Greater vegetable variety and amount are associated with lower prevalence of coronary heart disease: National Health and Nutrition Examination Survey, 1999–2014

Abstract

BackgroundThe 2015–2020 Dietary Guidelines for Americans (DGA) provides specific intake recommendations for vegetable variety and amount in order to protect against chronic disease. However, to the best of our knowledge, no studies have examined the link between DGA recommended vegetable variety and cardiometabolic disease. To address this research gap, our aim was to estimate the relationship between vegetable variety, vegetable amount, and prevalent cardiometabolic disease subtypes, and to assess potential determinants of vegetable variety.MethodsData on food intake and reported cardiometabolic disease status were acquired for 38,981 adults from the National Health and Nutrition Examination Survey (1999–2014). Vegetable variety was measured using a modified dietary diversity index that was adjusted for the potential confounding effects of vegetable amount. Temporal trends in vegetable variety and amount were assessed using univariate linear regression models. Multivariate logistic regression models were used to estimate the relationship between vegetable variety and prevalent disease, and between vegetable amount and prevalent disease. Multivariate ordered logistic regression models were used to assess the relationship between vegetable variety and explanatory variables.ResultsOverall, vegetable variety decreased (P = 0.035) from 1999 to 2014, but vegetable amount did not (P = 0.864). Intake of starchy vegetables decreased (P < 0.001), and intake of dark green vegetables increased (P < 0.001) over this 16-year period, but no trends were observed for other subgroups. An inverse linear relationship was observed between vegetable variety and prevalent coronary heart disease (P-trend = 0.032) but not other prevalent diseases; and between vegetable amount and coronary heart disease (P-trend = 0.026) but not other prevalent diseases. Individuals who reported consuming dark green vegetables had lower odds of having cardiovascular disease (0.86, 95% CI: 0.74–0.99) and coronary heart disease (0.78, 0.65–0.94) compared to individuals who reported not consuming any green vegetables. Living with a domestic partner was associated with greater vegetable variety (P = < 0.001), and currently smoking was associated with lower vegetable variety (P = < 0.001). Vegetable variety and amount were positively associated (P < 0.001).ConclusionsVegetable variety and amount were inversely associated with prevalent coronary heart disease. Vegetable variety was strongly associated with vegetable amount, likely mediated by reduced habituation and increased liking. Increasing vegetable variety and amount are still important messages for the public.Electronic supplementary materialThe online version of this article (10.1186/s12937-018-0376-4) contains supplementary material, which is available to authorized users.

Association between Ready-to-Eat Cereal Consumption and Nutrient Intake, Nutritional Adequacy, and Diet Quality in Adults in the National Health and Nutrition Examination Survey 2015–2016

“…Similar to previous studies using NHANES data [20][21][22][23][24], Day 1 dietary data were used in this study, which provide an appropriate estimate of population mean intake of nutrients on a given day [25]. Participants were classified as RTE cereal eaters or non-eaters depending on whether they reported consumption of RTE cereal food in their Day 1 dietary recall.…”

Evaluation and Ecological Risk Assessment of Selected Heavy Metal Pollution of Soils and Amaranthus cruentus and Telfairia occidentalis Grown Around Dump Site in Chanchaga Minna, Niger State, Nigeria

“…African spinach (Amaranthus cruentus) also known as alayyafoo in Hausa, efo tete in Yoruba and inine in Igbo. Vegetables contain nutrient such as protein, essential minerals, fiber, vitamins, carotene and some essential amino acids required for normal metabolic activities of the body [17,18]. The nutrients help to repair worn out tissues, reduce cancer risks, lower cholesterol levels, normalize digestion time, improve eye vision, fight free radicals, and boost immune system.…”

Prospective Analysis of Vegetable Amount and Variety on the Risk of All-Cause and Cause-Specific Mortality among US Adults, 1999–2011

“…Vegetable variety was measured using an index developed to measure adherence to the DGA-2015 recommendations for daily vegetable variety [ 13 ]. The index measures the variety of vegetable intake independent of amount, and penalizes the consumption of vegetable subgroups (dark green vegetables, red and orange vegetables, legumes, starchy vegetables, and other vegetables) that do not align with recommended intake proportions in the DGA 2015–2020 [ 13 ]. The index contains two parts.…”

“…Bhupathiraju, et al reported that the number of distinct fruits and vegetables consumed is not associated with a reduced risk of incident coronary heart disease (CHD) [ 12 ], yet recently, we demonstrated that greater DGA-recommended vegetable variety is positively associated with prevalent CHD [ 13 ]. However, to date, no longitudinal studies have evaluated the relationship between adherence to the DGA vegetable variety recommendations and risk of mortality, to the best of our knowledge.…”