CONSUMPTION OF FRUIT AND WINE AND THE DECLINE IN CEREBROVASCULAR-DISEASE MORTALITY IN SPAIN (1975-1993)

Background and Purpose-This study examines the changes in provincial d istribution of cerebrovascular disease (CVD) mortality and its socioec onomic and lifestyle risk factors to identify those factors that have most greatly contributed to the decline in CVD mortality in Spain duri ng the period 1975-1993. Methods-We performed a study using data aggre gated at a provincial level. Mortality data were taken from official v ital statistics, while data on risk factors were obtained from surveys of representative large Spanish population samples. Correlation and m ultiple linear re,regression analyses were performed on percent change s in age-standardized CVD mortality from 1975-1979 to 1989-1993 and it s potential determinants during the period 1964-1980, Results-CVD mort ality was higher in the southern and eastern (Mediterranean coast) pro vinces in 1975-1979 and again in 1989-1993. Between these periods ther e was a 55% decline in CVD mortality, which affected all provinces but was greater in those with a lower CVD mortality (r= -0.31, P=0.03), T he 1964-1980 period witnessed an increase in the intake of most foodst uffs and all types of fats. However, there was a decrease in the consu mption of vegetables and legumes and in the proportion of illiteracy a mong the population older than 45 years. The greatest increase in frui t and fish consumption and the greatest decrease in illiteracy were re gistered by Spain's northernmost provinces, the same provinces that re corded the greatest decline in CVD mortality. Changes in fruit, wine, and fish intake accounted for 22% of the variation in the decline in C VD mortality, The increase in fruit consumption and decrease in wine c onsumption showed a statistically significant relationship (P less tha n or equal to 0.04) with the decline in CVD mortality. Conclusions-The increase in fruit and decrease in wine consumption from 1964-1980 may have contributed to the decline in CVD mortality in Spain during 1975 -1993.