title: Association of raw fruit and fruit juice consumption with blood pressure: the INTERMAP Study.
abstract: BACKGROUND
  Epidemiologic evidence suggests that fruit consumption may lower the risk of cardiovascular diseases through blood pressure (BP)-lowering effects; little is known on the independent effect of raw fruit and fruit juice on BP.
  
  
  OBJECTIVE
  The objective was to quantify associations of raw fruit and fruit juice consumption with BP by using cross-sectional data from the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP) of 4680 men and women aged 40-59 y from Japan, China, the United Kingdom, and the United States.
  
  
  METHODS
  During 4 visits, 8 BP, four 24-h dietary recalls, and two 24-h urine samples were collected. Country-specific multivariate-controlled linear regression coefficients, including adjustment for urinary sodium excretion, were estimated and pooled, weighted by inverse of their variance.
  
  
  RESULTS
  The average total raw fruit consumption varied from a mean ± SD of 52 ± 65 g/1000 kcal in the United States to 68 ± 70 g/1000 kcal in China. Individual raw fruit intake was not associated with BP in pooled analyses for all countries or in participants from Western countries, although a positive association with diastolic BP was observed in East Asian participants (per 50 g/1000 kcal; 0.37 mm Hg; 95% CI: 0.02, 0.71). Positive relationships with diastolic BP were found for citrus fruit intake in Western consumers (per 25 g/1000 kcal; 0.47 mm Hg; 95% CI: 0.12, 0.81) and for apple intake in East Asian consumers (0.40 mm Hg; 95% CI: 0.03, 0.78). Among East Asian banana consumers, banana intake was inversely associated with diastolic BP (-1.01 mm Hg; 95% CI: -1.88, -0.02). Fruit juice intake, which was negligible in Asia, was not related to BP in Western countries.
  
  
  CONCLUSIONS
  Consistent associations were not found between raw fruit and fruit juice consumption of individuals and BP. This observational study was registered at www.clinicaltrials.gov as NCT00005271.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. l.oude-griep@imperial.ac.uk
authors.forename: Linda M
authors.initials: LM
authors.lastname: Oude Griep
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Stamler
authors.forename: Queenie
authors.initials: Q
authors.lastname: Chan
authors.forename: Linda
authors.initials: L
authors.lastname: Van Horn
authors.forename: Lyn M
authors.initials: LM
authors.lastname: Steffen
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Miura
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Ueshima
authors.forename: Nagako
authors.initials: N
authors.lastname: Okuda
authors.forename: Liancheng
authors.initials: L
authors.lastname: Zhao
authors.forename: Martha L
authors.initials: ML
authors.lastname: Daviglus
authors.forename: Paul
authors.initials: P
authors.lastname: Elliott
mesh_terms: D000328:Adult; D001628:Beverages; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000517:prevention & control; D002681:China; D003430:Cross-Sectional Studies; D002149:Energy Intake; D005260:Female; D005638:Fruit; D006801:Humans; D007564:Japan; D008019:Life Style; D016014:Linear Models; D008297:Male; D018977:Micronutrients / Q000494:pharmacology; D008875:Middle Aged; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D009753:Nutritive Value; D011795:Surveys and Questionnaires; D006113:United Kingdom; D014481:United States
chemical_list: D018977:Micronutrients
references.citation: Nature. 2008 May 15;453(7193):396-400
references.pmid: 18425110
references.citation: Lancet. 1983 Jan 1;1(8314-5):5-10
references.pmid: 6129380
references.citation: Am J Hypertens. 2012 Feb;25(2):180-9
references.pmid: 21993367
references.citation: Am J Epidemiol. 1994 May 1;139(9):927-39
references.pmid: 8166143
references.citation: Int J Food Sci Nutr. 2006 May-Jun;57(3-4):249-72
references.pmid: 17127476
references.citation: Eur J Clin Nutr. 2011 Jul;65(7):791-9
references.pmid: 21427746
references.citation: Eur J Clin Nutr. 2009 May;63(5):605-12
references.pmid: 18301434
references.citation: Stroke. 2011 Nov;42(11):3190-5
references.pmid: 21921279
references.citation: Hypertension. 2011 Apr;57(4):695-701
references.pmid: 21357284
references.citation: PLoS One. 2010 Oct 25;5(10):e13609
references.pmid: 21049053
references.citation: Am J Clin Nutr. 2009 May;89(5):1543S-1548S
references.pmid: 19279083
references.citation: JAMA. 1997 May 28;277(20):1624-32
references.pmid: 9168293
references.citation: Am J Epidemiol. 2004 Mar 15;159(6):572-80
references.pmid: 15003961
references.citation: Hypertension. 2012 Apr;59(4):787-95
references.pmid: 22331380
references.citation: Circulation. 1992 Nov;86(5):1475-84
references.pmid: 1330360
references.citation: Hypertension. 1996 May;27(5):1065-72
references.pmid: 8621198
references.citation: J Sci Food Agric. 2012 Jan 15;92(1):7-22
references.pmid: 22102258
references.citation: J Hum Hypertens. 2003 Sep;17(9):609-22
references.pmid: 13679951
references.citation: Circulation. 2012 Nov 20;126(21):2456-64
references.pmid: 23093587
references.citation: J Hypertens. 2005 Mar;23(3):475-81
references.pmid: 15716684
references.citation: Am J Clin Nutr. 2005 Dec;82(6):1169-77; quiz 1363-4
references.pmid: 16332648
references.citation: J Hum Hypertens. 2003 Sep;17(9):591-608
references.pmid: 13679950
references.citation: N Engl J Med. 1997 Apr 17;336(16):1117-24
references.pmid: 9099655
references.citation: Am J Clin Nutr. 1997 Jan;65(1 Suppl):211S-227S
references.pmid: 8988939
references.citation: Am J Clin Nutr. 2007 Oct;86(4):899-906
references.pmid: 17921363
references.citation: Am J Epidemiol. 1974 Nov;100(5):390-8
references.pmid: 4418801
references.citation: Br Med J (Clin Res Ed). 1986 Dec 6;293(6560):1468-71
references.pmid: 3026552
references.citation: J Food Compost Anal. 2003 Jun;16(3):395-408
references.pmid: 31354186
references.citation: Arch Intern Med. 2005 Jan 24;165(2):150-6
references.pmid: 15668359
references.citation: Am J Clin Nutr. 2011 Jan;93(1):73-80
references.pmid: 21068346
references.citation: Am J Clin Nutr. 1988 Sep;48(3 Suppl):795-800
references.pmid: 3414588
references.citation: Am J Clin Nutr. 1997 Apr;65(4 Suppl):1220S-1228S; discussion 1229S-1231S
references.pmid: 9094926
references.citation: Stat Med. 2005 Oct 15;24(19):2911-35
references.pmid: 16152135
references.citation: J Hum Hypertens. 2011 Mar;25(3):164-71
references.pmid: 20445569