Fruit and Vegetable Consumption and the Incidence of Hypertension in Three Prospective Cohort Studies

Abstract

Increased fruit and vegetable intake lowers blood pressure in short-term interventional studies. However, data on the association of long-term intake of fruits and vegetables with hypertension risk are scarce. We prospectively examined the independent association of whole fruit (excluding juices) and vegetable intake, as well as the change in consumption of whole fruits and vegetables, with incident hypertension in three large longitudinal cohort studies: Nurses’ Health Study (n=62,175), Nurses’ Health Study II (n=88,475), and Health Professionals Follow-up Study (n =36,803). We calculated hazard ratios and 95% confidence intervals for fruit and vegetable consumption while controlling for hypertension risk factors. Compared with participants whose consumption was ≤4servings/week, the pooled hazard ratios among those whose intake was ≥4servings/day were 0.92(0.87–0.97) for total whole fruit intake and 0.95(0.86–1.04) for total vegetable intake. Similarly, compared with participants who did not increase their fruit or vegetable consumption, the pooled hazard ratios for those whose intake increased by ≥7servings/week were 0.94(0.90–0.97) for total whole fruit intake and 0.98(0.94–1.01) for total vegetable. Analyses of individual fruits and vegetables yielded different results. Consumption levels of ≥4servings/per week (as opposed to <1serving/month) of broccoli, carrots, tofu or soybeans, raisins and apples was associated with lower hypertension risk. In conclusion, our results suggest that greater long-term intake and increased consumption of whole fruits may reduce the risk of developing hypertension.

Impact of lifestyle behaviors in early childhood on obesity and cardiometabolic risk in children: Results from the Spanish INMA birth cohort study

“…A previous study reported that a quarter of all the food available is ultra‐processed food in households across 19 European countries and the household availability of ultra‐proceed food was positively associated to prevalence of obesity . High intake of plants food was only inversely associated with DBP at age 7y, in agreement with several studies that showed fruits and vegetable consumption had favorable effects on blood pressure . Nevertheless, we did not find any associations between plant based food and obesity or any other risk factors.…”

Cruciferous and Allium Vegetable Intakes are Inversely Associated With 15‐Year Atherosclerotic Vascular Disease Deaths in Older Adult Women

“…In recent years, further analysis of the role of specific vegetable and fruit species has been undertaken to identify potentially beneficial varieties and thus to allow consideration of the potential nutrient and phytochemical effects on health outcomes. A recent report of the beneficial effects of certain vegetables and fruits on the risks of developing hypertension is an excellent example of the approach required to advance our knowledge of the role of specific vegetable and fruit species on preventing disease …”

Associations of 100% fruit juice versus whole fruit with hypertension and diabetes risk in postmenopausal women: Results from the Women's Health Initiative

“…Borgi and colleagues analyzed 187,453 US adults for a mean follow-up time of 15.7 years. 24 They compared participants who consumed ≥ 4 servings/d of whole fruit to participants who consumed ≤ 4 servings/week of whole fruit, and found a multivariable adjusted HR of 0.92 (95% CI 0.87–0.97) for incident hypertension. When we analyzed 100% fruit juice and whole fruit dietary exposures using the same categories as Borgi et al, we found that whole fruit was associated with a similar, but non-significant decreased risk of hypertension (HR 0.94; 95% CI 0.83–1.05), and found that comparing the highest to lowest categories of 100% fruit juice consumption was associated with an increased risk of hypertension (HR 1.29; 95% CI 1.06–1.56), with a significant increasing trend across categories (P for trend = 0.03).…”

“…Finally, our outcome measure of incident hypertension was based on self-report, which has been used in other WHI analyses but has not been objectively validated. 24 …”

“…We examined the influence of (1) stratifying by decade of age; (2) stratifying by study arm; (3) stratifying by baseline blood pressure category; (4) stratifying by race/ethnicity; (5) classifying the exposure as tertiles and quartiles; (6) performing change analysis as described Smith et al, xxiii which measured change in 100% fruit juice consumption and change in incident hypertension and diabetes over the same 3-year time period; (7) using cutpoints defined by Borgi et al xxiv to categorize the 100% fruit juice exposure (≤ 4 servings/week; 5–6 servings/week; 1 serving/d; 2–3 servings/d; ≥ 4 servings/d); (8) sub-classifying the exposures of 100% fruit juice and whole fruit into categories of citrus and non-citrus; and (9) restricting the analytic sample to the highest quintile of 100% fruit juice consumers.…”