Background: Higher vegetable intake is consistently associated with lower atherosclerotic vascular disease (ASVD) events. However, the components responsible and mechanisms involved are uncertain. Nonnutritive phytochemicals may be involved. The objective of this study was to investigate the associations of total vegetable intake and types of vegetables grouped according to phytochemical constituents with ASVD mortality.
Methods and results: The cohort consisted of 1226 Australian women aged 70 years and older without clinical ASVD or diabetes mellitus at baseline (1998). Vegetable intakes were calculated per serving (75 g/d) and were also classified into prespecified types relating to phytochemical constituents. ASVD-related deaths were ascertained from linked mortality data. During 15 years (15 947 person-years) of follow-up, 238 ASVD-related deaths occurred. A 1-serving increment of vegetable intake was associated with a 20% lower hazard of ASVD-related death (multivariable-adjusted hazard ratio, 0.80; 95% confidence interval, 0.69-0.94 [P=0.005]). In multivariable-adjusted models for vegetable types, cruciferous (per 10-g/d increase: hazard ratio, 0.87; 95% confidence interval, 0.81-0.94 [P<0.001]) and allium (per 5-g/d increase: hazard ratio, 0.82; 95% confidence interval, 0.73-0.94 [P=0.003]) vegetables were inversely associated with ASVD-related deaths. The inclusion of other vegetable types, as well as lifestyle and cardiovascular risk factors, did not alter these associations. Yellow/orange/red (P=0.463), leafy green (P=0.063), and legume (P=0.379) vegetables were not significant.
Conclusions: Consistent with current evidence, higher cruciferous and allium vegetable intakes were associated with a lower risk of ASVD mortality. In addition, cruciferous and allium vegetables are recognized to be a good source of several nonnutritive phytochemicals such as organosulfur compounds.
Clinical trial registration: URL: http://www.anzctr.org.au. Unique identifier: ACTRN12617000640303.
Keywords: allium; atherosclerosis; atherosclerotic vascular disease; cardiovascular events; cruciferous; diet; follow‐up study; observational studies; vegetables.
© 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.