Fruits and Vegetables Consumption and Risk of Stroke: A Meta-Analysis of Prospective Cohort Studies

Study Questions:

Is increased intake of fruits and vegetables associated with a lower risk for stroke?


This was a meta-analysis of studies identified through a search of Embase and PubMed databases from 1947 through January 2014. Inclusion criteria included a prospective cohort design, exposure of interest included fruits or vegetables, the outcome of interest was stroke, and a relative risk was provided. All study-specific relative risks (RRs) were pooled using a random-effects mode. Dose–response relationships were assessed by restricted cubic spline.


A total of 20 prospective cohort studies were included in the present meta-analysis. These studies comprised 16,981 stroke events among 760,629 participants. The multivariable RR of stroke for the highest versus lowest category of total fruits and vegetables consumption was 0.79 (95% confidence interval [CI], 0.75-0.84), and the effect was 0.77 (95% CI, 0.71-0.84) for fruits consumption and 0.86 (95% CI, 0.79-0.93) for vegetables consumption. Subgroup and meta-regression showed that the inverse association of total fruits and vegetables consumption with the risk of stroke was consistent in subgroup analysis. Citrus fruits, apples/pears, and leafy vegetables might contribute to the protection. The linear dose–response relationship showed that the risk of stroke decreased by 32% (0.68 [95% CI, 0.56-0.82]) and 11% (0.89 [95% CI, 0.81-0.98]) for every 200 gram per day increment in fruits consumption (p for nonlinearity = 0.77) and vegetables consumption (p for nonlinearity = 0.62), respectively.


The investigators concluded that fruits and vegetables consumption is inversely associated with the risk of stroke.


These data support the adoption of a healthy diet high in fruits and vegetables to reduce risk of cardiovascular events.

Clinical Topics: Diabetes and Cardiometabolic Disease, Prevention, Diet

Keywords: Pyrus, Metabolic Syndrome X, Fruit, Stroke, Vegetables, Cardiovascular Diseases, Risk Factors, Diet, Population Groups, Malus

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