Increasing fruit and vegetable variety helps to lower disease risk – American Society for Nutrition

A new study published in The Journal of Nutrition provides intriguing insights regarding the association between the quantity and the variety of fruit and vegetable consumption and lower-risk mortality in an older Chinese population.

Studies have shown beneficial effects of higher fruit and vegetable consumption and lower risk of coronary heart disease. While the American Institute for Cancer Research and the American Heart Association advocate choosing healthy fruits and vegetables based on color, evidence regarding the impact on health outcomes is limited. To bridge this knowledge gap, corresponding authors Xu, Lin (Sun Yat-sen University) and Zhang (Guangzhou Twelfth People’s Hospital) and colleagues used data from the Guangzhou Biobank Cohort Study in China, an ongoing population-based cohort with 15 years follow-up, to examine the associations of quantity and variety of fruit and vegetable consumption with the risks of all-cause and cause-specific mortality (cardiovascular disease and cancer mortality) in older Chinese (>50 years). Analyses also included associations of fruit and vegetable consumption based on color and mortality. Fruit and vegetable consumption was assessed using a 300-item validated food frequency questionnaire (intake per week over the past week) comprised of 30 types of fruits and 66 types of vegetables generally consumed in China.

During 286,821 person-year of follow-up, 4385 deaths occurred, including 1678 cardiovascular diseases, 1450 cancer, and 1257 other causes. Compared with the lowest quintile of variety in fruit and vegetable consumption, the highest quantile was associated with lower risks of all-cause and cardiovascular disease mortality. A greater variety of green and white fruit and vegetable intake was associated with lower risks of all-cause and cardiovascular disease mortality, and a greater variety of red/purple fruit and vegetable intake was associated with lower risks of all-cause and cancer mortality. However, the quantity of fruit and vegetable intake showed no association with all-cause, cardiovascular disease, and cancer mortality.

The primary finding from this study suggests higher variety, but not quantity, of fruit and vegetable intake lowers risk of all-cause and cardiovascular disease mortality in older Chinese adults.  Increased consumption of green, red/purple, and white fruits and vegetables may be especially beneficial. In a companion commentary, Griep (University of Cambridge School of Clinical Medicine) underscores the need to further understand the underlying mechanisms that confirm the health benefits of the variety and color of fruit and vegetable consumption in experimental settings.

References

Sun C, Zhang WS, Jiang CQ, Jin YL, Zhu T, Zhu F, Yeung SLA, Woo J, Cheng KK, Lam TH, Xu L. Quantity and Variety in Fruit and Vegetable Consumption and Mortality in Older Chinese: A 15-year Follow-Up of a Prospective Cohort Study. The Journal of Nutrition, Volume 153, Issue 7, July 2023, Pages 2061-2072, doi.org/10.1016/j.tjnut.2023.03.021.

Griep Oude LM. Addressing the Complexity of Fruits and Vegetables in Nutritional Epidemiology. The Journal of Nutrition, Volume 153, Issue 7, July 2023, Pages 1841-1842, doi.org/10.1016/j.tjnut.2023.04.014.

Images via canva.com.