| 30) Dauchet L (2004) | The Prospective Epidemiological Study of Myocardial Infarction (PRIME) Study. | Men aged 50-59 from France (n = 5982) and Northern Ireland (n = 2105). | 5
(1991-) | Total coronary events: 249.
Acute coronary events: 133. | Total coronary events (MI, CHD death, and angina events).
Acute coronary events (MI and CHD death) | All fruit (not defined) |
| Total coronary events: | Acute coronary events: |
RR = 0.90 (0.66-1.24; P = 0.13) for the highest vs lowest tertile of consumption.
Amount specific data (Freq/d):
≤ 0.57: RR = 1.
0.64-1.14: RR = 0.83 (0.60-1.14).
≥ 1.29: RR = 0.90 (0.66-1.24).
|
RR = 0.74 (0.48-1.14; P = < 0.05) for the highest vs lowest tertile of consumption.
Amount specific data (Freq/d):
≤ 0.57: RR = 1.
0.64-1.14: RR = 0.68 (0.44-1.05).
≥ 1.29: RR = 0.74 (0.48-1.14).
A protective effect was found in Northern Ireland (RRs for increasing tertiles: 1, 0.39 [0.18-0.85], and 0.39 [0.17-0.89; P = < 0.01]), but not in France (RRs for increasing tertiles: 1, 1.00 [0.57-1.77], and 1.08 [0.62-1.87; P = 0.57]).
|
Age, centre, smoking, alcohol, physical activity, education, employment status, systolic blood pressure, total cholesterol, HDL-cholesterol, BMI, treatment for hypertension, diabetes or dyslipidaemia. |
| 26) Buckland G (2009) | The Spanish EPIC Cohort Study | 40,757 subjects (15,335 men and 25,422 women) aged 29-69 and free of coronary events. | 10.4
(1992-96 to 2004) | See variables | CHD incidence (fatal or nonfatal myocardial infarction or unstable angina requiring revascularization) | Fruit (including nuts and seeds and excluding fruit juices) |
Total
(606 cases) | Men
(480 cases) | Women
(126 cases) |
HR = 0.91 (0.73-1.12; P = 0.34) for the highest vs lowest tertile of consumption.
Amount specific data (g/1,000 kcal/day):
0-97.4: HR = 1.
>97.4-183.4: HR = 0.90 (0.74-1.10).
>183.4-1,531.4: HR = 0.91 (0.73-1.12).
|
HR = 0.92 (0.72-1.18; P = 0.46) for the highest vs lowest tertile of consumption.
Amount specific data (g/1,000 kcal/day):
0-97.4: HR = 1.
>97.4-183.4: HR = 0.91 (0.73-1.12).
>183.4-1,531.4: HR = 0.92 (0.72-1.18).
|
HR = 0.94 (0.58-1.54; P = 0.74) for the highest vs lowest tertile of consumption.
Amount specific data (g/1,000 kcal/day):
0-97.4: HR = 1.
>97.4-183.4: HR = 1.05 (0.63-1.73).
>183.4-1,531.4: HR = 0.94 (0.58-1.54).
|
Stratified by center and age.
Adjusted for education, physical activity, BMI, smoking status, diabetes, hypertension, and hyperlipidemia status, and total calorie intake. |
| 21) Liu S (2000) | The Women's Health Study. | 39,876 female health professionals.
(USA) | 5
(1993-1999) | 126 | Myocardial infarction risk | All fruit (apple, pear, orange, grapefruit, peach, banana, strawberry, blueberry, cantaloupe, raisin, prune, and fruit juices) |
RR = 0.66 (0.36-1.22; P = 0.26) for the highest vs lowest quintile of consumption.
Amount specific data (median servings/d):
0.6: RR = 1.
1.3: RR = 0.76 (0.44-1.34).
1.9: RR = 0.58 (0.32-1.09).
2.6: RR = 0.82 (0.46-1.47).
3.9: RR = 0.66 (0.36-1.22).
| Age, smoking, exercise, alcohol use, postmenopausal hormone use, BMI, multivitamin use, vitamin C supplement use, history of diabetes, history of hypertension, history of cholesterol, and parental history of MI. |
| 19) Strandhagen E. (2000) | The Study Of Men Born In 1913. | 730 men aged 54.
