| 10) Joshipura KJ (2009) | The Nurses' Health Study
&
The Health Professional's Follow-up Study | 70,870 women aged 38-63, and 38,918 men aged 40-75. Subjects were without cancer, diabetes or CVD. | Men: 14 (1986-2000).
Women: 16 (1984-2000) | 2,040? men, and
1,852? women | Ischaemic CVD incidence (fatal and non-fatal MI and ischaemic stroke) | Green leafy vegetables (not defined) |
Highest vs lowest quintile of consumption.
Stratified by energy from carbohydrate intake:
| < 40% | 40-55% | > 55% |
Men: RR = 0.70
Women: RR = 0.83
Men & women: RR = 0.76 (0.60-0.96; P = < 0.05)
|
Men: RR = 0.87
Women: RR = 0.83
Men & women: RR = 0.85 (0.75-0.97; P = < 0.05)
|
Men: RR = 0.95
Women: RR = 0.90
Men & women: RR = 0.92 (0.72-1.18)
|
Per increment of 1 serving/d.
Stratified by energy from carbohydrate intake:
| < 40% | 40-55% | > 55% |
Men: RR = 0.78
Women: RR = 0.90
Men & women: RR = 0.84 (0.71-0.99; P = 0.04)
|
Men: RR = 0.89
Women: RR = 0.91
Men & women: RR = 0.90 (0.82-0.99; P = 0.03)
|
Men: RR = 1.00
Women: RR = 0.96
Men & women: RR = 0.98 (0.83-1.17)
|
Effect modification: All associations were generally attenuated among the multivitamin supplement users (data not shown).Total energy, whole grains, age, smoking, alcohol, BMI, multivitamin and vitamin E supplement use, aspirin use, physical activity, family history of MI, history of hypertension, hypercholesterolaemia and incident diabetes, and menopausal status and hormone replacement therapy. |
| 10) Hung HC. (2004) | The Nurses' Health Study
&
The Health Professionals' Follow-up Study. | 71,910 women (aged 30-55) and
37,725 men (aged 40-75).
(USA) | 14
(1984-1998)
(women), and
12
(1986-1998)
(men) | 1964? women, and
1670? men.
1314 never smokers, 1513 past smokers, and 988 current smokers.
1625 non-vitamin supplement users, and 1444 vitamin supplement users. | Cardiovascular disease risk | Green leafy vegetables (spinach, iceberg or head lettuce, romaine or leaf lettuce, kale, mustard, or chard greens, chicory, endive, escarole, and parsley) |
Stratified by sex:
| Men + women | Men | Women |
| A significant inverse association: RR = 0.89 (0.83-0.96; No P-value). |
RR = 0.89 (No 95% CI; No P-value). |
RR = 0.90 (No 95% CI; No P-value). |
Stratified by smoking status (men and women combined):
| Never | Past | Current |
| RR = 0.93 (0.82-1.05; No P-value). | RR = 0.90 (0.80-1.01; No P-value). | RR = 0.80 (0.60-1.06; No P-value). |
Stratified by multivitamin use (men and women combined):
| Non-vitamin use | Multivitamin use |
| RR = 0.88 (0.78-0.98; No P-value). | RR = 0.89 (0.79-1.00; No P-value). |
All RRs are for an increment of 1 serving/day.Total calorie intake, age, smoking status, alcohol use, body mass index, multivitamin and vitamin E supplement use, physical activity, family history of myocardial infarction, family history of colon cancer, personal history of hypertension, personal history of hypercholesterolemia, personal history of diabetes, and (for women only) family history of breast cancer, menopausal status, and use of hormone replacement therapy. |
| 9) Gaziano JM (1995) | The Massachusetts Health Care Panel Study. | 1,273 subjects aged ≥ 66. | 4.75 (1976-1980) | 161? | Cardiovascular death | Salads and/or green leafy vegetables (such as spinach and greens) | RR = 0.49 (0.31-0.77) for consumption ≥ 1 vs < 1 serving/day. | Age and sex. |
Coronary heart disease risk:
| Author | Cohort name | Subjects | Years of follow-up | Cases | End point | Consumption of | Relative Risk (RR) | Adjustments |
| 10) Erkkilä AT (2007) | The Health Professional's Follow-up Study | 40,087 men aged 40-75. | 1986-2000 | 1,857? | CHD incidence (fatal CHD and non-fatal MI) | Phylloquinone-rich vegetables (broccoli, Brussels sprouts, cabbage, kale, lettuce, and spinach) | Consumption of vegetables rich in phylloquinone (vitamin K1) was not associated with risk of CHD | Age, BMI, smoking elevated blood pressure, elevated serum cholesterol, diabetes, parental MI, physical activity, aspirin use, alcohol intake, use of multivitamin supplements, energy intake, saturated fat, polyunsaturated fat, EPA + DHA, trans fat, cereal fiber and folate intake. |
| 10) Erkkilä AT (2005) | The Nurses' Health Study | 72,874 women aged 38-63, and without cancer, angina pectoris, MI, or stroke.
