Higher intakes of fiber, total vegetables, and fruits may attenuate the risk of all-cause and cause-specific mortality: findings from a large prospective cohort study

• Published in: Nutrition journal Vol. 22; no. 1; pp. 1 - 60
• Main Authors: Ghorbani, Zeinab, Noormohammadi, Morvarid, Kazemi, Asma, Poustchi, Hossein, Pourshams, Akram, Martami, Fahimeh, Hashemian, Maryam, Malekzadeh, Reza, Hekmatdoost, Azita
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 17-11-2023; BioMed Central; BMC
• Subjects: Cancer; Cardiovascular disorders; Chronic illnesses; Cohort analysis; Death risk; Diet; Dietary fiber; Dietary intake; Fruits; Golestan cohort study; Investigations; Mortality; Mortality risk; Population studies; Risk reduction; Vegetables; Iran; United States > US
• ISSN: 1475-2891; 1475-2891
• DOI: 10.1186/s12937-023-00883-4

Although studies have reported an inverse association between fruits, vegetables, and fiber consumption and all-cause and cause-specific mortality, the issue remains incompletely defined in the Middle Eastern population. The current study aimed to investigate the association between dietary fiber, fruit, and vegetable intake and all-cause and cause-specific mortality. A total of 48632 participants (mean age = 52years), 57.5% (n = 27974) women and 42.5% (n = 20658) men, were recruited from an ongoing large-scale prospective cohort study (the Golestan Cohort Study (GCS)), in the north of Iran. Using a validated semi-quantitative 116-item food questionnaire, dietary intakes were collected. Hazard ratios (HRs) and 95% confidence intervals (95%CIs) of all-cause and cause-specific mortality were reported. After approximately 14 years of follow-up, 10,774 deaths were recorded. In the fully adjusted model, compared to those in the lowest quintile of intake, those in the second and third quintiles of dietary fiber intake had a 7%-10% reduction in risk of all-cause mortality, and a 15%-17% reduction in the risk of mortality from other causes. Increasing consumption of fruits was also associated with a decreased risk of mortality for all-cause mortality by 9%-11%, and all cancer by 15-20%. Further, those in the third and fourth quintiles of vegetables intake had 11%-12% lower risk for CVD mortality. The results from the GCS further support the current recommendations on following a healthy diet containing proper amounts of fiber, vegetables, and fruits, as health-protective dietary items. Higher intake of dietary fiber, fruits, and vegetables has the potential to reduce both overall and cause-specific mortality rates. However, additional cohort studies with larger sample size and long-term follow-up durations are required to establish these findings.