09; P for trend 0·10) for fruit consumption. Comparing those in the highest quintile of both fruit and vegetable consumption with those in the lowest quintile of both food groups, the prevalence odds ratio was 0·23 (95% CI 0·10, 0·55; P=0·001), after adjusting for risk factors for hypertension and other dietary exposures. In a Mediterranean population with an elevated fat consumption, a high fruit and vegetable intake is inversely associated with BP levels.

    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Fruit and vegetable consumption is inversely associated with blood pressure in a Mediterranean population with a high vegetable-fat intake: the Seguimiento Universidad de Navarra (SUN) Study
      Your Kindle email address
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Fruit and vegetable consumption is inversely associated with blood pressure in a Mediterranean population with a high vegetable-fat intake: the Seguimiento Universidad de Navarra (SUN) Study
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Fruit and vegetable consumption is inversely associated with blood pressure in a Mediterranean population with a high vegetable-fat intake: the Seguimiento Universidad de Navarra (SUN) Study
      Available formats
Corresponding author
*Corresponding author: Dr Miguel Angel Martínez-González, fax +34 948 42 56 49, email
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

BE Ainsworth , WL Haskell & MC Whitt Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc (2000) 32, S498S504.

LJ Appel , TJ Moore & E Obarzanek A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med (1997) 336, 11171124.

A Ascherio , CH Hennekens , WC Willett , FM Sacks , B Rosner , JE Manson , JCM Witteman & MJ Stampfer Prospective study of nutritional factors, blood pressure, and hypertension among US women. Hypertension (1996) 27, 10651072.

A Ascherio , EB Rimm , EL Giovanucci , GA Colditz , B Rosner , WC Willett , FM Sacks & MJ Stampfer A prospective study of nutritional factors and hypertension among US men. Circulation (1992) 86, 14751484.

JR Banegas , F Rodríguez-Artalejo , JJ de la Cruz Troca , P Guallar-Castillón & J del Rey Calero Blood pressure in Spain. Distribution, awareness, control, and benefits of a reduction in average pressure. Hypertension (1998) 32, 9981002.

AV Chobanian , GL Bakris & HR Black The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA (2003) 289, 25602571.

M De Lorgeril , P Salen , JL Martin , I Monjaud , J Delaye & N Mamelle Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart study. Circulation (1999) 99, 779785.

LA Ferrara , AS Raimondi , L d'Episcopo , L Guida , A Dello Russo & T Marotta Olive oil and reduced need for antihypertensive medications. Arch Intern Med (2000) 160, 837842.

N Goldman , I-F Lin , M Weinstein & Y-H Lin Evaluating the quality of self-reports of hypertension and diabetes. J Clin Epidemiol (2003) 56, 148154.

FJ He & GA MacGregor Beneficial effects of potassium. BMJ (2001) 323, 497501.

DW Hosmer & S Lemeshow Applied Logistic Regression 2nd ed. New York: Wiley. (2000).

MK Kim , S Sasaki , S Sasazuki , S Okubo , M Hayashi & S Tsugane Lack of long-term effect of vitamin C supplementation on blood pressure. Hypertension (2002) 40, 797803.

M McIntyre , DF Bohr & AF Dominiczak Endothelial function in hypertension: the role of superoxide anion. Hypertension (1999) 34, 539545.

MA Martínez-González , A Alonso , J de Irala-Estévez & E Fernández-Jarne What is protective in the Mediterranean diet?. Atherosclerosis (2003) 166, 405407.

MA Martínez-González , JA Martínez , FB Hu , MJ Gibney & J Kearney Physical inactivity, sedentary lifestyles, and obesity in the European Union. Int J Obes Relat Metab Disord (1999) 23, 11921201.

MA Martínez-González & A Sánchez-Villegas The emerging role of Mediterranean diets in cardiovascular epidemiology: monounsaturated fats, olive oil, red wine or the whole pattern?. Eur J Epidemiol (2004) 19, 913.

MA Martínez-González , A Sánchez-Villegas , J de Irala-Estévez , A Martí & JA Martínez Mediterranean diet and stroke: objectives and design of the SUN project. Nutr Neurosci (2002) 5, 6573.

JM Martín-Moreno , P Boyle , L Gorgojo , P Maisonneuve , JC Fernández-Rodríguez , S Salvini & WC Willett Development and validation of a food frequency questionnaire in Spain. Int J Epidemiol (1993) 22, 512519.

BA Mullan , IS Young , H Fee & DR McCance Ascorbic acid reduces blood pressure and arterial stiffness in type 2 diabetes. Hypertension (2002) 40, 804809.

RM Robertson & L Smaha Can a Mediterranean-style diet reduce heart disease?. Circulation (2001) 103, 18211822.

KJ Rothman & S Greenland Modern Epidemiology 2nd ed. Philadelphia, PA: Lippincott-Raven. (1998).

V Ruiz-Gutiérrez , FJ Muriana , A Guerrero , AM Cert & J Villar Plasma lipids, erythrocyte membrane lipids and blood pressure of hypertensive women after ingestion of dietary oleic acid from two different sources. J Hypertens (1996) 14, 14831490.

FM Sacks , LP Svetkey & WM Vollmer et al.. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med (2001) 344, 310.

A Sánchez-Villegas , M Delgado-Rodríguez , MA Martínez-González & J de Irala-Estévez Gender, age, socio-demographic and lifestyle factors associated with major dietary patterns in the Spanish project SUN (Seguimiento Universidad de Navarra). Eur J Clin Nutr (2003) 57, 285292.

S Sans , G Paluzie , L Balana , T Puig & I Balaguer-Vintró Trends in prevalence, awareness, treatment and control of arterial hypertension between 1986 and 1996: the MONICA-Catalonia study (in Spanish). Med Clin (Barc) (2001) 117, 246253.

RB Singh , G Dubnov , MA Niaz , S Ghosh , R Singh , SS Rastogi , O Manor , D Pella & EM Berry Effect of an Indo-Mediterranean diet on progression of coronary artery disease in high risk patients (Indo-Mediterranean Diet Heart study): a randomised single-blind trial. Lancet (2002) 360, 14551461.

JR Sowers Hypertension, angiotensin II, and oxidative stress. N Engl J Med (2002) 346, 19992001.

J Stamler , K Liu , KJ Ruth , J Pryer & P Greenland Eight-year blood pressure change in middle-aged men: relationship to multiple nutrients. Hypertension (2002) 39, 10001006.

LP Svetkey & CM Loria Blood pressure effects of vitamin C: what's the key question?. Hypertension (2002) 40, 789791.

MJ Tormo , C Navarro , MD Chirlaque & X Barber Is there a different dietetic pattern depending on self-knowledge of high blood pressure?. Eur J Epidemiol (2000) 16, 963971.

A Trichopoulou , T Costacou , C Barnia & D Trichopoulos Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med (2003) 348, 25992608.

PK Whelton , J He & LJ Appel Primary prevention of hypertension: clinical and public health advisory from the National High Blood Pressure Education Program. JAMA (2002) 288, 18821888.

WC Willett Nutritional Epidemiology 2nd ed. New York: Oxford University Press. (1998).

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *