Quantity and Variety in Fruit and Vegetable Consumption and Mortality in Older Chinese: A 15-year Follow-Up of a Prospective Cohort Study

Ce Sun; Wei Sen Zhang; Chao Qiang Jiang; Ya Li Jin; Tong Zhu; Feng Zhu; Shiu Lun Au Yeung; Jean Woo; Kar Keung Cheng; Tai Hing Lam; Lin Xu

doi:10.1016/j.tjnut.2023.03.021

Quantity and Variety in Fruit and Vegetable Consumption and Mortality in Older Chinese: A 15-year Follow-Up of a Prospective Cohort Study

J Nutr. 2023 Jul;153(7):2061-2072. doi: 10.1016/j.tjnut.2023.03.021. Epub 2023 Mar 22.

Authors

Ce Sun¹, Wei Sen Zhang², Chao Qiang Jiang², Ya Li Jin², Tong Zhu², Feng Zhu², Shiu Lun Au Yeung³, Jean Woo⁴, Kar Keung Cheng⁵, Tai Hing Lam⁶, Lin Xu⁷

Affiliations

¹ School of Public Health, Sun Yat-sen University, Guangzhou, China.
² Guangzhou Twelfth People's Hospital, Guangzhou, China.
³ School of Public Health, The University of Hong Kong, Hong Kong, China.
⁴ Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
⁵ Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
⁶ Guangzhou Twelfth People's Hospital, Guangzhou, China; School of Public Health, The University of Hong Kong, Hong Kong, China.
⁷ School of Public Health, Sun Yat-sen University, Guangzhou, China; School of Public Health, The University of Hong Kong, Hong Kong, China; Institute of Applied Health Research, University of Birmingham, Birmingham, UK. Electronic address: xulin27@mail.sysu.edu.cn.

PMID: 36963500
DOI: 10.1016/j.tjnut.2023.03.021

Abstract

Background: Independent associations of quantity and variety of fruit and vegetables (FVs) with mortality in older people are still unclear.

Objectives: This study aimed to explore the association between the quantity and variety in FV consumption and mortality in older Chinese.

Methods: A total of 19,597 participants of the Guangzhou Biobank Cohort Study aged >50 y were recruited from 2003 to 2006 and followed up until April 2021. The diet was assessed using a 300-item validated FFQ. Variety as a continuous variable was defined as the number of unique FV items (excluding potatoes, legumes, and fruit juices) intake per week over the past week. The associations of quantity and variety of FVs with mortality were analyzed, and analyses by the color of edible parts was performed. Multivariable Cox regression yielded HRs and 95% CIs.

Results: During 286,821 person-year of follow-up, 4385 deaths occurred, including 1678 cardiovascular diseases (CVD), 1450 cancer, and 1257 other causes. Compared with the lowest quintile of variety in FV, the highest quintile was associated with lower risks of all-cause (HR: 0.81; 95% CI: 0.73-0.89) and CVD mortality (HR: 0.79; 95% CI 0.67-0.92). A greater variety of green and white FV intake was associated with lower risks of all-cause and CVD morality, and a greater variety of red/purple FV intake was associated with lower risks of all-cause and cancer mortality. However, the quantity of FV intake showed no association with all-cause, CVD, and cancer mortality.

Conclusion: Our findings have first showed that the variety, rather than quantity, in FV intake was associated with a lower risk of mortality in older Chinese. Dietary guidelines may recommend increasing the variety in FV intake, especially green, red/purple, and white FVs in older people.

Keywords: Chinese; fruit and vegetable; fruit and vegetable quantity; fruit and vegetable variety; older people.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cardiovascular Diseases*
Cohort Studies
Diet
East Asian People
Follow-Up Studies
Fruit
Humans
Neoplasms*
Prospective Studies
Vegetables