Eating just one more serving of fruits or vegetables daily cut the risk of dying from heart disease by 4% in an observational study of more than 300,000 Europeans in 10 countries. And people who ate the most produce-eight or more daily portions-were 22% less likely to die of heart disease than those eating two or fewer daily portions of fruits and vegetables.Francesca L. Crowe, PhD, of the University of Oxford, and colleagues looked at data from a heart-study component of the large European Prospective Investigation into Cancer and Nutrition (EPIC) on 313,074 people, average age 54, who provided information on their diets and lifestyles. The study looked only at ischemic heart disease (IHD), which is characterized by a lack of blood flow to the heart; ischemic heart disease can lead to chest pains, angina and heart attack, and is the leading cause of death in the US for both men and women. Over an average followup of 8.4 years, 1,636 participants died from ischemic heart disease.Among all participants, the average total daily fruit and vegetable intake was almost five servings. A serving or portion was de- fined as 80 grams, or 2.82 ounces. Swedes had the lowest produce consumption, while Italians and Spaniards ate the most-more than six servings a day.When researchers analyzed the findings by gender, only the association for women remained statistically significant. Researchers said further study was needed to determine if there was a true gender difference.While some have suggested that antioxidants in vegetables and fruits might be key to protecting against heart disease, possibly by preventing atherosclerosis, thats not necessarily the whole story. Publishing their results in the European Heart Journal, Crowe and colleagues pointed out that consuming antioxidant supplements is not the same as increasing the consumption of fruits and vegetables because there are many other components in fruits and vegetables that may confer a cardioprotective effect.The main message, said Crowe and colleagues, is that in this study, people who consume more fruits and vegetables have lower risk of dying from IHD. However, we need to be cautious in our interpretation of the results because we are unsure whether the association between fruit and vegetable intake and risk of IHD is due to some other component of diet or lifestyle.In an accompanying editorial, Michael Marmot, PhD, of University College, London, expanded on that theme: Trials of antioxidant vitamins have not led to reductions in either cancer or cardiovascular disease. That may be because antioxidant vitamins were not the crucial protective components; or it is the foods and, indeed, dietary patterns that are important, not specific micronutrients.TO LEARN MORE: European Heart Journal, online before print, dx.doi.org/10.1093/eurheartj/ehq465.
