Skip to main content
×
Home

Intakes of fruits, vegetables and carbohydrate and the risk of CVD

  • Kaumudi J Joshipura (a1) (a2) (a3), Hsin-Chia Hung (a4), Tricia Y Li (a5), Frank B Hu (a2) (a5), Eric B Rimm (a2) (a5), Meir J Stampfer (a2) (a5) (a6), Graham Colditz (a2) (a7) (a8) and Walter C Willett (a2) (a5) (a6)...
Abstract
AbstractBackground

Low-carbohydrate diets could lead to reduced fruit and vegetable intake, which may be protective against CVD. The role of carbohydrate intake in modifying the association between fruits and vegetables and CVD has not been evaluated.

Objective

To evaluate whether carbohydrate intake affects the association between fruits and vegetables and CVD.

Design

We included participants from two large prospective studies, the Nurses’ Health Study (NHS) and the Health Professionals’ Follow-Up Study (HPFS). We followed 70 870 eligible NHS females for 16 years and 38 918 eligible HPFS males for 14 years. Diet was assessed from an FFQ updated every 4 years. Our primary outcome was ischaemic CVD (fatal and non-fatal myocardial infarction and ischaemic stroke). We used Cox proportional hazards models to evaluate the relationship between fruits and vegetables and ischaemic CVD within groups with low, moderate or high carbohydrate intake.

Results

Fruit intake was strongly related with carbohydrate intake, but vegetables showed a very small correlation. Vegetable intake showed stronger associations with ischaemic CVD among the low carbohydrate group (multivariate risk ratio (RR) = 0·82 for an increment of 3 servings/d; 95 % CI 0·68, 0·99); green leafy vegetables and carotene-rich fruits and vegetables followed a similar pattern. Total fruit intake was associated with a lower risk of ischaemic CVD only among participants with moderate carbohydrate intake (RR = 0·81 comparing extreme quintiles; 95 % CI 0·70, 0·94).

Conclusions

Total vegetables, green leafy vegetables and carotene-rich fruits and vegetables showed stronger associations with ischaemic CVD among the low carbohydrate group. No consistent trends were observed for fruit intake.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org 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 @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ 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.

      Intakes of fruits, vegetables and carbohydrate and the risk of CVD
      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.

      Intakes of fruits, vegetables and carbohydrate and the risk of CVD
      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.

      Intakes of fruits, vegetables and carbohydrate and the risk of CVD
      Available formats
      ×
Copyright
Corresponding author
*Email kjoshipura@rcm.upr.edu
References
Hide All
1.Atkins RC (1998) Dr. Atkins New Diet Revolution. New York: Avon Books.
2.Joshipura KJ, Ascherio A, Manson JE, Stampfer MJ, Rimm EB, Speizer FE, Hennekens CH, Spiegelman D & Willett WC (1999) Fruit and vegetable intake in relation to risk of ischemic stroke. JAMA 282, 12331239.
3.Joshipura KJ, Hu FB, Manson JE et al. (2001) The effect of fruit and vegetable intake on risk for coronary heart disease. Ann Intern Med 134, 11061114.
4.Hung HC, Joshipura KJ, Jiang R, Hu FB, Hunter D, Smith-Warner SA, Colditz GA, Rosner B, Spiegelman D & Willett WC (2004) Fruit and vegetable intake and risk of major chronic disease. J Natl Cancer Inst 96, 15771584.
5.Knekt P, Reunanen A, Jarvinen R, Seppanen R, Heliovaara M & Aromaa A (1994) Antioxidant vitamin intake and coronary mortality in a longitudinal population study. Am J Epidemiol 139, 11801189.
6.Rimm EB, Stampfer MJ, Ascherio A, Giovannucci E, Colditz GA & Willett WC (1993) Vitamin E consumption and the risk of coronary heart disease in men. N Engl J Med 328, 14501456.
7.Khaw KT & Barrett-Connor E (1987) Dietary potassium and stroke-associated mortality. A 12-year prospective population study. N Engl J Med 316, 235240.
8.Knekt P, Jarvinen R, Reunanen A & Maatela J (1996) Flavonoid intake and coronary mortality in Finland: a cohort study. BMJ 312, 478481.
9.Rimm EB, Ascherio A, Giovannucci E, Spiegelman D, Stampfer MJ & Willett WC (1996) Vegetable, fruit, and cereal fiber intake and risk of coronary heart disease among men. JAMA 275, 447451.
10.Curb JD, Masaki K, Rodriguez BL, Abbott RD, Burchfiel CM, Chen R, Petrovitch H, Sharp D & Yano K (1996) Peripheral artery disease and cardiovascular risk factors in the elderly. The Honolulu Heart Program. Arterioscler Thromb Vasc Biol 16, 14951500.
11.Feskanich D, Rimm EB, Giovannucci EL, Colditz GA, Stampfer MJ, Litin LB & Willett WC (1993) Reproducibility and validity of food intake measurements from a semiquantitative food frequency questionnaire. J Am Diet Assoc 93, 790796.
12.Rimm EB, Giovannucci EL, Stampfer MJ, Colditz GA, Litin LB & Willett WC (1992) Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals. Am J Epidemiol 135, 11141126.
13.Salvini S, Hunter DJ, Sampson L, Stampfer MJ, Colditz GA, Rosner B & Willett WC (1989) Food-based validation of a dietary questionnaire: the effects of week-to-week variation in food consumption. Int J Epidemiol 18, 858867.
14.Feskanich D, Ziegler RG, Michaud DS, Giovannucci EL, Speizer FE, Willett WC & Colditz GA (2000) Prospective study of fruit and vegetable consumption and risk of lung cancer among men and women. J Natl Cancer Inst 92, 18121823.
15.Caan B, Hiatt RA & Owen AM (1991) Mailed dietary surveys: response rates, error rates, and the effect of omitted food items on nutrient values. Epidemiology 2, 430436.
16.Hu FB, Stampfer MJ, Rimm E, Ascherio A, Rosner BA, Spiegelman D & Willett WC (1999) Dietary fat and coronary heart disease: a comparison of approaches for adjusting for total energy intake and modeling repeated dietary measurements. Am J Epidemiol 149, 531540.
17.DerSimonian R & Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7, 177188.
18.Willett W (1998) Nutritional Epidemiology. New York: Oxford University Press.
19.Hu FB, Stampfer MJ, Manson JE, Rimm E, Colditz GA, Rosner BA, Hennekens CH & Willett WC (1997) Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med 337, 14911499.
20.Liu S, Willett WC, Stampfer MJ, Hu FB, Franz M, Sampson L, Hennekens CH & Manson JE (2000) A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. Am J Clin Nutr 71, 14551461.
21.Fung TT, Stampfer MJ, Manson JE, Rexrode KM, Willett WC & Hu FB (2004) Prospective study of major dietary patterns and stroke risk in women. Stroke 35, 20142019.
22.Halton TL, Willett WC, Liu S, Manson JE, Albert CM, Rexrode K & Hu FB (2006) Low-carbohydrate-diet score and the risk of coronary heart disease in women. N Engl J Med 355, 19912002.
23.Dansinger ML, Gleason JA, Griffith JL, Selker HP & Schaefer EJ (2005) Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA 293, 4353.
24.Volpe SL (2006) Popular weight reduction diets. J Cardiovasc Nurs 21, 3439.
Recommend this journal

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

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 18
Total number of PDF views: 159 *
Loading metrics...

Abstract views

Total abstract views: 299 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 23rd November 2017. This data will be updated every 24 hours.