(USA) | 1984-2000 | See variables | CHD incidence | Phylloquinone-rich vegetables (broccoli, Brussels sprouts, cabbage, iceberg lettuce, romaine lettuce, and spinach) |
Total CHD:
(1,679 cases) | Nonfatal MI:
(1,201 cases) |
RR = 0.80 (0.66-0.96; P = 0.02) for the highest vs lowest quintile of consumption.
Amount specific data (servings/day):
0.4: RR = 1.
0.7: RR = 0.97 (0.82-1.14).
1.1: RR = 0.85 (0.72-1.00).
1.4: RR = 0.89 (0.75-1.06).
2.1: RR = 0.80 (0.66-0.96).
|
RR = 0.80 (0.64-1.00; P = 0.02) for the highest vs lowest quintile of consumption.
Amount specific data (servings/day):
0.4: RR = 1.
0.7: RR = 1.04 (0.86-1.27).
1.1: RR = 0.89 (0.73-1.08).
1.4: RR = 0.92 (0.75-1.13).
2.1: RR = 0.80 (0.64-1.00).
|
Age, BMI, smoking, elevated blood pressure, elevated serum cholesterol, diabetes, menopausal status, use of HRT, parental history of MI, physical activity, use of aspirin, alcohol intake, use of multivitamin supplements, energy intake, saturated fat, polyunsaturated fat, EPA + DHA, trans fatty acids, and cereal fiber. |
| 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) | Green leafy vegetables |
| Pooled | Women | Men |
RR = 0.72 (0.63-0.83; No P-value) for the highest vs lowest quintile of consumption.
Amount specific data (quintiles. not defined):
Q1: RR = 1.
Q2: RR = 0.90 (0.79-1.03).
Q3: RR = 0.91 (0.80-1.03).
Q4: RR = 0.81 (0.68-0.97).
Q5: RR = 0.72 (0.63-0.83).
RR for a 1-serving/d increase in intake: 0.77 (0.64-0.93).
|
RR = 0.69 (No 95% CI; No P-value) for the highest vs lowest quintile of consumption.
Amount specific data (median servings/d):
0.16: RR = 1.
Not defined: RR = 0.92.
Not defined: RR = 0.89.
Not defined: RR = 0.74.
1.51: RR = 0.69.
RR for a 1-serving/d increase in intake: 0.70.
|
RR = 0.76 (No 95% CI; No P-value) for the highest vs lowest quintile of consumption.
Amount specific data (median servings/d):
0.16: RR = 1.
Not defined: RR = 0.89.
Not defined: RR = 0.93.
Not defined: RR = 0.89.
1.36: RR = 0.76.
