16 September 2011 Last updated at 00:18 GMT
An apple or pear a day keeps strokes at bay
Eating lots of fruit and vegetables with white flesh may help to protect against strokes, says a study in the journal Stroke.
But Dutch researchers say they do not know why people with a high intake of apples, pears, bananas or cauliflower reduce their risk of stroke by 52%.
The study followed more than 20,000 adults over 10 years.
Stroke experts said people should not be put off eating other colours of fruit and veg.
At the start of the study, carried out in The Netherlands, participants were asked to fill in a detailed questionnaire on diet and lifestyle for the previous year.
By using this information and tracking the health of participants over the next decade, researchers were able to examine the link between the colour of fruit and vegetables consumed and stroke risk.
The study found that a 25g per day increase in white fruits and vegetables was linked to a 9% lower risk of stroke.
Of the white fruit and veg eaten, over half was apples and pears. An average apple weighs 120g.
But no link was found between stroke incidence and green (dark leafy vegetables, cabbages and lettuces) orange/yellow (mostly citrus fruits) or red/purple fruits and vegetables.
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Eating one apple a day is an easy way to increase white fruits and vegetable intake”
Dr Oude Griep Wageningen University
High in fibre
Linda Oude Griep, lead author of the study and postdoctoral fellow in human nutrition at Wageningen University in The Netherlands, said more research was needed to find out why white flesh was important.
"It is difficult to say which nutrients are responsible in white fruits and vegetables. We know that apples and pears are high in dietary fibre, but there may be other explanations."
She said it might be useful to consume considerable amounts of white-flesh fruit and veg to prevent strokes.
"Eating one apple a day is an easy way to increase white fruits and vegetable intake."
Dr Sharlin Ahmed from The Stroke Association said the findings should not deter people from eating other colours of fruit and vegetables.
"All fruit and vegetables have health benefits and remain an important part of a stable diet.
"A lot more research is needed before the colour of our groceries alone is used to determine what health benefits they may have.
"Everyone can reduce their risk of stroke by eating a healthy balanced diet that is low in saturated fat and salt, exercising regularly and ensuring that your blood pressure is checked and kept under control."
Colors of Fruit and Vegetables and 10-Year Incidence of Stroke
Linda M. Oude Griep, MSc;
W.M. Monique Verschuren, PhD;
Daan Kromhout, MPH, PhD;
Marga C. Ocke', PhD;
Johanna M. Geleijnse, PhD
Published online before print September 15, 2011, doi: 10.1161/STROKEAHA.110.611152
+ Author Affiliations
From the Division of Human Nutrition (L.M.O.G., D.K., J.M.G.), Wageningen University, Wageningen, the Netherlands; National Institute for Public Health and the Environment (W.M.M.V., M.C.O.), Bilthoven, the Netherlands.
Correspondence to Linda M. Oude Griep, Wageningen University, Division of Human Nutrition, P.O. Box 8129, 6700 EV Wageningen, the Netherlands. E-mail firstname.lastname@example.org
Background and Purpose―The color of the edible portion of fruits and vegetables reflects the presence of pigmented bioactive compounds, (eg, carotenoids, anthocyanidins, and flavonoids). Which fruit and vegetable color groups contribute most to the beneficial association of fruit and vegetables with stroke incidence is unknown. Therefore, we examined associations between consumption of fruit and vegetable color groups with 10-year stroke incidence.
Methods―This was a prospective, population-based cohort study, including 20 069 men and women age 20 to 65 years and free of cardiovascular diseases at baseline. Participants completed a validated, 178-item food frequency questionnaire. Hazard ratios (HR) were calculated for stroke incidence using multivariate Cox proportional hazards models adjusting for age, sex, lifestyle, and dietary factors.
Results―During 10 years of follow-up, 233 incident cases of stroke were documented. Fruits and vegetables were classified into 4 color groups. Medians of green, orange/yellow, red/purple, and white fruit and vegetable consumption were 62, 87, 57, and 118 g/d, respectively. Green, orange/yellow, and red/purple fruits and vegetables were not related to incident stroke. Higher intake of white fruits and vegetables was inversely associated with incident stroke (Q4, >171 g/d, versus Q1, ?78 g/d; HR, 0.48; 95% CI, 0.29--0.77). Each 25-g/d increase in white fruit and vegetable consumption was associated with a 9% lower risk of stroke (HR, 0.91; 95% CI, 0.85--0.97). Apples and pears were the most commonly consumed white fruit and vegetables (55%).
Conclusions―High intake of white fruits and vegetables may protect against stroke.
Received December 13, 2010.
Accepted April 7, 2011.
(c) 2011 American Heart Association, Inc.
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