The Association Of Fruit And Vegetable Intake With The Changes Of Serum Lipid Levels And Incidence Of Elevated TC And LDL-C In Middle-aged And Older Chinese Population

BackgroundCardiovascular disease brought a huge burden to the world and China.Hypercholesterolemia,mainly increased of low-density lipoprotein has confirmed to be one of the most significant risk factor for atherosclerotic cardiovascular disease(ASCVD).Other dyslipidemia,such as decreased of high-density lipoprotein or elevated triglycerides can also increase the risk of ASCVD.In recent years,foreign and domestic prospective studies have shown that fruit and vegetable intake can reduce the risk of cardiovascular disease.RCT research studies have been evaluated the role of fruit and/or fruit juice and vegetable on the blood lipids.Previous researches have indicated that different interventions of fruit and vegetable have different results.Among the natural population,the observational studies on the relationship between fruit,vegetable and blood lipid,especially the prospective studies,which has not yet been reported in China,are limited.The sample sizes of current prospective studies are small.At the same time,the kind,consumption and measurement of fruit and vegetable were not the same,and the research results are inconsistent.Therefore,this study aims to use prospective study methods to explore the association of fruit and vegetable intake with changes of serum lipid levels and incidence of elevated serum total cholesterol and low-density lipoprotein cholesterol in middle-aged and older Chinese population.ObjectiveTo investigate the association of fruit and vegetable intake with the long-term change of serum lipid levels and incidence of elevated serum total cholesterol and low-density lipoprotein cholesterol in Chinese middle-aged community population.MethodThe subjects were selected from the "Ninth Five-Year Plan" cohort of the China Multicenter Collaborative Study of Cardiovascular Epidemiology to participate in two reviewers in 2004 and 2007-08,and the survey in 2004 was used as the baseline.There were 5 263 people participated in both of the reviews,aged 41-66 years old.353 people with incomplete data,293 people with history of stroke,coronary heart disease,cancer or end-stage renal disease,and 122 people taking lipid-lowering drugs were excluded.Finally,4 495 participants(2 025 male and 2 470 female)from 10 groups in various regions of China were included.When analyse the incidence of elevated TC,1 559 people who's TC?5.18mmol/L in 2004 were excluded.Finally,2 936 participants(1 380 male and 1 566 female)were included.When analyse the incidence of elevated LDL-C,208 people with LDL-C deficiency and 955 people who's LDL-C>3.37mmol/L in 2004 were excluded.Finally,3332 participants(1 455 male and 1 777 female)were included.The data of demographic,behavior habits and history of diseases were collected by unified questionnaire.Diet consumption data in 2004 was collected with a simple food frequency questionnaire.Fasting venous blood was collected and tested the concentration of total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)and triglyceride(TG)and calculated low density lipoprotein cholesterol(LDL-C)levels.The percent change(?%)of serum TC,HDL-C and LDL-C and the logarithm change of TG between the two surveys were calculated.Multivariate linear regreesion was used to estimate the association of fruit and vegetable intake with ?%of serum levels.Logistic regressions was used to investigate the association between fruit and vegetable intake and incidence of elevated TC and LDL-C.The model was adjusted for age,sex,urban and rural,north and south,educational level,smoking,drinking,occupational physical activity intensity,waist circumference,blood lipid levels in 2004,hypertension,diabetes,intake of vegetable/fruit,staple,meat and milk.Results1.Baseline informationA total of 4 495 participants(2 025 males and 2 470 females)were analyzed in our study.The mean age was 52.6±7.0 years.The results showed that the ratio of urban residents,educational level,smoking,drinking,occupational physical activity intensity,meat intake>500g/week,staple intake>400g/day,and waist circumference,DBP and logTG were significant higher in male.And the ratio of fruit intake>500g/week,TC,HDL-C and LDL-C