Inverse Association between Fruit and Vegetable Intake and All-Cause Mortality: Japan Public Health Center-Based Prospective Study

Daily Adequate Intake of Fruit and Vegetables and All-Cause, Cardiovascular Disease, and Cancer Mortalities in Malaysian Population: A Retrospective Cohort Study

BACKGROUND/OBJECTIVE

We investigated the relationship between daily adequate FV intake and risk of all-cause, cardiovascular disease (CVD), and cancer mortalities among Malaysian adults.

METHODS

Data from a total of 18,211 Malaysian adults aged 18 years and above whom participated in the National Health and Morbidity Survey 2011 were analyzed. The participants were followed up for approximately 11 years, and mortality data were ascertained through record linkages with the death registry from the Malaysian National Registration Department. Multiple Cox regression was applied to assess the association between daily adequate FV intake and risk of all-cause, CVD, and cancer mortalities, adjusting for sociodemographic, lifestyle, and health conditions.

RESULTS

During the follow-up period, we observed a total of 1809 all-cause, 374 CVD, and 216 cancer mortalities. No significant association between daily adequate FV intake with all-cause mortality (adjusted hazard ratio (aHR): 1.01, 95% confidence interval (CI: 0.79-1.31), CVD mortality (aHR: 0.91, 95% CI: 0.57-1.47), and cancer mortality (aHR: 1.27, 95% CI: 0.74-2.17) were observed, even after excluding deaths that occurred in the first two years of observation.

CONCLUSIONS

Further investigation on the type of FV intake and its preparation method with risk of mortality will provide a holistic insight into the causal relationship between FV intake and mortality.

Importance of the Vegetable and Fruit Intake for Health Based on the Relationship between Urinary Potassium Excretion and Cerebro-cardiovascular-renal Events or All-cause Mortality

Since it is widely accepted that there is a positive correlation between the salt intake and hypertension or cerebro-cardiovascular-renal events, salt intake restriction is currently widely recommended, especially in patients with hypertension. However, salt intake restriction does not always have beneficial effects. Indeed, an excessively low salt intake has been reported to be harmful to health. While a reasonable vegetable and fruit intake reportedly decreases blood pressure, whether or not vegetable and fruit intake truly leads to reductions in cerebro-cardiovascular-renal events or all-cause mortality remains unclear. We reviewed the importance of vegetable and fruit intake for health, focusing on the relationship between urinary potassium excretion, a marker of vegetable and fruit intake, and cerebro-cardiovascular-renal events or all-cause mortality. In conclusion, vegetable and fruit intake may be essential for reducing cerebro-cardiovascular-renal events and all-cause mortality.

Factors associated with the leftover rate of side dishes in Japanese school lunches

This study investigated the leftover rate of side dishes in school lunches provided by communal kitchens in Japan's Chugoku region, with a focus on vegetable dishes supplied in containers and three types of menu items served daily to 20 elementary and junior high schools in communal kitchen A for 116 days. First, the leftovers in the containers that were returned to the communal kitchen were weighed and combined. The study then compared outside temperature, distance from communal kitchen A, school type, number of students per class, assignment of nutrition teachers, and time elapsed after cooking. Finally, we examined the relationship between these factors and the leftover rate using multiple regression analysis. The median leftover rate was 20.1% (0-96.9) for 250 side dishes with a high leftover rate; however, this was widely distributed. The number of students per class, assignment of nutrition teachers, and time elapsed after cooking were strongly related to the leftover rate; the adjusted coefficient of determination, R2, was 0.236. The regression results indicated that regarding the side dish leftover rate, the standardized coefficient, β, was 0.414, 0.215, 0.107, 0.093, and 0.094 for the number of students per class, assignment of nutrition teacher, the time elapsed after the end of cooking, distance from communal kitchen A, and presence of seaweed, respectively (p<0.001). Dietary education by homeroom and nutrition teachers and reducing the time elapsed after cooking impacts students' awareness and preferences, which may decrease the leftover rate.

Determinants of Consumption of Vegetables among the Spanish Population: A Cross-Sectional Study

The consumption of vegetables is one of the fundamentals of a healthy diet. The purposes of the present study were to describe the frequency of consumption of vegetables in the general Spanish population and to explore the relations between the consumption of vegetables and sex, age, cohabitation circumstances, educational level, and body mass index (BMI).

