Associations of Serum Biomarkers of Fruit and Vegetable Intake With the Risk of Cause–Specific Mortality and All–Cause Mortality: A National Prospective Cohort Study

Abstract

ObjectiveThe purpose of this study was to evaluate the associations of serum biomarkers of fruit and vegetable intake (vitamin C and carotenoids) with cause–specific mortality and all–cause mortality in a nationally representative sample of US adults.MethodsWe analyzed data from 12,530 participants from the National Health and Nutrition Examination Survey III (1988–1994). The Cox proportional hazards models with restricted cubic spline were used for the analysis.ResultsDuring 246,027 person–years of follow–up, 4,511 deaths occurred, including 1,395 deaths from cardiovascular disease, 1,072 deaths from heart disease, 323 deaths from cerebral disease, and 954 deaths from cancer. The serum vitamin C was significantly associated with the cancer and all–cause mortality, with hazard ratios (HRs) (95% CIs) for each one SD of 0.80 (0.71–0.91) and 0.91 (0.86–0.96). The serum alpha–carotene was significantly associated with the cancer mortality, with HRs (95% CIs) of 0.70 (0.54–0.90), 0.68 (0.48–0.95), 0.64 (0.43–0.95), and 0.44 (0.33–0.60) for comparisons of groups 2–5 with group 1 in model 2, respectively. The change for each one SD in the composite biomarker score, equivalent to a 0.483 times/month difference in total fruits and vegetables intake, gave an HR of 0.79 (0.69–0.90) for cancer mortality.ConclusionInverse associations were found between serum vitamin C, carotenoids, and composite biomarker score and outcomes expect for cerebral disease, heart disease, and cardiovascular disease mortality. This finding supports an increase in dietary fruit and vegetable intake as a primary prevention strategy for cancer and all–cause mortality.

Plant-based dietary patterns and lung cancer mortality: a perspective cohort study

“…[34][35][36] In addition, dietary antioxidants can protect against oxidative stress and the harmful effects of reactive oxygen species 37 and have been reported to inhibit the proliferation of human cancer cells 38 and decrease cancer mortality. 39,40 Second, a healthy plant-based diet could promote the gut microbial environment, the "gut-lung axis," which suggests that the gut microbiota can affect the lungs through local and systemic immune responses. 41 Previous studies have suggested that the gut microbiota significantly affects the efficacy of tumor immunotherapy.…”