Colors of Fruit and Vegetables and 10-Year Incidence of Stroke

Abstract

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.