Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies.
Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies.
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DOI：
10.1136/bmj.g4490
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发表时间：
2014-07-29
期刊：
影响因子：
--
通讯作者：
Hu FB
中科院分区：
文献类型：
--
作者：
Wang X;Ouyang Y;Liu J;Zhu M;Zhao G;Bao W;Hu FB
目的 检查并量化水果和蔬菜摄入量与全因死亡率、心血管死亡率和癌症死亡率之间的潜在剂量反应关系。数据来源 Medline、Embase 和 Cochrane 图书馆检索截至 2013 年 8 月 30 日，无语言限制。检索到的文章的参考列表。研究选择 前瞻性队列研究报告了按水果和蔬菜消费水平对全因死亡率、心血管死亡率和癌症死亡率的风险估计。数据合成随机效应模型用于计算汇总风险比和 95% 置信区间，并纳入研究之间的差异。使用每项研究中水果和蔬菜消费类别的数据评估线性和非线性剂量反应关系。结果 十六项前瞻性队列研究符合本荟萃分析的条件。在 4.6 至 26 年的随访期间，833-234 名参与者中有 56-423 人死亡（11-512 人死于心血管疾病，16-817 人死于癌症）。水果和蔬菜的消费量增加与全因死亡风险降低显着相关。每天增加一份水果和蔬菜的全因死亡率的汇总风险比为 0.95（95% 置信区间为 0.92 至 0.98）（P=0.001），水果为 0.94（0.90 至 0.98）（P=0.002），蔬菜为 0.95（0.92 至 0.99）（P=0.006）。每天吃五份水果和蔬菜有一个阈值，之后全因死亡的风险并没有进一步降低。观察到心血管死亡率存在显着的负相关（每天多吃水果和蔬菜的风险比为 0.96，95% 置信区间为 0.92 至 0.99），而较高的水果和蔬菜摄入量与癌症死亡风险没有明显相关。结论 这项荟萃分析提供了进一步的证据，表明水果和蔬菜的摄入量较高与全因死亡率（尤其是心血管死亡率）风险较低相关。
Objective To examine and quantify the potential dose-response relation between fruit and vegetable consumption and risk of all cause, cardiovascular, and cancer mortality. Data sources Medline, Embase, and the Cochrane library searched up to 30 August 2013 without language restrictions. Reference lists of retrieved articles. Study selection Prospective cohort studies that reported risk estimates for all cause, cardiovascular, and cancer mortality by levels of fruit and vegetable consumption. Data synthesis Random effects models were used to calculate pooled hazard ratios and 95% confidence intervals and to incorporate variation between studies. The linear and non-linear dose-response relations were evaluated with data from categories of fruit and vegetable consumption in each study. Results Sixteen prospective cohort studies were eligible in this meta-analysis. During follow-up periods ranging from 4.6 to 26 years there were 56 423 deaths (11 512 from cardiovascular disease and 16 817 from cancer) among 833 234 participants. Higher consumption of fruit and vegetables was significantly associated with a lower risk of all cause mortality. Pooled hazard ratios of all cause mortality were 0.95 (95% confidence interval 0.92 to 0.98) for an increment of one serving a day of fruit and vegetables (P=0.001), 0.94 (0.90 to 0.98) for fruit (P=0.002), and 0.95 (0.92 to 0.99) for vegetables (P=0.006). There was a threshold around five servings of fruit and vegetables a day, after which the risk of all cause mortality did not reduce further. A significant inverse association was observed for cardiovascular mortality (hazard ratio for each additional serving a day of fruit and vegetables 0.96, 95% confidence interval 0.92 to 0.99), while higher consumption of fruit and vegetables was not appreciably associated with risk of cancer mortality. Conclusions This meta-analysis provides further evidence that a higher consumption of fruit and vegetables is associated with a lower risk of all cause mortality, particularly cardiovascular mortality.
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作者：
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