Fruit and vegetable consumption and mortality in Eastern Europe: Longitudinal results from the Health, XXXX and Psychosocial Factors in Eastern Europe study.

@entity1 @entity64 @entity101 @entity285 @entity204 @entity65
BACKGROUND: It is estimated that disease burden due to low fruit and vegetable consumption is higher in Central and Eastern Europe (CEE) and the former Soviet Union (FSU) than any other parts of the world. However, no large scale studies have investigated the association between fruit and vegetable (F_V) intake and mortality in these regions yet. DESIGN: The Health, @entity285 and Psychosocial Factors in Eastern Europe (HAPIEE) study is a prospective cohort study with @entity1 recruited from the Czech Republic, Poland and Russia. METHODS: Dietary data was collected using food frequency questionnaire. Mortality data was ascertained through linkage with @entity204 registers. Multivariable adjusted hazard ratios were calculated by Cox regression models. RESULTS: Among 19,333 disease-free @entity1 at baseline, 1314 died over the mean follow-up of 7.1 years. After multivariable adjustment, we found statistically significant inverse association between cohort-specific quartiles of F_V intake and @entity64 mortality: the highest vs lowest quartile hazard ratio (HR) was 0.52 (95% confidence interval (CI): 0.28-0.98). For total mortality, significant interaction (p   =   0.008) between F_V intake and smoking was found. The associations were statistically significant in smokers, with HR 0.70 (0.53-0.91, p for trend: 0.011) for total mortality, and 0.62 (0.40-0.97, p for trend: 0.037) for @entity65 ( @entity65 ) mortality. The association was appeared to be mediated by blood pressure, and F_V intake explained a considerable proportion of the mortality differences between the Czech and Russian cohorts. CONCLUSIONS: Our results suggest that increasing F_V intake may reduce @entity65 mortality in CEE and FSU, particularly among smokers and @entity101 individuals.