RR for a 1-serving/d increase in intake: 0.84.
|
Stratified by multivitamin supplement use:
| Participants not using multivitamin supplements | Participants using multivitamin supplements |
| RR = 0.76 (0.63-0.93). |
RR = 0.78 (0.56-1.07). |
Stratified by smoking status:
| Never or past smokers | Current smokers |
| RR = 0.77 (0.59-1.00). |
RR = 0.78 (0.61-0.99). |
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). |
Coronary heart disease mortality:
| Author | Cohort name | Subjects | Years of follow-up | Cases | End point | Consumption of | Relative Risk (RR) | Adjustments |
| 37) Iso H (2007) | The JACC Study. | 40,209 men, and 56,330 women.
(Japan) | Not defined. | 548 men, and
396 women. | Ischemic heart disease mortality | Cabbage or head lettuce |
| Men: | Women |
HR = 0.95 (0.74-1.20) for the highest vs lowest tertile of consumption.
Amount specific data:
< 3/w: HR = 1.
3-4/w: HR = 1.08 (0.87-1.33).
≥ 5/w: HR = 0.95 (0.74-1.20).
|
HR = 0.82 (0.63-1.07) for the highest vs lowest tertile of consumption.
Amount specific data:
< 3/w: HR = 1.
3-4/w: HR = 0.84 (0.65-1.10).
≥ 5/w: HR = 0.82 (0.63-1.07).
|
Age and study area. |
| 37) Iso H (2007) | The JACC Study. | 43,850 men, and 60,169 women.
(Japan) | Not defined. | 617 men, and
420 women. | Ischemic heart disease mortality | Spinach or Garland chrysanthemum |
| Men: | Women |
HR = 0.87 (0.71-1.07) for the highest vs lowest tertile of consumption.
Amount specific data:
< 3/w: HR = 1.
3-4/w: HR = 1.00 (0.81-1.23).
≥ 5/w: HR = 0.87 (0.71-1.07).
|
HR = 0.85 (0.66-1.10) for the highest vs lowest tertile of consumption.
Amount specific data:
< 3/w: HR = 1.
3-4/w: HR = 1.07 (0.82-1.39).
≥ 5/w: HR = 0.85 (0.66-1.10).
|
Age and study area. |
| 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) | 98 | IHD mortality | Fresh or frozen green vegetables or salad (not defined) | RR = 0.63 (0.42-0.95; No P-value) for consumption ≥ 4 vs ≤ 3 days/wk.
This association changed after additional adjustment for pudding/cakes/biscuits/sweets, fresh or frozen meat, and use of hard margarine: RR = 0.87 (0.52-1.46).
Stratified by long-standing disease
| No | Yes |
| RR = 0.81 (0.39-1.68; No P-value). | RR = 0.53 (0.31-0.90; No P-value). |
Stratified by vigorous exercise
| No | Yes |
| RR = 0.68 (0.42-1.09; No P-value). | RR = 0.57 (0.16-2.01; No P-value). |
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 | Green vegetables (not defined) |
Death rate ratio = 134 (47-384; P = Not Significant) for the highest vs lowest tertile of consumption.
Amount specific data (times per week):
< once: DRR = 100.
1-4: DRR = 119 (42-340).
≥ 5: DRR = 134 (47-384). | Age, sex, smoking and social class. |
| 10) Erkkilä AT (2005) | The Nurses' Health Study | 72,874 women aged 38-63, and without cancer, angina pectoris, MI, or stroke.
(USA) | 1984-2000 | 484 | Fatal CHD | Phylloquinone-rich vegetables (broccoli, Brussels sprouts, cabbage, iceberg lettuce, romaine lettuce, and spinach) |
RR = 0.85 (0.61-1.19; P = 0.66) for the highest vs lowest quintile of consumption.
Amount specific data (servings/day):
0.4: RR = 1.
0.7: RR = 0.80 (0.59-1.08).
1.1: RR = 0.78 (0.58-1.06).
1.4: RR = 0.84 (0.61-1.15).