(Sweden) | 26
(1967-1993) | 209 | CVD morbitidy | Fruit (not defined) | No significant association was found for men in the highest vs lowest quartile of consumption (6-7 vs 0-1 times/wk) (No data shown). | No data shown. |
| 13) Hirvonen T (2001) | The Alpha-Tocopherol Beta-Carotene Cancer Prevention (ATBC) Study. | 25,372 male smokers (at least 5 cigarettes/day) aged 50-69.
(Finland) | 6.1 | 1,122 | Risk of nonfatal myocardial infarction | Fruits (not defined) |
RR = 0.87 (0.72-1.05; No P-value) for the highest vs lowest quintile of consumption.
Amount specific data (gm/day):
< 25: RR = 1.
25-53: RR = 0.97 (0.80-1.16).
54-88: RR = 0.91 (0.80-1.16).
89-136: RR = 0.89 (0.74-1.08).
> 136: RR = 0.87 (0.72-1.05).
| Age, supplementation group, systolic and diastolic blood pressure, serum total cholesterol, serum high-density lipoprotein cholesterol, BMI, smoking years, number of cigarettes smoked daily, history of diabetes mellitus and coronary heart disease, marital status, education, and leisure-time physical activity. |
| 13) Pietinen P (1996) | The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. | 21,930 smoking men aged 50-69.
(Finland) | 6.1
(? to 1993) | 1,399? | Risk of a major coronary event (nonfatal MI or CHD death) | Fruit and berries (not defined) | Not associated with major coronary events (data not shown). | Age, treatment group, smoking, BMI, blood pressure, intakes of energy, alcohol, and saturated fatty acids, education, and physical activity. |
| 10) Joshipura KJ (2001) | The Nurses' Health Study &
The Health Professionals' Follow-Up Study. | 84,251 women aged 34-59, and 42,148 men aged 40-75.
(USA) | Women: 14 (1980-1994).
Men: 8 (1986-1994). | 1,127? women and
1,063? men.
1.193? non-multivitamin supplement users and
729? multivitamin supplement users.
1.446? never or past smokers and
708? current smokers. | Coronary heart disease risk (nonfatal myocardial infarction or fatal coronary disease) | All fruits |
| Pooled | Women | Men |
RR = 0.80 (0.69-0.92; No P-value) for the highest vs lowest quintile of consumption.
Amount specific data (quintiles. not defined):
Q1: RR = 1.
Q2: RR = 0.87 (0.76-0.99).
Q3: RR = 0.94 (0.83-1.08).
Q4: RR = 0.81 (0.70-0.93).
Q5: RR = 0.80 (0.69-0.92).
RR for a 1-serving/d increase in intake: 0.94 (0.90-0.98).
|
RR = 0.85 (No 95% CI; No P-value) for the highest vs lowest quintile of consumption.
Amount specific data (median servings/d):
0.86: RR = 1.
Not defined: RR = 0.84.
Not defined: RR = 0.95.
Not defined: RR = 0.76.
4.54: RR = 0.85.
RR for a 1-serving/d increase in intake: 0.95 (0.89-1.01*).
|
RR = 0.74 (No 95% CI; No P-value) for the highest vs lowest quintile of consumption.
Amount specific data (median servings/d):
0.72: RR = 1.
Not defined: RR = 0.91.
Not defined: RR = 0.94.
Not defined: RR = 0.86.
4.33: RR = 0.74.
RR for a 1-serving/d increase in intake: 0.92 (0.87-0.98*).
|
Stratified by multivitamin supplement use:
| Participants not using multivitamin supplements | Participants using multivitamin supplements |
| RR = 0.94 (0.89-1.00). |
RR = 0.94 (0.87-1.00). |
Stratified by smoking status:
| Never or past smokers | Current smokers |
| RR = 0.95 (0.90-1.00). |
RR = 0.93 (0.86-1.00). |
* = 95% CI derived from the following meta-analysis: Dauchet L. Fruit and vegetable consumption and risk of coronary heart disease: a meta-analysis of cohort studies. J Nutr. 2006 Oct;136(10):2588-93. Full text
Age, smoking status, alcohol intake, family history of myocardial infarction, BMI, vitamin supplement use, vitamin E use, physical activity, aspirin use, 2-year follow-up period, presence of hypertension, presence of hypercholesterolemia, total daily caloric intake, and postmenopausal hormone use (women). |
| 4) Fraser GE. (1994) | The Adventist Health Study. | 26,473 nondiabetic California Seventh-day Adventists. | No data shown. | No data shown. | Coronary events incidence (nonfatal myocardial infarction or definite fatal coronary heart disease) | Fruit (not defined) |
< 1/d: Relative Hazard = 1.00.
