Greater Frequency of Fruit and Vegetable Consumption Is Associated With Lower Prevalence of Peripheral Artery Disease

Abstract

Objective: Although fruit and vegetable (F&V) consumption is associated with lower risk of coronary heart disease and stroke, its association with peripheral artery disease (PAD) is less certain. We, thus, sought to characterize F&V intake and investigate the association between F&V consumption and presence of PAD in a large community sample.

Approach and results: Self-referred participants at >20 000 US sites who completed medical and lifestyle questionnaires were evaluated by screening ankle brachial indices for PAD (ankle brachial index ≤0.9). Among 3 696 778 individuals, mean age was 64.1±10.2 years and 64.1% were female. Daily consumption of ≥3 servings of F&V was reported by 29.2%. Increasing age, female sex, white race, never smoking, being currently married, physical activity, increasing income, and frequent consumption of fish, nuts, and red meat were positively associated with daily consumption of F&V. After multivariable adjustment, there was a stepwise inverse association between F&V intake and PAD. Participants reporting daily intake of ≥3 servings of F&V had 18% lower odds of PAD than those reporting less than monthly consumption. In unadjusted and multivariable-adjusted models, the inverse association with F&V became stronger as ankle brachial index decreased. When stratified by smoking status, the association was present only among those subjects who currently or formerly smoked tobacco.

Conclusions: Our study demonstrates an inverse association of F&V consumption with prevalent PAD and overall low F&V consumption. These observations suggest the need to further efforts to increase F&V consumption and for more rigorous evaluation of the role of F&V in PAD prevention.

Keywords: ankle brachial index; coronary heart disease; exercise; peripheral arterial disease; stroke.

Figure 1A

Adjusted odds ratios for any PAD (ABI < 0.9) by fruit and vegetable intake relative to less than once/month consumption of at least three servings of fruits and vegetables. Adjusted model includes: diabetes, hypertension, hypercholesterolemia, sedentary lifestyle, tobacco use (current, former, never), family history of vascular disease, BMI (as a continuous variable) and consumption of nuts, fish and red meat.

Figure 1B

Adjusted odds ratios for increasingly abnormal ABI measures by fruit and vegetable intake relative to less than once/month consumption of at least three servings of fruits and vegetables. Adjusted models include: diabetes, hypertension, hypercholesterolemia, sedentary lifestyle, tobacco use (current, former, never), family history of vascular disease, BMI (as a continuous variable) and consumption of nuts, fish and red meat.