2.1: RR = 0.85 (0.61-1.19). | Age, BMI, smoking, elevated blood pressure, elevated serum cholesterol, diabetes, menopausal status, use of HRT, parental history of MI, physical activity, use of aspirin, alcohol intake, use of multivitamin supplements, energy intake, saturated fat, polyunsaturated fat, EPA + DHA, trans fatty acids, and cereal fiber. |
Stroke:
| Author | Cohort name | Subjects | Years of follow-up | Cases | End point | Consumption of | Relative Risk (RR) | Adjustments |
| 37) Iso H (2007) | The JACC Study. | 40,209 men, and 56,330 women.
(Japan) | Not defined. | 1,118 men, and
953 women. | Cerebrovascular mortality | Cabbage or head lettuce |
| Men: | Women |
HR = 0.90 (0.76-1.06) for the highest vs lowest tertile of consumption.
Amount specific data:
< 3/w: HR = 1.
3-4/w: HR = 0.94 (0.81-1.09).
≥ 5/w: HR = 0.90 (0.76-1.06).
|
HR = 0.95 (0.80-1.12) for the highest vs lowest tertile of consumption.
Amount specific data:
< 3/w: HR = 1.
3-4/w: HR = 1.01 (0.86-1.19).
≥ 5/w: HR = 0.95 (0.80-1.12).
|
Age and study area. |
| 37) Iso H (2007) | The JACC Study. | 43,850 men, and 60,169 women.
(Japan) | Not defined. | 1,229 men, and
1,015 women. | Cerebrovascular mortality | Spinach or Garland chrysanthemum |
| Men: | Women |
HR = 0.87 (0.75-1.01; P = < 0.10) for the highest vs lowest tertile of consumption.
Amount specific data:
< 3/w: HR = 1.
3-4/w: HR = 1.01 (0.87-1.18).
≥ 5/w: HR = 0.87 (0.75-1.01).
|
HR = 0.84 (0.71-0.98; P = < 0.05) for the highest vs lowest tertile of consumption.
Amount specific data:
< 3/w: HR = 1.
3-4/w: HR = 1.07 (0.91-1.26).
≥ 5/w: HR = 0.84 (0.71-0.98).
|
Age and study area. |
| 26) Johnsen SP (2003) | The Danish Diet, Cancer, and Health Study. | 54,506 men and women aged 50-64. | 3.09 (1993-1997) | 266? | Ischemic stroke risk | Leafy vegetables (eg, lettuce and spinach) |
RR = 0.77 (0.52-1.14; P = 0.35) for the highest vs lowest quintile of consumption.
Amount specific data (quintiles. median intake in g/d):
Q1 (1.4): RR = 1.
Q3 (7.8): RR = 0.65 (0.44-0.96).
Q5 (28.0): RR = 0.77 (0.52-1.14).
No data was shown for quintile 2 + 4! | Sex, total energy intake, smoking status, systolic blood pressure, diastolic blood presssure, total serum cholesterol, history of diabetes, BMI, alcohol intake, intake of red meat, intake of n-3 polyunsaturated fatty acids, physical activity, and education. Age was used as the time axis. |
| 16) Ross RK (1997) | No cohort name defined | 18,244 men aged 45-64 from Shanghai.
(China) | 1986-89 to 1994 | 245? | Stroke/cerebrovascular accident death | Dark green leafy vegetables (bok choi, spinach, Chinese celery, mustard green, etc.) | No significant association was found when evaluated either as median levels of daily intake or as tertiles of intake frequencies (No data shown). | Education, marital status, BMI, lifetime cigarette smoking, lifetime ethanol intake, and history of hypertension. |
| 10) Erkkilä AT (2007) | The Health Professional's Follow-up Study | 40,087 men aged 40-75. | 1986-2000 | 617 | Stroke incidence | Phylloquinone-rich vegetables (broccoli, Brussels sprouts, cabbage, kale, lettuce, and spinach) | Consumption of vegetables rich in phylloquinone (vitamin K1) was not associated with risk of stroke | Age, BMI, smoking elevated blood pressure, elevated serum cholesterol, diabetes, parental MI, physical activity, aspirin use, alcohol intake, use of multivitamin supplements, energy intake, saturated fat, polyunsaturated fat, EPA + DHA, trans fat, cereal fiber and folate intake. |
| 10) Erkkilä AT (2005) | The Nurses' Health Study | 72,874 women aged 38-63, and without cancer, angina pectoris, MI, or stroke.