1/d: Relative Hazard = 1.25.
> or = 2/d: Relative Hazard = 1.20 (No 95% CI; No P-value). | Proportional hazards analysis. |
| 4) Fraser GE. (1992) | The Adventist Health Study. | 31,208 non-Hispanic white California Seventh-Day Adventists.
(USA) | 6
(1977-1982) | 134? | MI risk | Fruit index (canned or frozen fruit, raisins, dates, and other dried fruits, fresh citrus fruit [not juice], fresh fruit commonly available in winter [apples, bananas, pears, etc.], and other fresh fruit) |
RR = 1.07 (0.57-2.61) for the highest vs lowest tertile of consumption.
Amount specific data (times/d):
< 1: RR = 1.
1-2: RR = 1.10 (0.57-2.61).
> 2: RR = 1.07 (0.58-1.96).
| Age, sex, smoking, exercise, relative weight, and high blood pressure. |
| 3) Tanaka H (1987) | The Shibata Study. | 963 men + 1,338 women aged ≥ 40.
(Japan) | 7.5
(1977-1984) | Not defined. | Ischemic heart disease risk
(MI + angina pectoris + sudden death) | Fruits (not defined) | No significant association was observed: RR = 0.96 (No 95% CI; No P-value) for intake ≥ 3.02 g/kg body weight per day. | Sex and age. |
Heart disease mortality:
| Author | Cohort name | Subjects | Years of follow-up | Cases | End point | Consumption of | Relative Risk (RR) | Adjustments |
| 37) Nagura J (2009) | The JACC Study | 25,206 men and 34,279 women aged 40-79, and without a history of CHD, stroke, or cancer.
(Japan) | 12.7
(1989-2003) | 452 | CHD mortality | Fruit (citrus fruits, other fruits, and fresh fruit juice in summer) |
HR = 0.79 (0.58-1.08; P = 0.061) for the highest vs lowest quartile of consumption.
Amount specific data (servings per week):
0.9: HR = 1.
2.3: HR = 0.97 (0.75-1.24).
3.9: HR = 0.84 (0.65-1.10).
5.9: HR = 0.79 (0.58-1.08).
The association did not vary by sex (no data shown). | Sex, age, BMI, smoking status, alcohol intake, hours of walking, hours of sleep, education years, perceived mental stress, cholesterol intake, SFA intake, n-3 fatty acids intake, sodium intake, vegetables intake, bean intake and histories of hypertension and diabetes. |
| 33) Chang-Claude J (2005) | The German Vegetarian Study | 1,724 vegetarians and health conscious persons. | 21
(1978-1999) | 60? | Ischemic heart disease mortality | Fruits (not defined) | Frequency of consumption did not show an appreciable effect on mortality (no data shown). | Age, gender, smoking, level of activity, alcohol consumption, vegetarianism, BMI, and education. |
| 32) Ness AR (2005) | The Boyd Orr Cohort. | 4,028 people (1,995 men, and 2,033 women) from England and Scotland. | average 37
(1948 to 2000) | 298 | CHD mortality | Fruit (not defined) |
RR = 1.19 (0.76-1.87; P = 0.7) for the highest vs lowest quartile of consumption.
Amount specific data (g):
0-4.7: RR = 1.
4.8-21.1: RR = 1.06 (0.72-1.56).
21.2-45.1: RR = 0.90 (0.60-1.34).
45.5-556.4: RR = 1.19 (0.76-1.87).
| Age, energy, sex, childhood family food expenditure, father's social class, district of residence as a child, period of birth, season when studied as a child, and Townsend score for current address or place of death. |
| 31) Tucker KL (2005) | The Baltimore Longitudinal Study of Aging. | 501 men age 34-80. | 18 | 71? | CHD mortality | Fruit (not defined) | RR = 0.97 (0.79-1.20) for an increment of 1 serving/d. | Age, total energy, BMI, smoking, alcohol, physical activity, supplement use, saturated fat, and secular trend. |
| 22) Albert CM (1998) | The Physician's Health Study | 20,551 men aged 40-84, and without a history of MI, stroke, transient ischemic attack, or cancer.
