Intake of fruit, vegetables and pulses, and all-cause, cardiovascular and cancer mortality: Results from a population-based prospective study

Abstract

Objectives

The aim of this study was to explore the association of fruit, vegetable, and pulses consumption with all-cause, cardiovascular, and cancer mortality.

Study design

This prospective study included 66,933 individuals from three Spanish health surveys linked to the national death registry up to December 2022.

Methods

Adjusted Poisson regression models were used to analyze the data, categorizing fruit, vegetable and pulses intake according to Spanish dietary recommendations and using splines to examine non-linear relationships.

Results

No clear association was found between pulses intake and mortality. Consuming fruits and vegetables ≥2 times/day reduced all-cause mortality risk by 20 % (95%CI = 10%–29 %) and 17 % (95%CI = 7%–26 %) respectively, compared with <3 times/week. Combined intake of fruits and vegetables from 1 to 1.99 to ≥5 times/day showed reductions in all-cause and CVD mortality ranging from 16 % (95%CI = 5%–26 %) to 30 % (95%CI = 20%–39 %), and from 25 % (95%CI = 5%–41 %) to 35 % (95%CI = 14%–50 %), respectively, compared with <1 time/day. No additional benefits against all-cause and CVD mortality for intakes of fruits over 2–3 times/day, but gradual reductions in mortality risk for vegetable intake of 2–5 times/day were observed. Combined intake showed protection up to intakes of 10 times/day, notably for CVD mortality. Associations were similar but weaker for cancer mortality.

Conclusions

This study suggests that significant benefits of fruits and, specially, vegetables intake might go beyond the recommended five servings a day. Confirmation of these results could lead to specific dietary recommendations to prevent chronic diseases.