Fruit and vegetable consumption and mortality

Max Leenders, Ivonne Sluijs, Martine M. Ros, Hendriek C. Boshuizen, Peter D. Siersema, Pietro Ferrari, Cornelia Weikert, Anne Tjønneland, Anja Olsen, Marie Christine Boutron-Ruault, Françoise Clavel-Chapelon, Laura Nailler, Birgit Teucher, Kuanrong Li, Heiner Boeing, Manuela M. Bergmann, Antonia Trichopoulou, Pagona Lagiou, Dimitrios Trichopoulos, Domenico PalliValeria Pala, Salvatore Panico, Rosario Tumino, Carlotta Sacerdote, Petra H M Peeters, Carla H. Van Gils, Eiliv Lund, Dagrun Engeset, Maria Luisa Redondo, Antonio Agudo, Maria José Sánchez, Carmen Navarro, Eva Ardanaz, Emily Sonestedt, Ulrika Ericson, Lena Maria Nilsson, Kay Tee Khaw, Nicholas J. Wareham, Timothy J. Key, Francesca L. Crowe, Isabelle Romieu, Marc J. Gunter, Valentina Gallo, Kim Overvad, Elio Riboli, H. Bas Bueno-De-Mesquita

Research output: Contribution to journalArticlepeer-review


In this study, the relation between fruit and vegetable consumption and mortality was investigated within the European Prospective Investigation Into Cancer and Nutrition. Survival analyses were performed, including 451,151 participants from 10 European countries, recruited between 1992 and 2000 and followed until 2010. Hazard ratios, rate advancement periods, and preventable proportions to respectively compare risk of death between quartiles of consumption, to estimate the period by which the risk of death was postponed among high consumers, and to estimate proportions of deaths that could be prevented if all participants would shift their consumption 1 quartile upward. Consumption of fruits and vegetables was inversely associated with all-cause mortality (for the highest quartile, hazard ratio = 0.90, 95% confidence interval (CI): 0.86, 0.94), with a rate advancement period of 1.12 years (95% CI: 0.70, 1.54), and with a preventable proportion of 2.95%. This association was driven mainly by cardiovascular disease mortality (for the highest quartile, hazard ratio = 0.85, 95% CI: 0.77, 0.93). Stronger inverse associations were observed for participants with high alcohol consumption or high body mass index and suggested in smokers. Inverse associations were stronger for raw than for cooked vegetable consumption. These results support the evidence that fruit and vegetable consumption is associated with a lower risk of death.

Original languageEnglish
Pages (from-to)590-602
Number of pages13
JournalAmerican Journal of Epidemiology
Issue number4
Publication statusPublished - Aug 15 2013


  • fruit
  • mortality
  • prospective studies
  • survival analysis
  • vegetables

ASJC Scopus subject areas

  • Epidemiology


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