The study consisted of 451,681 people that had no history of cardiovascular disease and were not on anti-hypertensive treatment at baseline from the China Kadoorie Biobank. The study was conducted in 10 different areas of China five rural and five urban. Habitual consumption of fruit was recorded at baseline and based on five categories: never, monthly, one to three days per week, four to six days per week, and daily.
The results of the seven-year follow-up period revealed:
- There were 19,300 cases of ischaemic heart disease (IHD) and 19,689 strokes.
- Some 18 percent of participants consumed fruit daily.
- 6.3 percent never consumed fruit.
- The average amount of fruit eaten by the daily consumers was 1.5 portions.
- Those who ate fruit daily compared to those who never ate fruit cut their cardiovascular risks by 25 to 40 percent around 15 percent for IHD; around 25 percent for ischaemic stroke and 40 percent for haemorrhagic stroke.
- There was a dose response relationship between the frequency of fruit consumption and the risk of cardiovascular disease.
- People who consumed fruit more often had significantly lower blood pressure.
- Eating fruit daily was associated with 3.44/4.1 mmHg lower systolic/diastolic blood pressure compared to those who never ate fruit.
Our data shows that eating fresh fruit was associated with lower baseline blood pressure (BP), said Dr. Huaidong Du. We also found that the beneficial effect of fruit on the risk of cardiovascular disease was independent of its impact on baseline BP. Cardiovascular disease, including ischaemic heart disease and stroke, is the leading cause of death worldwide. Improving diet and lifestyle is critical for cardiovascular risk reduction in the general population but the large majority of this evidence has come from western countries and hardly any from China.
China has a different pattern of cardiovascular disease, with stroke as the main cause compared to western countries where IHD is more prevalent, she continued. Previous studies have combined ischaemic and haemorrhagic stroke probably due to the limited number of stroke cases in their datasets. Given their different physiology and risk factors, we have conducted the first large prospective study on the association of fruit with subtypes of stroke in Chinese adults from both rural and urban areas.
The researchers also examined in a separate analysis the association of fruit consumption with total mortality and cardiovascular (CV) mortality in more than 61,000 patients from the China Kadoorie Biobank who had cardiovascular disease (CVD) or hypertension at baseline. Compared to those who never ate fruit, daily consumers of fruit cut their overall risk of death by 32 percent. They also reduced their risks of dying from IHD by 27 percent and from stroke by around 40 percent.
Patients with CVD and hypertension should also be encouraged to consume more fresh fruit, said Professor Zhengming Chen, principal investigator of the China Kadoorie Biobank. Many western populations have experienced a rapid decrease in CVD mortality during the past several decades, especially stroke mortality since the early 1950s for reasons that are not yet fully explained. Improved access to fresh fruit may well have contributed importantly to that decline.
Our results show the benefit of eating fruit in the healthy general population and in patients with CVD and hypertension, Zhengming continued. Fruit consumption is an effective way to cut CVD risk and should not only be regarded as might be useful. Policies are needed to promote that availability, affordability and acceptability of fresh fruit through educational and regulatory measures.