METHODS

An analytical cross-sectional study was accomplished based on data from the European Health Survey in Spain (2020).

RESULTS

A total of 20,745 (52.1% women) subjects with a median age of 54 years old were included. Only 2.8% of them ate vegetables at least three times a day. The adjusted generalized linear model showed that being a woman increased the odds of consuming vegetables at least three times a day by 1.666 times (p < 0.001). Not cohabiting as a couple decreased the odds by 0.783 (p < 0.001). Having studied at a university increased the odds by 1.812 times (p < 0.001) and possessing a certificate of higher education by 1.408 (p = 0.030). Being overweight decreased the odds by 0.924 (p = 0.006). For every additional year of age, the odds of consuming vegetables at least three times a day increased by 1.3% (p < 0.001).

CONCLUSIONS

The vast majority of the general Spanish population did not consume an optimal amount of vegetables. Women, people with higher levels of education, and older individuals reported having a more frequent intake of vegetables. Not cohabiting as a couple and being overweight were related to a less frequent intake of vegetables.

Revisiting carotenoids as dietary antioxidants for human health and disease prevention

Humans are unique indiscriminate carotenoid accumulators, so the human body accumulates a wide range of dietary carotenoids of different types and to varying concentrations. Carotenoids were once recognized as physiological antioxidants because of their ability to quench singlet molecular oxygen (1O2). In the 1990s, large-scale intervention studies failed to demonstrate that supplementary β-carotene intake reduces the incidence of lung cancer, although its antioxidant activity was supposed to contribute to the prevention of oxidative stress-induced carcinogenesis. Nevertheless, the antioxidant activity of carotenoids has attracted renewed attention as the pathophysiological role of 1O2 has emerged, and as the ability of dietary carotenoids to induce antioxidant enzymes has been revealed. This review focuses on six major carotenoids from fruit and vegetables and revisits their physiological functions as biological antioxidants from the standpoint of health promotion and disease prevention. β-Carotene 9',10'-oxygenase-derived oxidative metabolites trigger increases in the activities of antioxidant enzymes. Lutein and zeaxanthin selectively accumulate in human macular cells to protect against light-induced macular impairment by acting as antioxidants. Lycopene accumulates exclusively and to high concentrations in the testis, where its antioxidant activity may help to eliminate oxidative damage. Dietary carotenoids appear to exert their antioxidant activity in photo-irradiated skin after their persistent deposition in the skin. An acceptable level of dietary carotenoids for disease prevention should be established because they can have deleterious effects as prooxidants if they accumulate to excess levels. Finally, it is expected that the reason why humans are indiscriminate carotenoid accumulators will be understood soon.

Prevention of Metabolic Syndrome by Phytochemicals and Vitamin D

In recent years, attention has focused on the roles of phytochemicals in fruits and vegetables in maintaining and improving the intestinal environment and preventing metabolic syndrome. A high-fat and high-sugar diet, lack of exercise, and excess energy accumulation in the body can cause metabolic syndrome and induce obesity, diabetes, and disorders of the circulatory system and liver. Therefore, the prevention of metabolic syndrome is important. The current review shows that the simultaneous intake of phytochemicals contained in citruses and grapes together with vitamin D improves the state of gut microbiota and immunity, preventing metabolic syndrome and related diseases. Phytochemicals contained in citruses include polyphenols such as hesperidin, rutin, and naringin; those in grapes include quercetin, procyanidin, and oleanolic acid. The intake of these phytochemicals and vitamin D, along with prebiotics and probiotics, nurture good gut microbiota. In general, Firmicutes are obese-prone gut microbiota and Bacteroidetes are lean-prone gut microbiota; good gut microbiota nurture regulatory T cells, which suppress inflammatory responses and upregulate immunity. Maintaining good gut microbiota suppresses TNF-α, an inflammatory cytokine that is also considered to be a pathogenic contributor adipokine, and prevents chronic inflammation, thereby helping to prevent metabolic syndrome. Maintaining good gut microbiota also enhances adiponectin, a protector adipokine that prevents metabolic syndrome. For the prevention of metabolic syndrome and the reduction of various disease risks, the intake of phytochemicals and vitamin D will be important for human health in the future.