(USA) | 1984-2000 | Total stroke: 1,009?
Ischemic stroke: 567? | Stroke incidence | Phylloquinone-rich vegetables (broccoli, Brussels sprouts, cabbage, iceberg lettuce, romaine lettuce, and spinach) | No association was found with total or ischemic stroke risk (data not shown). | Age, BMI, smoking, elevated blood pressure, elevated serum cholesterol, diabetes, menopausal status, use of HRT, parental history of MI, physical activity, use of aspirin, alcohol intake, use of multivitamin supplements, energy intake, saturated fat, polyunsaturated fat, EPA + DHA, trans fatty acids, and cereal fiber. |
| 10) Joshipura KJ (1999) | The Nurses' Health Study
&
The Health Professionals' Follow-Up Study | 75,596 women aged 34-59, and 38,683 men aged 40-75.
(USA) | Women: 14
(1980-1994).
Men: 8
(1986-1994). | 570?
295 non-users of vitamin supplements, and 216 users of multivitamin supplements.
388 never & past smokers, and 172 current smokers. | Ischemic stroke risk | Green leafy vegetables (not defined) |
| Pooled | Women
(366? cases) | Men
(204? cases) |
RR = 0.76 (0.58-0.99) for the highest vs lowest quintile of consumption.
Amount specific data (not defined):
Q1: RR = 1.
Q2: RR = 0.80 (0.51-1.24).
Q3: RR = 0.85 (0.57-1.27).
Q4: RR = 0.77 (0.59-0.99).
Q5: RR = 0.76 (0.58-0.99).
RR for an increment of 1 serving/day:
0.79 (0.62-0.99).
|
RR = 0.76 (0.55-1.05) for the highest vs lowest quintile of consumption.
Amount specific data (servings/day):
0.16: RR = 1.
Not defined: RR = 0.65 (0.46-0.91).
Not defined: RR = 0.71 (0.52-0.96).
Not defined: RR = 0.77 (0.56-1.06).
1.51: RR = 0.76 (0.55-1.05).
RR for an increment of 1 serving/day:
0.84 (0.61-1.15).
|
RR = 0.76 (0.48-1.20) for the highest vs lowest quintile of consumption.
Amount specific data (servings/day):
0.16: RR = 1.
Not defined: RR = 1.01 (0.67-1.52).
Not defined: RR = 1.08 (0.70-1.67).
Not defined: RR = 0.76 (0.49-1.17).
1.36: RR = 0.76 (0.48-1.20).
RR for an increment of 1 serving/day:
0.73 (0.52-1.03).
|
Stratified by vitamin supplement use:
| No vitamin supplement | Multivitamin supplement |
| RR for an increment of 1 serving/day: 0.78 (0.56-1.09).
|
RR for an increment of 1 serving/day: 0.81 (0.56-1.17).
|
Stratified by smoking status:
| Never and past smokers | Current smokers |
| RR for an increment of 1 serving/day: 0.74 (0.56-0.98).
|
RR for an increment of 1 serving/day: 0.91 (0.58-1.43).
|
Age, smoking, alcohol, family history of MI, BMI, vitamin supplement use, vitamin E use, physical activity, aspirin use, time period, hypertension and hypercholesterolemia, total energy intake, and amon women, postmenopausal hormone use. |
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