Dataset Information

Fruit and Vegetable Intake and the Risk of Chronic Obstructive Pulmonary Disease: A Dose-Response Meta-Analysis of Observational Studies.

ABSTRACT: Object. Results on the associations of fruit and vegetable intake with risk of chronic obstructive pulmonary disease (COPD) are still in conflict. Hence, we conducted a meta-analysis to quantitatively evaluate the association between fruit and vegetable intake and the risk of COPD.

Methods

PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) were searched for relevant studies published up to September 2019. Combined relative risks (RRs) and 95% confidence intervals (CIs) were calculated with the random effects model (REM). Dose-response relationship was assessed by the restricted cubic spline model.

Results

There are 8 studies involving 5,787 COPD cases among 244,154 participants included in this meta-analysis. For the highest versus the lowest level, the pooled RR of COPD was 0.75 (95% CI, 0.68-0.84; I ²?=?46.7%) for fruits plus vegetables, 0.72 (95% CI, 0.66-0.79; I ²?=?46.7%) for fruits plus vegetables, 0.72 (95% CI, 0.66-0.79; I ²?=?46.7%) for fruits plus vegetables, 0.72 (95% CI, 0.66-0.79; P _{non-linearity} < 0.01).

Conclusions

This meta-analysis indicates that fruit and vegetable intake might be related to a lower risk of COPD.

SUBMITTER: Zhai H

PROVIDER: S-EPMC7057001 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Fruit and Vegetable Intake and the Risk of Chronic Obstructive Pulmonary Disease: A Dose-Response Meta-Analysis of Observational Studies.

Zhai Hongrui H Wang Yu Y Jiang Wenjie W

BioMed research international 20200221

<i>Object</i>. Results on the associations of fruit and vegetable intake with risk of chronic obstructive pulmonary disease (COPD) are still in conflict. Hence, we conducted a meta-analysis to quantitatively evaluate the association between fruit and vegetable intake and the risk of COPD.<h4>Methods</h4>PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) were searched for relevant studies published up to September 2019. Combined relative risks (RRs) and 95% confidence inte ...[more]

PMID: 32219131

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Project description:BackgroundAlthough intake of fruits and vegetables seemed to have a protective effect on bone metabolism, its effect on fractures remains uncertain.MethodsA systematic review of randomized controlled trials (RCTs) and cohort studies (PROSPERO: CRD42016041462) was performed. RCTs and cohort studies that evaluated the combined intake of fruits and vegetables in men and women aged over 50 years were included. We considered fractures as a primary outcome measure. Changes in bone markers were considered as secondary outcomes. The search strategy included the following descriptors: fruit, vegetables, vegetable products, bone and bones, bone fractures, postmenopausal osteoporosis, and osteoporosis. PubMed, Embase, and Cochrane Library were the databases used. The appraisal of the studies was performed by two independent reviewers, and discussed and agreed upon by both examiners. The data extracted from the RCTs and cohort studies were summarized separately. The risks of fractures were combined across studies using random models. Bone resorption marker (CTx) was summarized with standardized mean differences. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to evaluate the strength of recommendations.ResultsOf the 1,192 studies screened, 13 articles were included in the systematic review and 10 were included in the pooled analysis (6 cohort studies and 4 RCTs). The six cohort studies included in the meta-analysis included a population of 225,062. The pooled hazard ratio (HR) (95% confidence interval (CI)) of the hip in five studies was 0.92 (0.87, 0.98). Its heterogeneity was moderate (I2 = 55.7%, p = 0.060), GRADE (⊕⊕⊕O). Two cohort studies evaluated the risk of any fracture; the HR was 0.90 (95% CI: 0.86-0.96), with aheterogeneity of 24.9% (p = 0.249, GRADE (⊕⊕⊕O)). There was no association between the bone resorption marker CTx and 3 months of fruit and vegetable intake evaluated by four RCTs, GRADE (⊕⊕O O).ConclusionThere was an association between the increase of at least one serving of fruits and vegetables per day and decreases in the risk of fractures. The level of evidence for this association is moderate.

Project description:Questions remain about the strength and shape of the dose-response relationship between fruit and vegetable intake and risk of cardiovascular disease, cancer and mortality, and the effects of specific types of fruit and vegetables. We conducted a systematic review and meta-analysis to clarify these associations.PubMed and Embase were searched up to 29 September 2016. Prospective studies of fruit and vegetable intake and cardiovascular disease, total cancer and all-cause mortality were included. Summary relative risks (RRs) were calculated using a random effects model, and the mortality burden globally was estimated; 95 studies (142 publications) were included.For fruits and vegetables combined, the summary RR per 200?g/day was 0.92 [95% confidence interval (CI): 0.90-0.94, I 2? =?0%, n ?=?15] for coronary heart disease, 0.84 (95% CI: 0.76-0.92, I 2? =?73%, n ?=?10) for stroke, 0.92 (95% CI: 0.90-0.95, I 2? =?31%, n ?=?13) for cardiovascular disease, 0.97 (95% CI: 0.95-0.99, I 2? =?49%, n ?=?12) for total cancer and 0.90 (95% CI: 0.87-0.93, I 2? =?83%, n ?=?15) for all-cause mortality. Similar associations were observed for fruits and vegetables separately. Reductions in risk were observed up to 800 g/day for all outcomes except cancer (600?g/day). Inverse associations were observed between the intake of apples and pears, citrus fruits, green leafy vegetables, cruciferous vegetables, and salads and cardiovascular disease and all-cause mortality, and between the intake of green-yellow vegetables and cruciferous vegetables and total cancer risk. An estimated 5.6 and 7.8 million premature deaths worldwide in 2013 may be attributable to a fruit and vegetable intake below 500 and 800 g/day, respectively, if the observed associations are causal.Fruit and vegetable intakes were associated with reduced risk of cardiovascular disease, cancer and all-cause mortality. These results support public health recommendations to increase fruit and vegetable intake for the prevention of cardiovascular disease, cancer, and premature mortality.

