Salads and all-cause mortality/survival cancer.

Data about salads was provided by 3 cohorts. A strong significant protective effect was found in one cohort (1), but no associations were found in the other cohorts (8, 17).

Conclusion: A significant protective effect in one cohort. No evidence was found for an association between salads and mortality.

Author

Cohort name

Subjects

Years of follow-up

Cases

End point

Consumption of

Relative Risk (RR)

Adjustments

17) Fortes C. (2000)

Cohort name = ?

161 elderly (52 men, and 109 women) ≥ 65 years. (Mean age 80) in Rome.
(Italy)

5
(1993-1998)

53? (21 men, and 32 women)

Overall mortality

Salad

RR = 0.66 (0.34-1.27; No P-value) for the highest vs lowest tertile of consumption.

Amount specific data (times/wk):
< 1: RR = 1.
1-2: RR = 0.58 (0.31-1.11).
> 2: RR = 0.66 (0.34-1.27).

Unadjusted.

8) 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

2,529 (1,160 men, and 1,369 women. 2,055 non-smokers)?

All-cause mortality

Raw vegetable salads (not defined)

RR = 0.98 (0.90-1.07; No P-value) for daily consumption vs less frequent consumption.

Age at recruitment, sex, smoking, and each other food (fresh fruit, wholemeal bread, nuts/dried fruit, raw vegetable salads, and bran cereals).

8) 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)

1.343? (666 men, 677 women)

all cause mortality

raw salad (not defined)

RR = 0.91 (0.82-1.02; No P-value) for consumption at least daily vs < daily.

age, sex, and smoking

1) Fraser GE (1997)

The Adventist Health Study

1.668 black California men and women aged ≥ 25.

1976-1985

See variables

All-cause mortality

Green salads (tossed salad, coleslaw, etc.)


Both sexes (153? cases)	Men (73? cases)	Women (80? cases)
HR = 0.7 (0.4-1.1) for the highest vs lowest tertile of consumption. Amount specific data (Frequency of use): < 3x/week: HR = 1. 3-6x/week: HR = 0.5 (0.4-0.9). ≥ 1x/day: HR = 0.7 (0.4-1.1). This association remained after additional adjusmtent for meat, fish and poultry: HR's for increasing tertiles: 1, 0.57, and 0.66	HR = 0.7 (0.3-1.3) for the highest vs lowest tertile of consumption. Amount specific data (Frequency of use): < 3x/week: HR = 1. 3-6x/week: HR = 0.7 (0.4-1.3). ≥ 1x/day: HR = 0.7 (0.3-1.3).	HR = 0.7 (0.3-1.3) for the highest vs lowest tertile of consumption. Amount specific data (Frequency of use): < 3x/week: HR = 1. 3-6x/week: HR = 0.4 (0.2-0.8). ≥ 1x/day: HR = 0.7 (0.3-1.3).

Age, smoking and exercise.

1) 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)

1,387?
(451 men, and 936 women)

All-cause mortality

Green salad (not defined)


Total:	Men:	Women:
HR = 0.91 (0.78-1.05) for the highest vs lowest tertile of consumption. Amount specific data: < 3 per week: RR = 1. 3-6 per week: RR = 0.95 (0.84-1.09). ≥ 1 per day: RR = 0.91 (0.78-1.05).	HR = 0.96 (0.73-1.24) for the highest vs lowest tertile of consumption. Amount specific data: < 3 per week: RR = 1. 3-6 per week: RR = 1.03 (0.82-1.29). ≥ 1 per day: RR = 0.96 (0.73-1.24).	HR = 0.88 (0.74-1.05) for the highest vs lowest tertile of consumption. Amount specific data: < 3 per week: RR = 1. 3-6 per week: RR = 0.92 (0.78-1.08). ≥ 1 per day: RR = 0.88 (0.74-1.05).

Age and sex.

1) Kahn HA. (1984)

The Adventist Health Study.

27,530 California members of the Seventh-Day Adventist Church aged > or = 30.
(USA)

21
(1960-1980)

5,662

All-cause mortality

Green salad


OR with consideration of lenght of survival	OR without consideration of lenght of survival
OR = 0.72 (No 99% CI; P = < 0.01) for the highest vs lowest quartile of consumption. Amount specific data (days/wk): < 1: OR = 1.00. 1-3: OR = 0.82. 4-6: OR = 0.74. 7: OR = 0.72.	Total: OR = 0.67 (99% CI = 0.50-0.88; P = < 0.01) for the highest vs lowest quartile of consumption. Amount specific data (days/wk): < 1: OR = 1.00. 1-3: OR = 0.79 (99% CI = 0.66-0.95; P = < 0.01). 4-6: OR = 0.71 (99% CI = 0.55-0.92; P = < 0.01). 7: OR = 0.67 (99% CI = 0.50-0.88; P = < 0.01). Men: OR = 0.82 (No 99% CI; No P-value). Women: OR = 0.67 (99% CI = 0.51-0.88; P = < 0.01).

After additional adjustment for cooked vegetables and fruit/fruit juice the OR remained significant (0.81).
After additional adjustment for meat and eggs the association also remained significant (OR = 0.79).

Salad consumption was significantly associated with lower risk for both vegetarian and non-vegetarian groups, and among persons in high, medium, and low categories of percentage of ideal weight.

Age (15-year intervals for men & women combined, 10-year intervals for associations stratified by sex), sex, history of disease (heart disease, stroke, hypertension, diabetes, or cancer), age at initial exposure to the Adventist Church, and smoking history (never vs ever).

Mortality & Diet.

A systematic review.

Literature review

Relating various aspects of our
diet to mortality & survival.

Salads and all-cause mortality/survival cancer.

Mortality & Diet.

A systematic review.

Literature review

Relating various aspects of ourdiet to mortality & survival.

Salads and all-cause mortality/survival cancer.

Relating various aspects of our
diet to mortality & survival.