Fruit and vegetable intake and rate of heart failure: a population-based prospective cohort of women

AimsAlthough numerous studies have investigated fruit and vegetable consumption in association with cardiovascular diseases (CVD) such as coronary heart disease and stroke, a limited number of studies have investigated the association with heart failure. The aim of this study was to assess the association between fruit and vegetable intake and the incidence of heart failure among women. Methods and resultsIn September 1997, a total of 34 319 women (aged 49-83 years) from the Swedish Mammography Cohort, free of cancer and CVD at baseline, completed a food-frequency questionnaire. Women were followed for incident heart failure (diagnosis as primary or secondary cause) through December 2011 using administrative health registries. Over 12.9years of follow-up (442 348 person-years), we identified 3051 incident cases of heart failure. Total fruit and vegetable consumption was inversely associated with the rate of heart failure {the multivariable-adjusted rate ratio (RR) in the highest quintile compared with the lowest was 0.80 [95% confidence interval (CI) 0.70-0.90]}. Fruit (mutually adjusted for vegetables) were not significantly associated with rate of heart failure (RR 0.94; 95% CI 0.83-1.07), whereas vegetables showed an inverse association (RR 0.83; 95% CI 0.73-0.95). When investigating the shape of association, we found evidence of a non-linear association (P = 0.01), and the lowest rates of heart failure were observed among women consuming 5 servings/day of fruit and vegetables, without further decrease with increasing intake. ConclusionsIn this population-based prospective cohort study of women, higher total consumption of fruit and vegetables was inversely associated with the incidence of heart failure.