Project description:Insufficient intake of total fruits and vegetables is linked to an increased cancer risk, but the relation is not understood for dried fruits. Dried fruits are generally perceived, by both consumers and researchers, as a less attractive but shelf-stable equivalent to fresh fruits and constitute a small but significant proportion of modern diets. Chemical compositions of raw and dried fruits, however, may differ substantially. Several clinical and laboratory intervention studies have reported the protective effects of dehydrated fruits against the progression of some cancers and the modulating effects of dried fruits on common cancer risk factors. In this systematic review, we identified, summarized, and critically evaluated 9 prospective cohort and 7 case-control studies that examined the relations between traditional dried fruit (raisins, prunes, dates) consumption and cancer risk in humans. Prospective cohort studies determined that significant reductions in relative risk of precancerous colorectal polyps, incidence of prostate cancer, or mortality from pancreatic cancer, by, respectively, 24%, 49%, and 65%, were associated with 3-5 or more servings of dried fruits per week. Selected case-control studies revealed inverse associations between dried fruit intake and risk of cancer as well. The reported associations were comparable to or stronger than those observed for total or raw fruits. Although the small number and high heterogeneity impede meta-analysis of these studies, we conclude that currently available data provide some initial evidence that consumption of dried fruits may be associated with a lower cancer incidence or mortality in populations. The data suggest that higher intake of raisins and other dried fruits may be important in the prevention of cancers of the digestive system. Because only a limited number of health outcome and dried fruit intake relations have been evaluated in prospective studies to date, reanalyzing existing high-quality epidemiological data may expand the knowledge base.

Project description:BackgroundThe optimal intake levels of fruit and vegetables for maintaining long-term health are uncertain.MethodsWe followed 66 719 women from the Nurses' Health Study (1984-2014) and 42 016 men from the Health Professionals Follow-up Study (1986-2014) who were free from cardiovascular disease (CVD), cancer, and diabetes at baseline. Diet was assessed using a validated semiquantitative food frequency questionnaire at baseline and updated every 2 to 4 years. We also conducted a dose-response meta-analysis, including results from our 2 cohorts and 24 other prospective cohort studies.ResultsWe documented 33 898 deaths during the follow-up. After adjustment for known and suspected confounding variables and risk factors, we observed nonlinear inverse associations of fruit and vegetable intake with total mortality and cause-specific mortality attributable to cancer, CVD, and respiratory disease (all Pnonlinear<0.001). Intake of ≈5 servings per day of fruit and vegetables, or 2 servings of fruit and 3 servings of vegetables, was associated with the lowest mortality, and above that level, higher intake was not associated with additional risk reduction. In comparison with the reference level (2 servings/d), daily intake of 5 servings of fruit and vegetables was associated with hazard ratios (95% CI) of 0.87 (0.85-0.90) for total mortality, 0.88 (0.83-0.94) for CVD mortality, 0.90 (0.86-0.95) for cancer mortality, and 0.65 (0.59-0.72) for respiratory disease mortality. The dose-response meta-analysis that included 145 015 deaths accrued in 1 892 885 participants yielded similar results (summary risk ratio of mortality for 5 servings/d=0.87 [95% CI, 0.85-0.88]; Pnonlinear<0.001). Higher intakes of most subgroups of fruits and vegetables were associated with lower mortality, with the exception of starchy vegetables such as peas and corn. Intakes of fruit juices and potatoes were not associated with total and cause-specific mortality.ConclusionsHigher intakes of fruit and vegetables were associated with lower mortality; the risk reduction plateaued at ≈5 servings of fruit and vegetables per day. These findings support current dietary recommendations to increase intake of fruits and vegetables, but not fruit juices and potatoes.

Dataset Information

Fruit and Vegetable Intake and the Risk of Chronic Obstructive Pulmonary Disease: A Dose-Response Meta-Analysis of Observational Studies.

Methods

Results

Conclusions

Publications

Fruit and Vegetable Intake and the Risk of Chronic Obstructive Pulmonary Disease: A Dose-Response Meta-Analysis of Observational Studies.

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