fruit and vegetable intake and risk of

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Fruit and vegetable intake and risk of

cardiovascular disease in US adults: thefirst National Health and Nutrition

Examination Survey Epidemiologic

Follow-up Study

Carolina Agurto

Daniela Hernandez

Ignacio Quintana

Mnica Vargas

Guillermo Vsquez


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Objective of this research

The objective was toexamine the relation

between fruit andvegetable intake andthe risk ofcardiovascular

disease.


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Kind of study

Study population: participants inthe first National Health and

Nutrition Examination Survey(NHANES) aged 25-74 years.

Prospective cohort study


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Methodology (1)

Study population : cohort of9608 participants (applying

exclusion criteria).

Baseline data:

Medical history

Standardized medical examination

Dietary assessment

Laboratory tests

Anthropometric measurements

Blood pressure , body weight

and height were obtainedwith the use of standard

protocols.


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Methodology (2)

Education level, physical activityand alcohol consumption were

obtained by Interviewer-

administered questionnaires.

Smoking status was obtained

by questions on lifetimesmoking history at follow-upinterviews in 1982 through

1984 or later.


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Methodology (3)

Food-frequency questionnaire

3 items referring to fruit and vegetable intake. Frequency of

consumption of fruit and vegetables was coded into categoriesranging from never to 8 times/day.

Frequency of consumption of meat, poultry and of fish andshellfish.

Total energy intakes were calculated for each participantby the National Center for Health Statistics.


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Observations to the methodology that

could affect the results and

conclusions of the study

They did not exclude overweight participants,

Frequency of consumption of junk food was

not included in the Food-frequency

questionnaire.


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While they consume less fruitand vegetable in their diet ,they

have more blood pressure

,hypertension (%), serum total

cholesterol, diabetes (%) and BMI

(Kg/m ^2).

We can see that: people with less

frequency in intake of fruit and

vegetable practice quantity low

physical activity. They show more

current cigarette smoking, etc


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FIGURE 1. Age-adjusted cumulative mortality from stroke, ischemic heart disease, cardiovascular

disease, and all causes according to frequency of fruit and vegetable intake in 9608 participants in

the research.

We can see that : the intake

of fruit and vegetable is a

protect factor of ischemic

heart disease, stroke,cardiovascular disease.

The frequency of fruit

and vegetable in the

intake is directly

proportional to level ofprotection for these

diseases.

The connection between

frecuency and disease , is

more evident while more

age has the partcipant ofthe research.


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This study shows a correlation between consumption of

fruit and vegetables and the incidence of ischemic heart

disease?

This study shows that the intake of fruitand vegetables 3 times/d comparedwith < 1 time/d was associated with a

24% lower mortality from ischemic heartdisease.

Also, recent prospective studies reportedan inverse association between fruit and

vegetables intake and the risk ofischemic stroke and ischemic heart

disease.

Accordingly with the results this study,increased fruit and vegetables intakeshave been recommended to prevent

morbidity and mortality from

cardiovascular diseases.


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How do the articles authors try to explain in the

discussion the answer to the question above?

Although each of these nutrients may play a

protective role in the prevention of cardiovasculardisease, their effect in combination with those of

other components in whole foods may have agreater effect.

Fruit and vegetables have abundant individualnutrients, including potassium, antioxidants, andfolic acid may contribute to inverse association ofthe intake of these foods with the risk of stroke

and mortality from cardiovascular disease.


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What limitations do you find to the

conclusions of this study?

The most important limitation of this study is

the no contemplation of the environmental

factors and the quality of life of the people; it

includes depression and psychological factors,

because those factors are related to highest

levels of heart problems and heart disease.

Wh li i i d fi d h


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Other limitations that we found were theabsence of relations between some particular

vitamin or substance in the fruits or

vegetables or even some reaction betweenthis nutrients with the cause the results

presented. We didnt find in this study the

cause of the lower risk of cardiovascular

disease, it can be considered as a limitation.

Wh li i i d fi d h


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The last limitation that we found was the

absence of blood and urine exams, its

important because the researchers can

exclude to persona with drug abuse, renalfailure or some medical condition can disturb

this study. Other factor is the stress level of

the person of this study and use of medicationfor other disease that can affect the final

results.


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Which additional studies would you

make in order to complement the

material presented in this article? The most important complementary study would

be the blood analysis searching some component

responsible of results exposed in this study. Other complementary studies may include

regular blood pressure control in a close relationwith the intake of fruits and vegetables.

Analysis of the most important fruits andvegetables for the cardiovascular disease risk

fruit and vegetable intake and risk of

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