Variety in fruit and vegetable consumption and 10-year incidence of CHD and stroke

Objective: Consuming a variety of fruit and vegetables provides many different micronutrients and bioactive compounds. Whether this contributes to the beneficial association between fruit and vegetables and incident CHD and stroke is unknown. Design: Prospective population-based cohort study. Setting: The Netherlands. Subjects: Men and women (n 20 069) aged 20-65 years. Participants completed a validated 178-item FFQ, including nine fruit and thirteen vegetable items. Variety in fruit and vegetables was defined as the sum of different items consumed at least once per 2 weeks over the previous year. Hazard ratios (HR) for variety in relation to incident CHD and stroke were calculated using multivariable Cox proportional hazards models additionally adjusted for quantity of fruit and vegetables. Results: Variety and quantity in fruit and vegetables were highly correlated (r=0.81). Variety was not associated with total energy intake (r=-0.01) and positively associated with nutrient intakes, particularly vitamin C (r=0.70). During 10 years of follow-up, 245 cases of CHD and 233 cases of stroke occurred. Variety in vegetables (HR per 2 items = 1.05; 95% CI 0.94, 1.17) and in fruit (HR per 2 items = 1.00; 95% CI 0.87, 1.15) were not related to incident CHD. Variety in vegetables (HR per 2 items = 0.93; 95% CI 0.83, 1.04) and in fruit (HR per 2 items = 1.03; 95% CI 0.89, 1.18) were also not related to incident stroke. Conclusions: More variety in fruit and vegetable consumption was associated with higher intakes of fruit and vegetables and micronutrients. Independently of quantity, variety in fruit and vegetables was related neither to incident CHD nor to incident stroke.