title: Fruit and vegetable consumption and mortality: European prospective investigation into cancer and nutrition.
abstract: In this study, the relation between fruit and vegetable consumption and mortality was investigated within the European Prospective Investigation Into Cancer and Nutrition. Survival analyses were performed, including 451,151 participants from 10 European countries, recruited between 1992 and 2000 and followed until 2010. Hazard ratios, rate advancement periods, and preventable proportions to respectively compare risk of death between quartiles of consumption, to estimate the period by which the risk of death was postponed among high consumers, and to estimate proportions of deaths that could be prevented if all participants would shift their consumption 1 quartile upward. Consumption of fruits and vegetables was inversely associated with all-cause mortality (for the highest quartile, hazard ratio = 0.90, 95% confidence interval (CI): 0.86, 0.94), with a rate advancement period of 1.12 years (95% CI: 0.70, 1.54), and with a preventable proportion of 2.95%. This association was driven mainly by cardiovascular disease mortality (for the highest quartile, hazard ratio = 0.85, 95% CI: 0.77, 0.93). Stronger inverse associations were observed for participants with high alcohol consumption or high body mass index and suggested in smokers. Inverse associations were stronger for raw than for cooked vegetable consumption. These results support the evidence that fruit and vegetable consumption is associated with a lower risk of death.
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, the Netherlands. M.Leenders-6@umcutrecht.nl
authors.forename: Max
authors.initials: M
authors.lastname: Leenders
authors.forename: Ivonne
authors.initials: I
authors.lastname: Sluijs
authors.forename: Martine M
authors.initials: MM
authors.lastname: Ros
authors.forename: Hendriek C
authors.initials: HC
authors.lastname: Boshuizen
authors.forename: Peter D
authors.initials: PD
authors.lastname: Siersema
authors.forename: Pietro
authors.initials: P
authors.lastname: Ferrari
authors.forename: Cornelia
authors.initials: C
authors.lastname: Weikert
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Anja
authors.initials: A
authors.lastname: Olsen
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Boutron-Ruault
authors.forename: Françoise
authors.initials: F
authors.lastname: Clavel-Chapelon
authors.forename: Laura
authors.initials: L
authors.lastname: Nailler
authors.forename: Birgit
authors.initials: B
authors.lastname: Teucher
authors.forename: Kuanrong
authors.initials: K
authors.lastname: Li
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.forename: Manuela M
authors.initials: MM
authors.lastname: Bergmann
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: Pagona
authors.initials: P
authors.lastname: Lagiou
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Trichopoulos
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Valeria
authors.initials: V
authors.lastname: Pala
authors.forename: Salvatore
authors.initials: S
authors.lastname: Panico
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Carlotta
authors.initials: C
authors.lastname: Sacerdote
authors.forename: Petra H M
authors.initials: PH
authors.lastname: Peeters
authors.forename: Carla H
authors.initials: CH
authors.lastname: van Gils
authors.forename: Eiliv
authors.initials: E
authors.lastname: Lund
authors.forename: Dagrun
authors.initials: D
authors.lastname: Engeset
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Redondo
authors.forename: Antonio
authors.initials: A
authors.lastname: Agudo
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Sánchez
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro
authors.forename: Eva
authors.initials: E
authors.lastname: Ardanaz
authors.forename: Emily
authors.initials: E
authors.lastname: Sonestedt
authors.forename: Ulrika
authors.initials: U
authors.lastname: Ericson
authors.forename: Lena Maria
authors.initials: LM
authors.lastname: Nilsson
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Wareham
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Key
authors.forename: Francesca L
authors.initials: FL
authors.lastname: Crowe
authors.forename: Isabelle
authors.initials: I
authors.lastname: Romieu
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Gunter
authors.forename: Valentina
authors.initials: V
authors.lastname: Gallo
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
authors.forename: H Bas
authors.initials: HB
authors.lastname: Bueno-de-Mesquita
mesh_terms: D000328:Adult; D000368:Aged; D002423:Cause of Death; D004034:Diet Surveys / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005260:Female; D005638:Fruit; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D016019:Survival Analysis; D014675:Vegetables
keywords: fruit; mortality; prospective studies; survival analysis; vegetables