Higher Intake of Fruit, but Not Vegetables or Fiber, at Baseline Is Associated with Lower Risk of Becoming Overweight or Obese in Middle-Aged and Older Women of Normal BMI at Baseline.
BACKGROUND
Fruit, vegetable, and dietary fiber intake have been associated with lower risk of cardiovascular disease (CVD); however, little is known about their role in obesity prevention.


OBJECTIVE
Our goal was to investigate whether intake of fruits, vegetables, and dietary fiber is associated with weight change and the risk of becoming overweight and obese.


METHODS
We studied 18,146 women aged ≥45 y from the Women's Health Study free of CVD and cancer with an initial body mass index (BMI) of 18.5 to <25 kg/m². Fruit, vegetable, and dietary fiber intakes were assessed at baseline through a 131-item food-frequency questionnaire, along with obesity-related risk factors. Women self-reported body weight on annual questionnaires.


RESULTS
During a mean follow-up of 15.9 y, 8125 women became overweight or obese (BMI ≥25 kg/m²). Intakes of total fruits and vegetables, fruits, and dietary fiber were not associated with the longitudinal changes in body weight, whereas higher vegetable intake was associated with greater weight gain (P-trend: 0.02). In multivariable analyses, controlling for total energy intake and physical activity along with other lifestyle, clinical, and dietary factors, women in the highest vs. lowest quintile of fruit intake had an HR of 0.87 (95% CI: 0.80, 0.94; P-trend: 0.01) of becoming overweight or obese. No association was observed for vegetable or dietary fiber intake. The association between fruit intake and risk of becoming overweight or obese was modified by baseline BMI (P-interaction: <0.0001) where the strongest inverse association was observed among women with a BMI <23 kg/m² (HR: 0.82; 95% CI: 0.71, 0.94).


CONCLUSIONS
Our results suggest that greater baseline intake of fruit, but not vegetables or fiber, by middle-aged and older women with a normal BMI at baseline is associated with lower risk of becoming overweight or obese.
Divisions of Preventive Medicine and Harvard Medical School, Boston, MA; Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; and susanne.rautiainen@ki.se.
Susanne
S
Rautiainen
Divisions of Preventive Medicine and Harvard Medical School, Boston, MA;
Lu
L
Wang
Divisions of Preventive Medicine and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard School of Public Health, Boston, MA.
I-Min
IM
Lee
Divisions of Preventive Medicine and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard School of Public Health, Boston, MA.
JoAnn E
JE
Manson
Divisions of Preventive Medicine and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard School of Public Health, Boston, MA.
Julie E
JE
Buring
Divisions of Preventive Medicine and Department of Epidemiology, Harvard School of Public Health, Boston, MA.
Howard D
HD
Sesso
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015992:Body Mass Index; D015331:Cohort Studies; D004032:Diet / Q000009:adverse effects; D004043:Dietary Fiber / Q000008:administration & dosage / Q000627:therapeutic use; D002149:Energy Intake; D005260:Female; D005638:Fruit; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D050177:Overweight / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D017698:Postmenopause; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014675:Vegetables; D016387:Women's Health
dietary fiber; epidemiology; fruits; obesity; overweight; vegetables