| 13) Larsson SC (2009) | The Alpha-tocopherol Beta-carotene Cancer Prevention Study | 26,556 male smokers (≥ 5 cigarettes/day) aged 50-69 without a history of stroke, angina, cancer and several other conditions.
(Finland) | 13.6
(1985-88 to 2004) | See variables | Stroke risk | Fruits (not defined) |
Cerebral infarction
(2,702 cases) | Intracerebral hemorrhage
(383 cases) | Subarachnoid hemorrhage
(196 cases) |
RR = 0.82 (0.73-0.93; P = 0.003) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
11.6: RR = 1.
40.7: RR = 0.90 (0.80-1.02).
74.0: RR = 0.91 (0.81-1.02).
113.5: RR = 0.85 (0.76-0.96).
192.9: RR = 0.82 (0.73-0.93).
|
RR = 0.84 (0.59-1.20; P = 0.26) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
11.6: RR = 1.
40.7: RR = 1.14 (0.84-1.55).
74.0: RR = 1.04 (0.75-1.43).
113.5: RR = 1.14 (0.83-1.57).
192.9: RR = 0.84 (0.59-1.20).
|
RR = 0.80 (0.51-1.26; P = 0.79) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
11.6: RR = 1.
40.7: RR = 0.64 (0.40-1.04).
74.0: RR = 0.98 (0.63-1.50).
113.5: RR = 0.98 (0.64-1.51).
192.9: RR = 0.80 (0.51-1.26).
|
Age, supplementation group, number of cigarettes smoked daily, BMI, systolic and diastolic blood pressures, total serum cholesterol, serum HDL, histories of diabetes and CHD, leisure time physical activity, and intakes of alcohol and total energy. |
| 13) Hirvonen T (2000) | The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. | 26,497 male smokers aged 50-69 in a double-blind, placebo-controlled, primary prevention trial undertaken to determine whether supplementation with alpha-tocopherol, beta-carotene, or both would reduce the incidence of lung cancer in male smokers.
(Finland) | 6.1
(?-1993) | Cerebral infarction: 736.
Subarachnoid hemmorhage: 83.
Intracerebral hemmorhage: 95. | Stroke risk | Fruits (not defined) |
| Cerebral infarction: | Subarachnoid hemmorhage: | Intracerebral hemmorhage: |
RR = 0.96 (0.78-1.18; P = 0.73) for the highest vs lowest quartile of consumption.
Amount specific data (g/d):
< 32: RR = 1.
32-70: RR = 0.90 (0.74-1.11).
71-120: RR = 0.92 (0.75-1.13).
> 120: RR = 0.96 (0.78-1.18).
A protective effect was found in the placebo group of the trial cohort: RR = 0.59 (0.39-0.89; P = 0.01).
|
RR = 1.17 (0.65-2.13; P = 0.31) for the highest vs lowest quartile of consumption.
Amount specific data (g/d):
< 32: RR = 1.
32-70: RR = 0.66 (0.34-1.30).
71-120: RR = 1.19 (0.67-2.14).
> 120: RR = 1.17 (0.65-2.13).
|
RR = 0.43 (0.22-0.81; P = 0.03) for the highest vs lowest quartile of consumption.
Amount specific data (g/d):
< 32: RR = 1.
32-70: RR = 0.65 (0.37-1.13).
71-120: RR = 0.87 (0.52-1.45).
> 120: RR = 0.43 (0.22-0.81).
|
In a multivariate model that simultaneously included all foods (fruits, berries, vegetables, tea, and wine), RRs for different subtypes of stroke were similar to those when the foods were included one at a time in the model.Age, supplementation group, systolic and diastolic blood pressures, serum total cholesterol, serum HDL cholesterol, BMI, height, smoking-years, number of cigarettes/day, history of diabetes or CHD, alcohol intake, and education. |
| 10) Joshipura KJ (1999) | The Nurses' Health Study
&
The Health Professionals' Follow-Up Study | 75,596 women aged 34-59, and 38,683 men aged 40-75.
(USA) | Women: 14
(1980-1994).
Men: 8
(1986-1994). | 570?
295 non-users of vitamin supplements, and 216 users of multivitamin supplements.
388 never & past smokers, and 172 current smokers. | Ischemic stroke risk | All fruits (not defined) |
| Pooled | Women
(366? cases) | Men
(204? cases) |
RR = 0.69 (0.52-0.91) for the highest vs lowest quintile of consumption.
Amount specific data (not defined):
Q1: RR = 1.
Q2: RR = 0.85 (0.66-1.09).
Q3: RR = 0.83 (0.64-1.07).
Q4: RR = 0.73 (0.56-0.96)..
Q5: RR = 0.69 (0.52-0.91).
RR for an increment of 1 serving/day:
0.89 (0.82-0.97).
|
RR = 0.69 (0.49-0.98) for the highest vs lowest quintile of consumption.
Amount specific data (servings/day):
0.86: RR = 1.