(USA) | 11
(1983-1995) | 133? | Sudden cardiac death | Fruits (not defined) | No significant association was found (no data shown). | Age, aspirin and beta carotene treatment assignment, evidence of CVD, BMI, smoking status, history of diabetes, history of hypertension, history of hypercholesterolemia, alcohol, vigorous exercise, vitamine E, vitamin C, and multivitamin use. |
| 19) Strandhagen E. (2000) | The Study Of Men Born In 1913. | 730 men aged 54.
(Sweden) | 26
(1967-1993) | 226 | CVD death | Fruit (not defined) | A protective effect was found for men in the highest vs lowest quartile of consumption (6-7 vs 0-1 times/wk) (No data shown; P = 0.042). | No data shown. |
| 18) Whiteman D. (1999) | The OXCHECK Study. | 10,522 men and women aged 35-64 without a previous history of angina.
(UK) | 9
(1989-1997) | 97 | IHD mortality | Fresh fruit or fruit juice (not defined) |
RR = 0.84 (0.50-1.43; No P-value) for the highest vs lowest tertile of consumption.
Amount specific data (days/wk):
< 1: RR = 1.
1-3: RR = 1.18 (0.69-2.04).
4-7: RR = 0.84 (0.50-1.43). | Gender, smoking and age. |
| 15) Mann JI (1997) | The Oxford Vegetarian Study. | 10,802 subjects (4102 men and 6700 women) aged 16-79.
(UK) | 13.3
(1980-84 to 1995) | 63 | Ischaemic heart disease death | Fresh or dried fruit (not defined) |
Death rate ratio = 89 (44-180; P = Not Significant) for the highest vs lowest tertile of consumption.
Amount specific data (times per week):
< 5: DRR = 100.
5-9: DRR = 107 (58-196).
≥ 10: DRR = 89 (44-180). | Age, sex, smoking and social class. |
| 13) Hirvonen T (2001) | The Alpha-Tocopherol Beta-Carotene Cancer Prevention (ATBC) Study. | 25,372 male smokers (at least 5 cigarettes/day) aged 50-69.
(Finland) | 6.1 | 815 | Coronary death | Fruits (not defined) |
RR = 0.87 (0.70-1.08; No P-value) for the highest vs lowest quintile of consumption.
Amount specific data (gm/day):
< 25: RR = 1.
25-53: RR = 0.87 (0.71-1.08).
54-88: RR = 0.93 (0.76-1.15).
89-136: RR = 0.90 (0.73-1.12).
> 136: RR = 0.87 (0.70-1.08).
| Age, supplementation group, systolic and diastolic blood pressure, serum total cholesterol, serum high-density lipoprotein cholesterol, BMI, smoking years, number of cigarettes smoked daily, history of diabetes mellitus and coronary heart disease, marital status, education, and leisure-time physical activity. |
| 13) Pietinen P (1996) | The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. | 21,930 smoking men aged 50-69.
(Finland) | 6.1
(? to 1993) | 635 | CHD death | Fruit and berries (not defined) |
RR = 0.78 (0.59-1.03; P = 0.008) for the highest vs lowest quintile of consumption.
Amount specific data (g):
25.4: RR = 1.
65.0: RR = 1.02 (0.81-1.30).
105.1: RR = 0.93 (0.73-1.19).
152.3: RR = 0.86 (0.66-1.11).
246.2: RR = 0.78 (0.59-1.03).
| Age, treatment group, smoking, BMI, blood pressure, intakes of energy, alcohol, and saturated fatty acids, education, and physical activity. |
| 12) Appleby PN. (2002) | The Health Food Shoppers Study. | 10,741 subjects, aged 16-89 (4,325 men, 6,416 women. 8,675 non-smokers).
(UK) | 1973-79 to 1997 | 605 (347 men, and 258 women. 484 non-smokers) | Ischaemic heart disease mortality | Fresh fruit (not defined) |
| All subjects | Men | Women | Non-smokers |
RR = 0.74 (0.61-0.89; P = < 0.01).
Additional adjustment for wholemeal bread, nuts/dried fruit, raw vegetable salads, and bran cereals: RR = 0.80 (0.66-0.98; P = < 0.05). | RR = 0.89 (0.70-1.14; No P-value). | RR = 0.52 (0.39-0.70; P = < 0.01). | RR = 0.67 (0.54-0.82; P = < 0.01). |
RRs are for daily consumption vs less frequent consumption.Age at recruitment, sex, and smoking. |
| 12) Key TJ. (1996) | The Health Food Shoppers Study. | 10.771 (4.336 men and 6.435 women) aged > or = 16, recruited through health food shops, vegeterian societies, and magazines.
