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Int J Food Sci Nutr. 2019 Sep;70(6):652-667. doi: 10.1080/09637486.2019.1571021. Epub 2019 Feb 15.

Fruit and vegetable consumption and health outcomes: an umbrella review of observational studies.

Author information

1
a The Laboratory of Phytochemicals in Physiology, Department of Food and Drug , University of Parma , Parma , Italy.
2
b Department of Biomedical and Biotechnological Sciences , University of Catania , Catania , Italy.
3
c NNEdPro Global Centre for Nutrition and Health , St John's Innovation Centre , Cambridge , United Kingdom.
4
d Wolfson College at the University of Cambridge , United Kingdom.
5
e Nutrition Innovation Centre for Food and Health at Ulster University , United Kingdom.
6
f SmartFood Program, Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS , Milan , Italy.
7
g Biccoca , University of Milano , Milan , Italy.
8
h Care and Public Health Research Institute , Maastricht University , Maastricht , The Netherlands.
9
i Rimini Women's Health, Childhood and Adolescent Department , AUSL Romagna , Rimini , Italy.
10
j Food and Nutrition Security and Public Health Service , ASP Catania , Catania , Italy.
11
k Azienda Ospedaliero-Universitaria Policlinico-Vittorio Emanuele , Catania , Italy.
12
l Integrated Cancer Registry of Catania-Messina-Siracusa-Enna , Azienda Ospedaliero-Universitaria Policlinico-Vittorio Emanuele , Catania , Italy.
13
m Biomedical Department of Internal and Specialist Medicine (DIBIMIS) , University of Palermo , Palermo , Italy.
14
n Medical Research Council (MRC) Human Nutrition Research Unit , Cambridge , United Kingdom.
15
o The Laboratory of Phytochemicals in Physiology, Department of Veterinary Science , University of Parma , Parma , Italy.

Abstract

The aim of this study was to provide a comprehensive evaluation of current evidence on fruit and vegetable consumption and health outcomes. A systematic search for quantitative syntheses was performed. Several criteria, including study design, dose-response relationship, heterogeneity and agreement of results over time, and identification of potential confounding factors, were used to assess the level of evidence. The strongest (probable) evidence was found for cardiovascular disease protection; possible evidence for decreased risk of colon cancer, depression and pancreatic diseases was found for fruit intake; and colon and rectal cancer, hip fracture, stroke, depression and pancreatic diseases was found for vegetable intake. Suggestive and rather limited associations with other outcomes have been found. Evidence of potential confounding by sex and geographical localisation has been reported. Despite findings are consistent enough for hypothesising causation (at least for cardiovascular-related outcomes), further studies are needed to clarify the role of potential confounding factors.

KEYWORDS:

Fruit; cohort study; evidence; meta-analysis; umbrella review; vegetable

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