Daily fresh fruit consumption linked to 30% lower risk of CVD in study of 500,000+

Girl manning a fruit stall in a Fuji town street market, Lu Zhou, China.
Girl mans a fruit stall in a Fuji town street market, Lu Zhou, China: a new large-scale study of more than half a million Chinese shows a significant association between daily consumption of fresh fruit and reduced incidence of cardiovascular disease.
C Foulger, Flickr CC

Researchers at the University of Oxford and China Academy of Chinese Medical Sciences (CACMS) surveyed more than half a million adults from 10 urban and regional areas across China, evaluating their health over seven years using hospital records of illness and death. The majority of subjects had no history of CVD or anti-hypertensive treatments prior to the study.

Between 2004 and 2008, the researchers recruited 512,891 adults aged between 30 and 79 years from 10 diverse localities. Among the 451,665 participants who did not have a history of cardiovascular disease or antihypertensive treatments at baseline, 3.2 million person-years of follow-up using subjects’ hospital and death records showed that:

  • 5,173 of the subjects had died from cardiovascular disease;
  • 2,551 had experienced major coronary events (fatal and non-fatal);
  • 14,579 had suffered ischaemic strokes; and
  • 3,523 had had intracerebral haemorrhages.

The findings showed that those subjects who ate a 100g portion of fresh fruit a day were around a third less likely to experience death from cardiovascular disease (CVD), across all localities and whether they were male or female.

Girl eating a peach: only 18 percent of Chinese people currently consume fresh fruit daily, and this could partly explain the nation's high incidence of stroke.
Only 18 percent of Chinese people currently consume fresh fruit daily, and this could partly explain the nation's high incidence of stroke.
Rhobinn, Flickr CC

Compared to those who reported consuming fresh fruit never or rarely, the 18 percent of participants who consumed fresh fruit daily had lower systolic blood pressure (by 4.0 mm Hg) and blood glucose levels (by 0,5 mmol per litre [9.0 mg per decilitre]).There was a strong linear relationship between the amount of fresh fruit consumed and the incidence of these outcomes.

“Among Chinese adults, a higher level of fruit consumption was associated with lower blood pressure and blood glucose levels and, largely independent of these and other dietary and nondietary factors, with significantly lower risks of major cardiovascular diseases,” reported the study’s authors in the original paper, published in New England Journal of Medicine on 7 April 2016.

The findings remained significant even allowing for factors such as higher levels of educational attainment, not smoking, having lower blood glucose levels and having lower blood pressure.

“There is evidence that the association of fruit consumption with disease risks may be particularly strong at the low end of the range of intake (i.e. fewer than two servings per day),” the study’s authors noted.

Previous findings have typically included both fresh and processed fruit produce (such as frozen and/or canned fruit, fruit juice and the like). Of the few previous studies that explored the association between fresh fruit consumption and disease, a Chinese study of 130,000 adults found that the risk of CV death among those people in the highest quintile of fruit consumption was about 30 percent lower than among those in the lowest quintile.

In this study, though, no significant association was found between lower fruit consumption and the incidence of major coronary events – maybe because only 365 such events in total occurred in this study.

Source: Huaidong Du et al. ‘Fresh Fruit Consumption and Major Cardiovascular Disease in China’New England Journal of Medicine 2016; 374:1332-1343, DOI: 10.1056/NEJMoa1501451

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