level,?TC%and ?LDL-C%were significant lower in male.2.The relationship between fruit and vegetable intake and the change of blood lipids2.1 Baseline informationThe proportion of fruit intake were 24.0%,21.8%,54.2%in the categories<250g/week,250-499g/week and>500g/week,and the proportion of vegetable intake were 76.7%,23.3%in the categories<500g/day and>500g/day.In the total population,male and female,there were differences in some basic characteristics of different fruit intake groups,vegetable intake groups,and fruit and vegetable intake groups(P<0.05).2.2 Multivariate analysis2.2.1 After adjusted for possible confounders(Model.3),compared with fruit intake<250g/week,the regression coefficients(95%CI)of ATC%in 250-499g/week and?500g/week group were-1.54(-2.71?-0.37)and-1.77(-2.79?-0.76)for the total population,-1.98(-3.63?-0.34)and-2.31(-3.75?-0.88)for women,but no significance for men.And the regression coefficients(95%CI)of ALDL-C%were-2.43(-4.39?-0.48)and-2.89(-4.59?-1.19)for the total population,-3.21(-5.91?-0.50)and-3.57(-5.94?-1.20)for women,but no significance for men.For the total population,men and women,fruit intake had no relationship with AHDL-C%and AlogTG.2.2.2 After adjusted for possible confounders(Model 3),compared with vegetable intake<500g/day,the regression coefficients(95%CI)of ATC%and ALDL-C%in vegetable intake>500g/day group were-1.01(-1.95?-0.06)and-1.83(-3.41?-0.24)for the total population,-1.88(-3.27?-0.48)and-2.48(-4.86?-0.09)for men,but no significance for women.And the regression coefficients(95%CI)of AlogTG was-0.06(-0.10?-0.01)for men,but no significance for the total population and women.For the total population,men and women,vegetable intake had no relationship with AHDL-C%.2.2.3 After adjusted for possible confounders(Model 3),compared with the first group of total intake of fruit and vegetable(FV),the regression coefficients(95%CI)of ATC%in the second and third group were-2.17(-3.19?-1.15)and-2.97(-4.30?-1.65)for the total population,-2.01(-3.45?-0.57)and-3.27(-5.17?-1.37)for men and-2.26(-3.71?-0.81)and-2.69(-4.56?-0.83)for women.And the regression coefficients(95%CI)of ALDL-C%were-3.60(-5.30?-1.89)and-4.75(-6.96?-2.54)for the total population,-3.15(-5.61?-0.68)and-4.30(-7.54?-1.06)for men and-3.96(-6.35?-1.57)and-5.10(-8.16?-2.05)for women.For the total population,men and women,total intake of FV had no relationship with ?HDL-C%and AlogTG.3.The relationship between fruit and vegetable intake and incidence of elevated TC andLDL-C3.1 Baseline information.For the total population,compared with normal population,the ratio of men and consumption of vegetable,staple and fruit were significant lower,and TC level,the ratio of northern residents,urban residents and educational level,and intake of meat and milk were significant higher in elevated TC population.For the total population,compared with normal population,the consumption of staple was significant lower,and LDL-C level,the ratio of urban residents and intake of meat were significant higher in elevated LDL-C population.3.2 Multivariate analysisMultivariate analysis showed that compared with the fruit intake<250g/week group,the risk of elevated TC was lower in the two other groups,the relative risk(95%CI)were 0.71(0.53?0.96)and 0.72(0.56?0.92)in the fruit intake 250-499g/week and>500g/week group,respectively.However,fruit consumption did not affect the risk of elevated LDL-C.Vegetable consumption did not affect the risk of elevated TC and LDL-C.Compared with the frist FV intake group,the risk of elevated TC was lower in the two other groups,the relative risk(95%confidence intervals)were 0.68(0.53?0.87)and 0.56(0.40-0.78)in the second and third group,respectively.However,fruit and vegetable consumption did not affect the risk of elevated LDL-C.ConclusionThe study found that the consumption of fruits,vegetables and total fruits and vegetables were negatively correlated with the long-term changes of TC and LDL-C,and the consumption of fruits and total fruits and vegetables could reduce the risk of TC elevation.In the male population,vegetable intake was negatively correlated with long-term changes in TG.The results suggested that the intake of fruit and vegetable has a protective effect on the levels of serum TC,LDL-C and TG in middle-aged and elderly people in the community.