title: Fruit intake and cardiovascular disease mortality in the UK Women's Cohort Study.
abstract: In observational studies, fruit intake is associated with a reduced risk of cardiovascular disease (CVD), though fruit type has been less frequently explored. The aim of the current study was to explore the association between total fruit and fruit subgroup intake according to polyphenol content and CVD mortality in the UK Women's Cohort Study. Total fruit intake (g/day) derived from a 217-item food frequency questionnaire was obtained from 30,458 women (aged 35-69 years) at baseline from 1995-1998. Fruit intakes were sub-categorised according to similarities in polyphenol profile from Phenol Explorer, including berries, citrus, drupes, pomes and tropical fruits. Mortality events were derived from the NHS Central Register. During the mean follow-up period of 16.7 years, 286 fatal CVD deaths [138 coronary heart disease (CHD), 148 stroke] were observed. Survival analysis was conducted using participants free from history of CVD at baseline. Total fruit intake was associated with lower risk of CVD and CHD mortality, with a 6-7 % reduction in risk for each 80 g/day portion consumed (99 % CI 0.89, 1.00 and 0.85, 1.01 respectively). Concerning particular fruit types, the direction of the associations tended to be inverse, but point estimates and tests for trend were not generally statistically significant. However, women in the highest intake group of grapes and citrus experienced a significant reduction in risk of CVD and stroke respectively compared with non-consumers [HR 0.56 (99 % CI 0.32, 0.98) and 0.34 (0.14, 0.82) respectively]. These findings support promoted guidelines encouraging fruit consumption for health in women, but do not provide strong evidence to suggest that fruit type is as important.
authors.affiliation: Functional Food Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK.|Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, UK.
authors.forename: Heidi Tsz Mung
authors.initials: HT
authors.lastname: Lai
authors.affiliation: Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, UK.|Division of Epidemiology, Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Diane Erin
authors.initials: DE
authors.lastname: Threapleton
authors.affiliation: Functional Food Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK.
authors.forename: Andrea Jill
authors.initials: AJ
authors.lastname: Day
authors.affiliation: Functional Food Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK.
authors.forename: Gary
authors.initials: G
authors.lastname: Williamson
authors.affiliation: Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, UK.
authors.forename: Janet Elizabeth
authors.initials: JE
authors.lastname: Cade
authors.affiliation: Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, UK. v.j.burley@leeds.ac.uk.
authors.forename: Victoria Jane
authors.initials: VJ
authors.lastname: Burley
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000401:mortality*; D015331:Cohort Studies; D003327:Coronary Disease / Q000401:mortality; D004043:Dietary Fiber; D005260:Female; D005638:Fruit; D006801:Humans; D008875:Middle Aged; D059808:Polyphenols; D020521:Stroke / Q000401:mortality; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D004043:Dietary Fiber; D059808:Polyphenols
keywords: Cardiovascular disease; Coronary heart disease; Epidemiology; Fruit intake; Polyphenol; Stroke