Low Fruit Consumption in China Linked to Heightened Risks of Cardiovascular Death, Stroke


Fewer than one in five Chinese adults eat fresh fruit on a daily basis, a dietary habit that researchers say likely carries health consequences. Regular consumption of fresh fruit was associated with lower blood pressure and blood glucose levels as well as independently linked to reduced risks of cardiovascular death, incident major coronary events, and stroke.

“If these associations are largely causal, the potential health gain from increased consumption of fresh fruit in China would be substantial,” write lead author Huaidong Du, PhD (University of Oxford, England), and colleagues in the April 7, 2016, issue of the New England Journal of Medicine.

The study looked at 451,665 Chinese adults, with a total follow-up of 3.2 million person-years. None had a history of cardiovascular disease or antihypertensive treatments at baseline. Mean age was 50.5 years (range 30-79 years), 59% were women, and 43% lived in urban areas.

Less than one-fifth (18.0%) reported daily fruit consumption, 9.4% said they ate fruit 4 to 6 days per week, and 6.3% reported rarely or never eating fruit.

For people living in rural areas and urban women, fruit consumption tended to be lower in those who were older. Among urban men, the lowest consumption was for men aged 50 to 55 years. Compared to those who rarely or never ate fruit, those who did so daily had mean adjusted levels of systolic blood pressure and blood glucose levels that were 4.0 mm Hg and 0.5 mmol/L lower, respectively.

Daily fruit consumption was significantly associated with lower adjusted risks of cardiovascular death, incident major coronary events, ischemic stroke, and hemorrhagic stroke. The link was largely independent of blood pressure and glucose levels, the researchers say, observing a dose-response relationship between each outcome and the amount of fruit consumed.

Table. Low Fruit Consumption in China Linked to Heightened Risks of Cardiovascular Death, Stroke

Notably, around 95% of study participants reported daily consumption of fresh vegetables. After adjustment for this and other dietary factors, the association between fruit and outcomes held steady.


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Sources
  • Du H, Li L, Bennett D, et al. Fresh fruit consumption and major cardiovascular disease in China. N Engl J Med. 2016;374:1332-1343.

Disclosures
  • The study was supported by grants from the Wellcome Trust, the Kadoorie Charitable Foundation, and the Chinese National Natural Science Foundation, with core funding provided by the British Heart Foundation, the Medical Research Council, and Cancer Research UK to the Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford.
  • Du reports no relevant conflicts of interest.

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