European Journal of Epidemiology

, Volume 30, Issue 9, pp 1035–1048 | Cite as

Fruit intake and cardiovascular disease mortality in the UK Women’s Cohort Study

  • Heidi Tsz Mung Lai
  • Diane Erin Threapleton
  • Andrea Jill Day
  • Gary Williamson
  • Janet Elizabeth Cade
  • Victoria Jane BurleyEmail author


In observational studies, fruit intake is associated with a reduced risk of cardiovascular disease (CVD), though fruit type has been less frequently explored. The aim of the current study was to explore the association between total fruit and fruit subgroup intake according to polyphenol content and CVD mortality in the UK Women’s Cohort Study. Total fruit intake (g/day) derived from a 217-item food frequency questionnaire was obtained from 30,458 women (aged 35–69 years) at baseline from 1995–1998. Fruit intakes were sub-categorised according to similarities in polyphenol profile from Phenol Explorer, including berries, citrus, drupes, pomes and tropical fruits. Mortality events were derived from the NHS Central Register. During the mean follow-up period of 16.7 years, 286 fatal CVD deaths [138 coronary heart disease (CHD), 148 stroke] were observed. Survival analysis was conducted using participants free from history of CVD at baseline. Total fruit intake was associated with lower risk of CVD and CHD mortality, with a 6–7 % reduction in risk for each 80 g/day portion consumed (99 % CI 0.89, 1.00 and 0.85, 1.01 respectively). Concerning particular fruit types, the direction of the associations tended to be inverse, but point estimates and tests for trend were not generally statistically significant. However, women in the highest intake group of grapes and citrus experienced a significant reduction in risk of CVD and stroke respectively compared with non-consumers [HR 0.56 (99 % CI 0.32, 0.98) and 0.34 (0.14, 0.82) respectively]. These findings support promoted guidelines encouraging fruit consumption for health in women, but do not provide strong evidence to suggest that fruit type is as important.


Fruit intake Polyphenol Epidemiology Cardiovascular disease Stroke Coronary heart disease 



We would like to thank the World Cancer Research Fund for providing the initial funding for the UK Women’s Cohort Study, the cohort participants who have taken part and provided valuable information for the cohort, as well as those who have contributed towards data collection and management.


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Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  • Heidi Tsz Mung Lai
    • 1
    • 2
  • Diane Erin Threapleton
    • 2
    • 3
  • Andrea Jill Day
    • 1
  • Gary Williamson
    • 1
  • Janet Elizabeth Cade
    • 2
  • Victoria Jane Burley
    • 2
    Email author
  1. 1.Functional Food Group, School of Food Science and NutritionUniversity of LeedsLeedsUK
  2. 2.Nutritional Epidemiology Group, School of Food Science and NutritionUniversity of LeedsLeedsUK
  3. 3.Division of Epidemiology, Jockey Club School of Public Health and Primary CareChinese University of Hong KongShatinHong Kong

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