Raw and processed fruit and vegetable consumption and 10-year stroke incidence in a population-based cohort study in the Netherlands

Eur J Clin Nutr. 2011 Jul;65(7):791-9. doi: 10.1038/ejcn.2011.36. Epub 2011 Mar 23.


Background/objectives: Prospective cohort studies have shown that high fruit and vegetable consumption is related to a lower risk of stroke. Whether food processing affects this association is unknown. We evaluated the associations of raw and processed fruit and vegetable consumption independently from each other with 10-year stroke incidence and stroke subtypes in a prospective population-based cohort study in the Netherlands.

Subjects/methods: We used data of 20 069 men and women aged 20-65 years and free of cardiovascular diseases at baseline who were enrolled from 1993 to 1997. Diet was assessed using a validated 178-item food frequency questionnaire. Hazard ratios (HRs) were calculated for total, ischemic and hemorrhagic stroke incidence using multivariable Cox proportional hazards models.

Results: During a mean follow-up time of 10.3 years, 233 incident stroke cases were documented. Total and processed fruit and vegetable intake were not related to incident stroke. Total stroke incidence was 30% lower for participants with a high intake of raw fruit and vegetables (Q4: >262 g/day; HR: 0.70; 95% confidence intervals (95% CIs): 0.47-1.03) compared with those with a low intake (Q1: ≤92 g/day) and the trend was borderline significant (P for trend=0.07). Raw vegetable intake was significantly inversely associated with ischemic stroke (>27 vs ≤27 g/day; HR: 0.50; 95% CI: 0.34-0.73), and raw fruit borderline significantly with hemorrhagic stroke (>120 vs ≤120 g/day; HR: 0.53; 95% CI: 0.28-1.01).

Conclusions: High intake of raw fruit and vegetables may protect against stroke. No association was found between processed fruit and vegetable consumption and incident stroke.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Brain Ischemia / epidemiology
  • Brain Ischemia / prevention & control
  • Cardiovascular Diseases / epidemiology
  • Cerebral Hemorrhage / epidemiology
  • Cerebral Hemorrhage / prevention & control
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Food Handling*
  • Fruit* / chemistry
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Stroke / epidemiology*
  • Stroke / prevention & control
  • Surveys and Questionnaires
  • Vegetables* / chemistry
  • Young Adult