Mw. Gillman et al., PROTECTIVE EFFECT OF FRUITS AND VEGETABLES ON DEVELOPMENT OF STROKE IN MEN, JAMA, the journal of the American Medical Association, 273(14), 1995, pp. 1113-1117
Objective.-To examine the effect of fruit and vegetable intake on risk
of stroke among middle-aged men over 20 years of follow-up. Design.-C
ohort. Setting.-The Framingham Study, a population-based longitudinal
study. Participants.-All 832 men, aged 45 through 65 years, who were f
ree of cardiovascular disease at baseline (1966 through 1969). Measure
ments and Data Analysis.-The diet of each subject was assessed at base
line by a single 24-hour recall. The estimated total number of serving
s per day of fruits and vegetables was the exposure variable for this
analysis. Using Kaplan-Meier survival analysis, we examined age-adjust
ed cumulative incidence of stroke by quintile of servings per day. To
adjust for multiple covariates, we used proportional hazards regressio
n to calculate the relative risk (RR) of stroke for each increment of
three servings per day. Main Outcome Measure.-Incidence of completed s
trokes and transient ischemic attacks. Results.-At baseline, the mean
(+/-SD) number of fruit and vegetable servings per day was 5.1 (+/-2.8
). During follow-up there were 97 incident strokes, including 73 compl
eted strokes and 24 transient ischemic attacks. Age-adjusted risk of s
troke decreased across increasing quintile of servings per day (log ra
nk P for trend, .01). Age-adjusted RR for all stroke, including transi
ent ischemic attack, was 0.78 (95% confidence interval [CI], 0.62 to 0
.98) for each increase of three servings per day. For completed stroke
the RR was 0.74 (95% CI, 0.57 to 0.96); for completed stroke of ische
mic origin the RR was 0.76 (95% CI, 0.57 to 1.02); and for completed s
troke of hemorrhagic origin, 0.49 (95% CI, 0.25 to 0.95). Adjustment f
or body mass index, cigarette smoking, glucose intolerance, physical a
ctivity, blood pressure, serum cholesterol, and intake of energy, etha
nol, and fat did not materially change the results. Conclusion.Intake
of fruits and vegetables may protect against development of stroke in
men.