Fruit and vegetable intake in relation to risk of ischemic stroke

Context Few studies have evaluated the relationship between fruit and veget able intake and cardiovascular disease. Objective To examine the associations between fruit and vegetable intake an d ischemic stroke. Design, Setting, and Subjects Prospective cohort studies, including 75 596 women aged 34 to 59 years in the Nurses' Health Study with 14 years of foll ow-up (1980-1994), and 38 683 men aged 40 to 75 years in the Health Profess ionals' Follow-up Study with 8 years of follow-up (1986-1994). All individu als were free of cardiovascular disease, cancer, and diabetes at baseline. Main Outcome Measure Incidence of ischemic stroke by quintile of fruit and vegetable intake. Results A total of 366 women and 204 men had an ischemic stroke. After cont rolling for standard cardiovascular risk factors, persons in the highest qu intile of fruit and vegetable intake (median of 5.1 servings per day among men and 5.8 servings per day among women) had a relative risk (RR) of 0.69 (95% confidence interval [CI], 0.52-0.92) compared with those in the lowest quintile. An increment of 1 serving per day of fruits or vegetables was as sociated with a 6% tower risk of ischemic stroke (RR, 0.94; 95% CI, 0.90-0. 99; P = .01, test for trend). Cruciferous vegetables (RR, 0.68 for an incre ment of 1 serving per day; 95% CI, 0.49-0.94), green leafy vegetables (RR, 0.79; 95% CI, 0.62-0.99), citrus fruit including juice (RR, 0.81; 95% CI, 0 .68-0.96), and citrus fruit juice (RR, 0.75; 95% CI, 0.61-0.93) contributed most to the apparent protective effect of total fruits and vegetables. Leg umes or potatoes were not associated with lower ischemic stroke risk. The m ultivariate pooled RR for total stroke was 0.96 (95% CI, 0.93-1.00) for eac h increment of 2 servings per day. Conclusions These data support a protective relationship between consumptio n of fruit and vegetables-particularly cruciferous and green leafy vegetabl es and citrus fruit and juice-and ischemic stroke risk.