High intake of raw fruit and vegetables may protect against stroke.
Prospective cohort studies have shown that high fruit and vegetable consumption is related to a lower risk of stroke. Whether food processing affects this association is unknown. We evaluated the associations of raw and processed fruit and vegetable consumption independently from each other with 10-year stroke incidence and stroke subtypes in a prospective population-based cohort study in the Netherlands.
We used data of 20 069 men and women aged 20–65 years and free of cardiovascular diseases at baseline who were enrolled from 1993 to 1997. Diet was assessed using a validated 178-item food frequency questionnaire. Hazard ratios (HRs) were calculated for total, ischemic and hemorrhagic stroke incidence using multivariable Cox proportional hazards models.
During a mean follow-up time of 10.3 years, 233 incident stroke cases were documented. Total and processed fruit and vegetable intake were not related to incident stroke. Total stroke incidence was 30% lower for participants with a high intake of raw fruit and vegetables (Q4: >262 g/day; HR: 0.70; 95% confidence intervals (95% CIs): 0.47–1.03) compared with those with a low intake (Q1: 92 g/day) and the trend was borderline significant (P for trend=0.07). Raw vegetable intake was significantly inversely associated with ischemic stroke (>27 vs 27 g/day; HR: 0.50; 95% CI: 0.34–0.73), and raw fruit borderline significantly with hemorrhagic stroke (>120 vs 120 g/day; HR: 0.53; 95% CI: 0.28–1.01).
High intake of raw fruit and vegetables may protect against stroke. No association was found between processed fruit and vegetable consumption and incident stroke.