Greater variety in fruit and vegetable intake is associated with lower inflammation in Puerto Rican adults

Abstract

Background: Puerto Rican adults have prevalent metabolic abnormalities, but few studies have explored fruit and vegetable (FV) intake and coronary heart disease (CHD) risk in this population.

Objective: We tested the hypothesis that greater FV intake and variety are associated with a lower 10-y risk of CHD and C-reactive protein (CRP) concentrations.

Design: In a cross-sectional study of ≈1200 Puerto Rican adults aged 45-75 y, we assessed FV intake with a food-frequency questionnaire. The 10-y risk of CHD was assessed with the Framingham risk score (FRS) in participants free of cardiovascular disease. CRP was measured in fasting serum.

Results: Variety, but not quantity, of FV intake was inversely associated with FRS after adjustment for the following: sex; waist circumference; perceived stress; alcohol use; intakes of energy, trans fatty acids, and saturated fatty acids; and use of supplements, cardiovascular medications, and diabetes medications (P = 0.02). However, the association was attenuated after adjustment for income (P = 0.11). Variety, but not quantity, was associated with a lower serum CRP concentration after adjustment for age, sex, smoking status, alcohol use, servings of FV, white blood cell count, diastolic blood pressure, diabetes, nonsteroidal antiinflammatory medication use, intakes of energy and vitamin B-6, waist circumference, perceived stress, and income. The adjusted odds of a high CRP concentration for those in the highest compared with the lowest tertile of FV variety was 0.68 (95% CI: 0.49, 0.94).

Conclusions: FV variety, but not quantity, appears to be important in reducing inflammation. Although the results are suggestive, larger studies are needed to confirm a possible association with CHD risk score.

Figures

FIGURE 1.

Flow diagram of participants included in the current analysis. 1Identified as of Puerto Rican descent. 2Met the exclusion criteria (eg, serious illness, moved from the study area, homeless, or hostile). 3Reasons for declining participation (eg, not interested, too busy, did not want blood drawn, length of study, or doctor/spouse advised against participation). 4Low Mini-Mental State Examination Score (MMSE; <10). 5Valid food-frequency questionnaire (FFQ; <10 questions left unanswered and energy intake between 600 and 4800 kcal or between 2510 and 20,083 kJ).

FIGURE 2.

Odds ratios (95% CIs) of high C-reactive protein category across tertiles of fruit and vegetable intake (servings/d). Data were adjusted for age (y), sex, energy intake (kcal/d), smoking (current, former, or never), alcohol use (current, former, or never), white blood cell count (mm3), variety in fruit and vegetable intake (number of unique fruit and vegetables consumed at least once per month), waist circumference (cm), diastolic blood pressure (mm Hg), diabetes status (yes or no), perceived stress score, vitamin B-6 intake (mg/d), nonsteroidal antiinflammatory medication use (yes or no), and total household income (US$/y) by cumulative logistic regression (PROC LOGISTIC; SAS Institute, Cary, NC). Tertile 1, n = 383; tertile 2, n = 383; tertile 3, n = 383. REF, reference.

FIGURE 3.

Odds ratios (95% CIs) of high C-reactive protein category across tertiles of fruit and vegetable variety (number of unique fruit and vegetables consumed at least once per month). Data were adjusted for age (y), sex, energy intake (kcal/d), smoking (current, former, or never), alcohol use (current, former, or never), white blood cell count (mm3), fruit and vegetable intake (servings/d), waist circumference (cm), diastolic blood pressure (mm Hg), diabetes status (yes or no), perceived stress score, vitamin B-6 intake (mg/d), nonsteroidal antiinflammatory medication use (yes or no), and total household income (US$/y) by using cumulative logistic regression (PROC LOGISTIC; SAS Institute, Cary, NC). Tertile 1, n = 386; tertile 2, n = 387; tertile 3, n = 386. REF, reference.