title: Fruit and vegetable intakes, C-reactive protein, and the metabolic syndrome.
abstract: BACKGROUND
  Limited data on the relation between the risk of the metabolic syndrome and fruit and vegetable intakes and inflammatory marker concentrations are available.
  
  
  OBJECTIVE
  We evaluated the relation between fruit and vegetable intakes and C-reactive protein (CRP) concentrations and the prevalence of the metabolic syndrome.
  
  
  METHODS
  Fruit and vegetable intakes were assessed with the use of a validated semiquantitative food-frequency questionnaire in a cross-sectional study of 486 Tehrani female teachers aged 40-60 y. Anthropometric measurements were made and blood pressure was assessed according to standard methods. Fasting blood samples were taken for biochemical measurements. The metabolic syndrome was defined on the basis of the National Cholesterol Education Program Adult Treatment Panel III guidelines.
  
  
  RESULTS
  The reported mean daily fruit and vegetable intakes were 228 +/- 79 and 186 +/- 88 g/d, respectively. Both fruit and vegetable intakes were inversely associated with plasma CRP concentrations. After statistical control for age, body mass index, and waist circumference, mean plasma CRP concentrations across increasing quintile categories of fruit intakes were 1.94, 1.79, 1.65, 1.61, and 1.56 mg/L and of vegetable intakes were 2.03, 1.82, 1.58, 1.52, and 1.47 mg/L (P for trend < 0.01 for both). These inverse associations remained significant after additional control for other potential confounding variables and dietary factors. After control for potential confounders, persons in the highest quintile of fruit intake had a 34% (95% CI: 20%, 46%) lower and those in the highest quintile of vegetables intake had a 30% (95% CI: 16%, 39%) lower chance of having the metabolic syndrome than did those in the lowest quintiles.
  
  
  CONCLUSIONS
  Higher intakes of fruit and vegetables are associated with a lower risk of the metabolic syndrome; the lower risk may be the result of lower CRP concentrations. These findings support current dietary recommendations to increase daily intakes of fruit and vegetables as a primary preventive measure against cardiovascular disease.
authors.affiliation: Department of Human Nutrition, School of Nutrition and Food Science, Shaheed Beheshti University of Medical Sciences, Tehran, Iran. esmaillzadeh@yahoo.ca
authors.forename: Ahmad
authors.initials: A
authors.lastname: Esmaillzadeh
authors.forename: Masoud
authors.initials: M
authors.lastname: Kimiagar
authors.forename: Yadollah
authors.initials: Y
authors.lastname: Mehrabi
authors.forename: Leila
authors.initials: L
authors.lastname: Azadbakht
authors.forename: Frank B
authors.initials: FB
authors.lastname: Hu
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
mesh_terms: D000328:Adult; D000886:Anthropometry; D015415:Biomarkers; D001794:Blood Pressure; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis* / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D005638:Fruit; D006801:Humans; D007492:Iran / Q000453:epidemiology; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000517:prevention & control; D008875:Middle Aged; D018673:Nutrition Policy; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014675:Vegetables
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein