Am J Clin Nutr. 2003 Jul;78(1):57-64.
Intake of fruit and vegetables and the
risk of ischemic stroke in a cohort of Danish men and women.
Johnsen SP, Overvad K, Stripp C, Tjonneland A, Husted SE, Sorensen HT.
Department of Clinical Epidemiology, Aarhus University Hospital and Aalborg
Hospital, Aarhus, Denmark (SPJ and HTS).
BACKGROUND: Previous studies have
suggested that a high dietary intake of fruit and vegetables is associated
with a reduced risk of ischemic stroke. The magnitude of the effect is
uncertain, and only one study reported data on the intake of specific
fruit and vegetables and the risk of stroke.
OBJECTIVE: We examined whether the intake of fruit and vegetables
is associated with a reduced risk of ischemic stroke, with particular
attention paid to specific fruit and vegetables and subtypes of ischemic
DESIGN: In a prospective cohort study of 54,506 men and women
who were included in the Danish Diet, Cancer, and Health study from 1993
to 1997, estimated total intakes of fruit and vegetables (in g/d) were
extracted from a semiquantitative food-frequency questionnaire completed
at baseline. Data about subjects hospitalized with ischemic stroke were
obtained from the Danish National Registry of Patients and were verified
later by record reviews. The follow-up for ischemic stroke ended on the
date of a first hospital admission for stroke or transient ischemic attack,
the date of death or emigration, or the end of the study, whichever came
RESULTS: We identified 266 cases of ischemic stroke involving
hospitalization during 168 388 person-years of follow-up (median follow-up:
3.09 y; range: 0.02-5.10 y). After adjustment for potential confounders,
persons in the top quintile of fruit and vegetable intake (median:
673 g/d) had a risk ratio of ischemic stroke of 0.72 (95% CI: 0.47,
1.12) relative to persons in the bottom quintile of intake (median:
147 g/d) (P for trend = 0.04). When comparing the top quintile with the
bottom quintile, an inverse association was most evident for fruit
intake (risk ratio: 0.60; 95% CI: 0.38, 0.95; P for trend = 0.02).
Similar risk estimates were seen for most types of fruit and vegetables,
although the risks were significant only for citrus fruit.
CONCLUSION: An increased intake of fruit may reduce the
risk of ischemic stroke.