Fruit, vegetables, and olive oil and risk of coronary heart disease in Italian women: The EPICOR Study

Benedetta Bendinelli, Giovanna Masala, Calogero Saieva, Simonetta Salvini, Carmela Calonico, Carlotta Sacerdote, Claudia Agnoli, Sara Grioni, Graziella Frasca, Amalia Mattiello, Paolo Chiodini, Rosario Tumino, Paolo Vineis, Domenico Palli, Salvatore Panico

Research output: Contribution to journalArticle


Background: Many observational studies support the recommendation to eat sufficient amounts of fruit and vegetables as part of a healthy diet. Objective: The present study aimed to investigate the association between consumption of fruit, vegetables, and olive oil and the incidence of coronary heart disease (CHD) in 29,689 women enrolled between 1993 and 1998 in 5 European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts in northern (Turin and Varese), central (Florence), and southern (Naples and Ragusa) Italy. Design: Baseline dietary, anthropometric, and lifestyle characteristics were collected. Major events of CHD (fatal and nonfatal myocardial infarction and coronary revascularization) were identified through a review of clinical records. Analyses were stratified by center and adjusted for hypertension, smoking, education, menopause, physical activity, anthropometric measures, nonalcohol energy, alcohol, total meat, vegetables in analyses for fruit, and fruit in analyses for vegetables. Results: During a mean follow-up of 7.85 y, 144 major CHD events were identified. A strong reduction in CHD risk among women in the highest quartile of consumption of leafy vegetables (hazard ratio: 0.54; 95% CI: 0.33, 0.90; P for trend = 0.03) and olive oil (hazard ratio: 0.56; 95% CI: 0.31, 0.99; P for trend = 0.04) was found. In contrast, no association emerged between fruit consumption and CHD risk. Conclusion: An inverse association between increasing consumption of leafy vegetables and olive oil and CHD risk emerged in this large cohort of Italian women.

Original languageEnglish
Pages (from-to)275-283
Number of pages9
JournalAmerican Journal of Clinical Nutrition
Issue number2
Publication statusPublished - Feb 1 2011


ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Bendinelli, B., Masala, G., Saieva, C., Salvini, S., Calonico, C., Sacerdote, C., Agnoli, C., Grioni, S., Frasca, G., Mattiello, A., Chiodini, P., Tumino, R., Vineis, P., Palli, D., & Panico, S. (2011). Fruit, vegetables, and olive oil and risk of coronary heart disease in Italian women: The EPICOR Study. American Journal of Clinical Nutrition, 93(2), 275-283.