Not defined: RR = 0.88 (0.65-1.20).
Not defined: RR = 0.82 (0.60-1.13).
Not defined: RR = 0.66 (0.47-0.93).
4.54: RR = 0.66 (0.47-0.93).
RR for an increment of 1 serving/day:
0.87 (0.78-0.96).
|
RR = 0.68 (0.42-1.10) for the highest vs lowest quintile of consumption.
Amount specific data (servings/day):
0.72: RR = 1.
Not defined: RR = 0.78 (0.50-1.22).
Not defined: RR = 0.84 (0.54-1.31).
Not defined: RR = 0.87 (0.56-1.34).
4.33: RR = 0.68 (0.42-1.10).
RR for an increment of 1 serving/day:
0.93 (0.82-1.05).
|
Stratified by vitamin supplement use:
| No vitamin supplement | Multivitamin supplement |
| RR for an increment of 1 serving/day: 0.90 (0.76-1.05).
|
RR for an increment of 1 serving/day: 0.96 (0.84-1.09).
|
Stratified by smoking status:
| Never and past smokers | Current smokers |
| RR for an increment of 1 serving/day: 0.94 (0.85-1.03).
|
RR for an increment of 1 serving/day: 0.86 (0.70-1.06).
|
Age, smoking, alcohol, family history of MI, BMI, vitamin supplement use, vitamin E use, physical activity, aspirin use, time period, hypertension and hypercholesterolemia, total energy intake, and amon women, postmenopausal hormone use. |
| 10) Ascherio A (1998) | The Health Professionals Follow-Up Study. | 43,378 men age 40-75.
(USA) | 8
(1986-1994) | Total stroke: 328?
Ischemic stroke: 210? | Stroke risk | Fruits (not defined) | RR for an increase of 1 serving/day: 0.96 (0.89-1.03; P = 0.26).
Results for ischemic stroke were similar. | Not defined, but probably age, total energy intake, smoking, alcohol consumptioin, history of hypertension, history of hypercholesterolemia, parental history of MI before age 65, profession, BMI, and physical activity. |
| 8) Gillman MW (1995) | The Framingham Study. | 832 men aged 45-65. | 20
(1966-69 to ?) | 97? | Total stroke risk (including transient ischemic attack = history of a focal neuroligical deficit persisting for < 24 hours) | Fruits (peaches, grapes, oranges, and orange juice; apples, bananas, and apple juice; canned and frozen fruits) |
RR for an increment of 3 servings/day = 0.81 (0.56-1.19).
A serving of fruit was defined as 120 ml. | Systolic blood pressure, serum cholesterol, cigarette smoking, glucose intolerance, BMI, physical activity, left ventricular hypertrophy, energy intake, and consumption of ethanol and fat. |
| 6) Keli SO (1996) | The Zutphen Study.
(The Dutch contribution to The Seven Countries Study) | 552 men aged 50-69. | 15
(1970-1985) | 42 | Stroke incidence | Solid fruit (mainly apples) |
RR = 0.52 (0.21-1.31; P = 0.17) for the highest vs lowest tertile of consumption.
Amount specific data (g/d):
< 41: RR = 1.
41-99.7: RR = 0.83 (0.41-1.66).
≥ 99.8: RR = 0.52 (0.21-1.31). | Age, average systolic blood pressure, serum cholesterol, energy intake, lifetime cigarette smoking exposure, fish consumption, and alcohol habits. |
| 3) Yokoyama T (2000) | The Shibata Study. | 880 men and 1241 women aged ≥ 40.
(Japan) | 20
(1977-1997) | All stroke: 196? (91 men, and 105 women)
Cerebral infarction: 109? (58 men, and 51 women)
Hemmorhagic stroke: 54? (18 men, and 36 women) | Stroke incidence | Fruit (not defined) |
All stroke:
| Both sexes | Men | Women |
HR = 0.85 (0.58-1.23; P = 0.426) for the highest vs lowest tertile of consumption.
Amount specific data (d/wk):
0-2: HR = 1.
3-5: HR = 0.84 (0.57-1.25).
6-7: HR = 0.85 (0.58-1.23).
|
HR = 1.14 (0.69-1.91; P = 0.626) for the highest vs lowest tertile of consumption.
Amount specific data (d/wk):
0-2: HR = 1.
3-5: HR = 0.68 (0.38-1.22).
6-7: HR = 1.14 (0.69-1.91).
|
HR = 0.70 (0.40-1.20; P = 0.150) for the highest vs lowest tertile of consumption.
Amount specific data (d/wk):
0-2: HR = 1.
3-5: HR = 0.88 (0.49-1.58).
6-7: HR = 0.70 (0.40-1.20).
|
Cerebral infarction:
| Both sexes | Men | Women |
HR = 0.68 (0.41-1.12; P = 0.142) for the highest vs lowest tertile of consumption.
Amount specific data (d/wk):
0-2: HR = 1.