(UK) | 16.8
(1973-79 to 1995) | 350? (224 men, 126 women) | Ischaemic heart disease mortality | fresh fruit (not defined) | RR = 0.76 (0.60-0.97; P = < 0.05) for consumption at least daily vs < daily.
Adjustment for raw salad increased the mortality ratio to 0.82 (0.64-1.05; No P-value). | age, sex, and smoking |
| 11) Sahyoun NR. (1996) | No cohort name. | 725 subjects (254 men, and 471 women) aged 60-101 from Massachusetts.
(USA) | 9-12
(1981-84 to 1993) | 101? | Mortality from heart disease | All fruit and juices (not defined) | RR = 0.64 (0.34-1.21; P = 0.48) for the highest vs lowest tertile of consumption.
Amount specific data (tertiles. No amounts defined):
T1: RR = 1.
T2: RR = 0.74 (0.46-1.20).
T3: RR = 0.64 (0.34-1.21). | Age, sex, disease status, and disabilities affecting shopping. |
| 7) Knekt P (1994) | The Finnish Mobile Clinic Health Cohort. | 5,133 men and women aged 30-69. | 14
(1968-72 to 1984) | 186? men, and 58? women. | CHD mortality | Fruit (not defined) |
| Men: | Women: |
RR = 0.77 (0.52-1.12; P = 0.28) for the highest vs lowest tertile of consumption.
Amount specific data (g):
≤ 75: RR = 1.
76-159: RR = 0.98 (0.70-1.37).
> 159: RR = 0.77 (0.52-1.12).
|
RR = 0.66 (0.36-1.22; P = 0.10) for the highest vs lowest tertile of consumption.
Amount specific data (g):
≤ 77: RR = 1.
78-137: RR = 0.47 (0.24-0.92).
> 137: RR = 0.66 (0.36-1.22).
|
Age, smoking, serum cholesterol, hypertension, BMI, and energy intake. |
| 4) Fraser GE (1997) | The Adventist Health Study | Non-Hispanic white Seventh Seventh Day Adventists aged ≥ 84.
At study baseline there were 603 subjects older than 84 years, and during a 12-year follow-up, these and intitially younger subjects contributed 11,828 person-years of observation in the oldest-old age range.
(USA) | 12
(1976-88) | 364?
(110 men, and 254 women) | CHD death | Fruit (not defined) |
| Total: | Men: | Women: |
HR = 1.35 (0.87-2.08) for the highest vs lowest tertile of consumption.
Amount specific data (per day):
< 1: RR = 1.
1: RR = 1.64 (1.05-2.57).
≥ 2: RR = 1.35 (0.87-2.08).
|
HR = 2.03 (0.83-5.00) for the highest vs lowest tertile of consumption.
Amount specific data (per day):
< 1: RR = 1.
1: RR = 1.53 (0.61-3.83).
≥ 2: RR = 2.03 (0.83-5.00).
|
HR = 1.23 (0.74-2.05) for the highest vs lowest tertile of consumption.
Amount specific data (per day):
< 1: RR = 1.
1: RR = 1.75 (1.04-2.95).
≥ 2: RR = 1.23 (0.74-2.05).
|
Sex, diabetes, smoking, exercise, nuts, bread, donuts, sweet desserts, beef, and fish. |
| 4) Fraser GE. (1992) | The Adventist Health Study. | 31,208 non-Hispanic white California Seventh-Day Adventists.
(USA) | 6
(1977-1982) | Definite fatal CHD: 260?
Incident coronary death (by death certificate): 463? | CHD death | Fruit index (canned or frozen fruit, raisins, dates, and other dried fruits, fresh citrus fruit [not juice], fresh fruit commonly available in winter [apples, bananas, pears, etc.], and other fresh fruit) |
| Definite fatal CHD: | Fatal CHD determined by death certificate: |
RR = 1.08 (0.67-1.75) for the highest vs lowest tertile of consumption.
Amount specific data (times/d):
< 1: RR = 1.
1-2: RR = 1.30 (0.80-2.12).
> 2: RR = 1.08 (0.67-1.75).
|
RR = 1.18 (0.82-1.70) for the highest vs lowest tertile of consumption.
Amount specific data (times/d):
< 1: RR = 1.
1-2: RR = 1.17 (0.79-1.73).
> 2: RR = 1.18 (0.81-1.70).
|
Age, sex, smoking, exercise, relative weight, and high blood pressure. |
| | | | | | |