title: Consumption of Fruit or Fiber-Fruit Decreases the Risk of Cardiovascular Disease in a Mediterranean Young Cohort.
abstract: Fiber and fiber-rich foods have been inversely associated with cardiovascular disease (CVD), but the evidence is scarce in young and Mediterranean cohorts. We used Cox regression models to assess the association between quintiles of total fiber and fiber from different sources, and the risk of CVD adjusted for the principal confounding factors in a Mediterranean cohort of young adults, the SUN (Seguimiento Universidad de Navarra, Follow-up) cohort. After a median follow-up of 10.3 years, we observed 112 cases of CVD among 17,007 participants (61% female, mean age 38 years). We observed an inverse association between fiber intake and CVD events (pfor trend = 0.024) and also between the highest quintile of fruit consumption (hazard ratio (HR) 0.51, 95% confidence interval (CI) 0.27-0.95) or whole grains consumption (HR 0.43 95% CI 0.20-0.93) and CVD compared to the lowest quintile, and also a HR of 0.58 (95% CI 0.37-0.90) for the participants who ate at least 175 g/day of fruit. Only the participants in the highest quintile of fruit-derived fiber intake had a significantly lower risk of CVD (HR 0.52, 95% CI 0.28-0.97). The participants who ate at least one serving per week of cruciferous vegetables had a lower risk than those who did not (HR 0.52, 95% CI 0.30-0.89). In conclusion, high fruit consumption, whole grain consumption, or consumption of at least one serving/week of cruciferous vegetables may be protective against CVD in young Mediterranean populations.
authors.affiliation: Atención Primaria, Servicio Navarro de Salud-Osasunbidea, 08010 Navarra, Spain. pilarbuil@ono.com.|Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain. pilarbuil@ono.com.|IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Navarra, Spain. pilarbuil@ono.com.
authors.forename: Pilar
authors.initials: P
authors.lastname: Buil-Cosiales
authors.affiliation: Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain. mamartinez@unav.es.|IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Navarra, Spain. mamartinez@unav.es.|Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Navarra, Spain. mamartinez@unav.es.|Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA. mamartinez@unav.es.
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Martinez-Gonzalez
authors.affiliation: Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain. mcanela@unav.es.|IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Navarra, Spain. mcanela@unav.es.|Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Navarra, Spain. mcanela@unav.es.
authors.forename: Miguel
authors.initials: M
authors.lastname: Ruiz-Canela
authors.affiliation: Atención Primaria, Servicio Navarro de Salud-Osasunbidea, 08010 Navarra, Spain. javierdiezesp@ono.com.|Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain. javierdiezesp@ono.com.|IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Navarra, Spain. javierdiezesp@ono.com.
authors.forename: Javier
authors.initials: J
authors.lastname: Díez-Espino
authors.affiliation: Department of Emergency, Complejo Hospitalario de Navarra Servicio Navarro de Salud-Osasunbidea, 31008 Pamplona, Navarra, Spain. agarare@gmail.com.
authors.forename: Ana
authors.initials: A
authors.lastname: García-Arellano
authors.affiliation: Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain. etoledo@unav.es.|IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Navarra, Spain. etoledo@unav.es.|Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Navarra, Spain. etoledo@unav.es.
authors.forename: Estefania
authors.initials: E
authors.lastname: Toledo
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D038441:Diet, Mediterranean; D004043:Dietary Fiber / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D005638:Fruit; D006801:Humans; D008297:Male; D019083:Mediterranean Region; D015596:Nutrition Assessment; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014675:Vegetables; D000067348:Whole Grains; D055815:Young Adult
keywords: cardiovascular disease; fiber; fruit; legumes; vegetables; whole grains