Association of Fruit and Vegetable Consumption During Early Adulthood With the Prevalence of Coronary Artery Calcium After 20 Years of Follow-Up: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.
BACKGROUND
The relationship between intake of fruits and vegetables (F/V) during young adulthood and coronary atherosclerosis later in life is unclear.


RESULTS
We studied participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of young, healthy black and white individuals at baseline (1985-1986). Intake of F/V at baseline was assessed using a semiquantitative interview administered diet history, and coronary artery calcium was measured at year 20 (2005-2006) using computed tomography. We used logistic regression to adjust for relevant variables and estimate the adjusted odds ratios and 95% confidence intervals across energy-adjusted, sex-specific tertiles of total servings of F/V per day. Among our sample (n=2506), the mean (SD) age at baseline was 25.3 (3.5) years, and 62.7% were female. After adjustment for demographics and lifestyle variables, higher intake of F/V was associated with a lower prevalence of coronary artery calcium: odds ratio (95% confidence interval) =1.00 (reference), 0.78 (0.59-1.02), and 0.74 (0.56-0.99), from the lowest to the highest tertile of F/V, P value for trend <0.001. There was attenuation of the association between F/V and coronary artery calcium after adjustment for other dietary variables, but the trend remained significant: odds ratio (95% confidence interval): 1.00 (reference), 0.84 (0.63-1.11), and 0.92 (0.67-1.26), P value for trend <0.002].


CONCLUSIONS
In this longitudinal cohort study, higher intake of F/V during young adulthood was associated with lower odds of prevalent coronary artery calcium after 20 years of follow-up. Our results reinforce the importance of establishing a high intake of F/V as part of a healthy dietary pattern early in life.
From the Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, MN (M.D.M.); Brigham and Women's Hospital, Division of Aging, and Boston Veterans Affairs Healthcare System, Harvard Medical School, MA (A.P., J.M.G., L.D.); Division of Preventive Medicine, University of Alabama at Birmingham (J.M.S.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Department of Epidemiology and Biostatistics, University of California - San Francisco (C.E.L., M.J.P.). mdm307@mail.harvard.edu.
Michael D
MD
Miedema
From the Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, MN (M.D.M.); Brigham and Women's Hospital, Division of Aging, and Boston Veterans Affairs Healthcare System, Harvard Medical School, MA (A.P., J.M.G., L.D.); Division of Preventive Medicine, University of Alabama at Birmingham (J.M.S.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Department of Epidemiology and Biostatistics, University of California - San Francisco (C.E.L., M.J.P.).
Andrew
A
Petrone
From the Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, MN (M.D.M.); Brigham and Women's Hospital, Division of Aging, and Boston Veterans Affairs Healthcare System, Harvard Medical School, MA (A.P., J.M.G., L.D.); Division of Preventive Medicine, University of Alabama at Birmingham (J.M.S.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Department of Epidemiology and Biostatistics, University of California - San Francisco (C.E.L., M.J.P.).
James M
JM
Shikany
From the Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, MN (M.D.M.); Brigham and Women's Hospital, Division of Aging, and Boston Veterans Affairs Healthcare System, Harvard Medical School, MA (A.P., J.M.G., L.D.); Division of Preventive Medicine, University of Alabama at Birmingham (J.M.S.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Department of Epidemiology and Biostatistics, University of California - San Francisco (C.E.L., M.J.P.).
Philip
P
Greenland
From the Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, MN (M.D.M.); Brigham and Women's Hospital, Division of Aging, and Boston Veterans Affairs Healthcare System, Harvard Medical School, MA (A.P., J.M.G., L.D.); Division of Preventive Medicine, University of Alabama at Birmingham (J.M.S.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Department of Epidemiology and Biostatistics, University of California - San Francisco (C.E.L., M.J.P.).
Cora E
CE
Lewis
From the Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, MN (M.D.M.); Brigham and Women's Hospital, Division of Aging, and Boston Veterans Affairs Healthcare System, Harvard Medical School, MA (A.P., J.M.G., L.D.); Division of Preventive Medicine, University of Alabama at Birmingham (J.M.S.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Department of Epidemiology and Biostatistics, University of California - San Francisco (C.E.L., M.J.P.).
Mark J
MJ
Pletcher
From the Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, MN (M.D.M.); Brigham and Women's Hospital, Division of Aging, and Boston Veterans Affairs Healthcare System, Harvard Medical School, MA (A.P., J.M.G., L.D.); Division of Preventive Medicine, University of Alabama at Birmingham (J.M.S.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Department of Epidemiology and Biostatistics, University of California - San Francisco (C.E.L., M.J.P.).
J Michael
JM
Gaziano
From the Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, MN (M.D.M.); Brigham and Women's Hospital, Division of Aging, and Boston Veterans Affairs Healthcare System, Harvard Medical School, MA (A.P., J.M.G., L.D.); Division of Preventive Medicine, University of Alabama at Birmingham (J.M.S.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Department of Epidemiology and Biostatistics, University of California - San Francisco (C.E.L., M.J.P.).
Luc
L
Djousse
D000328:Adult; D002118:Calcium / Q000032:analysis; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000517:prevention & control; D004032:Diet / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D005638:Fruit; D006801:Humans; D008019:Life Style; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012306:Risk; D014481:United States / Q000453:epidemiology; D061205:Vascular Calcification / Q000453:epidemiology* / Q000517:prevention & control; D014675:Vegetables; D055815:Young Adult
D002118:Calcium
atherosclerosis; coronary disease; diet; epidemiology; imaging, diagnostic; nutrition