3-5: HR = 0.74 (0.45-1.23).
6-7: HR = 0.68 (0.41-1.12).
|
HR = 0.98 (0.52-1.86; P = 0.922) for the highest vs lowest tertile of consumption.
Amount specific data (d/wk):
0-2: HR = 1.
3-5: HR = 0.63 (0.31-1.28).
6-7: HR = 0.98 (0.52-1.86).
|
HR = 0.51 (0.24-1.10; P = 0.070) for the highest vs lowest tertile of consumption.
Amount specific data (d/wk):
0-2: HR = 1.
3-5: HR = 0.78 (0.35-1.70).
6-7: HR = 0.51 (0.24-1.10).
|
Hemmorhagic stroke:
| Both sexes | Men | Women |
HR = 0.92 (0.46-1.85; P = 0.978) for the highest vs lowest tertile of consumption.
Amount specific data (d/wk):
0-2: HR = 1.
3-5: HR = 0.61 (0.28-1.36).
6-7: HR = 0.92 (0.46-1.85).
|
HR = 1.53 (0.55-4.27; P = 0.390) for the highest vs lowest tertile of consumption.
Amount specific data (d/wk):
0-2: HR = 1.
3-5: HR = 0.15 (0.02-1.28).
6-7: HR = 1.53 (0.55-4.27).
|
HR = 0.71 (0.27-1.94; P = 0.520) for the highest vs lowest tertile of consumption.
Amount specific data (d/wk):
0-2: HR = 1.
3-5: HR = 0.72 (0.27-1.94).
6-7: HR = 0.71 (0.28-1.76).
|
Sex, age, MBP, TC, BMI, presence of atrial fibrillation, use of antihypertensive medication, personal history of IHD, physical activity, smoking, and alcohol drinking. |
Fruit and stroke death:
| Author | Cohort name | Subjects | Years of follow-up | Cases | End point | Consumption of | Relative Risk (RR) | Adjustments |
| 37) Nagura J (2009) | The JACC Study | 25,206 men and 34,279 women aged 40-79, and without a history of CHD, stroke, or cancer.
(Japan) | 12.7
(1989-2003) | 1,053 | Total stroke mortality | Fruit (citrus fruits, other fruits, and fresh fruit juice in summer) |
HR = 0.65 (0.53-0.80; P = < 0.001) for the highest vs lowest quartile of consumption.
Amount specific data (servings per week):
0.9: HR = 1.
2.3: HR = 0.81 (0.69-0.96).
3.9: HR = 0.76 (0.64-0.90).
5.9: HR = 0.65 (0.53-0.80).
The association did not vary by sex (no data shown).
Haemorrhagic stroke:
(393 cases) | Ischaemic stroke:
(362 cases) |
HR = 0.59 (0.42-0.82; P = 0.002) for the highest vs lowest quartile of consumption.
Amount specific data (servings per week):
0.9: HR = 1.
2.3: HR = 0.76 (0.58-1.00).
3.9: HR = 0.72 (0.55-0.95).
5.9: HR = 0.59 (0.42-0.82).
|
HR = 0.71 (0.50-1.00; P = 0.081) for the highest vs lowest quartile of consumption.
Amount specific data (servings per week):
0.9: HR = 1.
2.3: HR = 0.76 (0.57-1.01).
3.9: HR = 0.83 (0.63-3.11).
5.9: HR = 0.71 (0.50-1.00).
|
Sex, age, BMI, smoking status, alcohol intake, hours of walking, hours of sleep, education years, perceived mental stress, cholesterol intake, SFA intake, n-3 fatty acids intake, sodium intake, vegetables intake, bean intake and histories of hypertension and diabetes. |
| 32) Ness AR (2005) | The Boyd Orr Cohort. | 4,028 people (1,995 men, and 2,033 women) from England and Scotland. | average 37
(1948 to 2000) | 83 | Stroke mortality | Fruit (not defined) |
RR = 0.48 (0.21-1.10; P = 0.3) for the highest vs lowest quartile of consumption.
Amount specific data (g):
0-4.7: RR = 1.
4.8-21.1: RR = 0.93 (0.51-1.71).
21.2-45.1: RR = 1.13 (0.63-2.04).
45.5-556.4: RR = 0.48 (0.21-1.10).
| Age, energy, sex, childhood family food expenditure, father's social class, district of residence as a child, period of birth, season when studied as a child, and Townsend score for current address or place of death. |
| 28) Sauvaget C (2003) | The Hiroshima/Nagasaki Life Span Study. | 39,337 subjects (14,966 men and 23,471 women) aged 34-103.
(Japan) | 1980-81 to 1998 | Total stroke: 598 men, and 1,103 women.
Cerebral hemorrhage: 141 men, and 265 women.
Cerebral infarction 304 men, and 513 women. | Stroke death | Fruits (not defined) |
Total stroke death:
| Men | Women |
RH = 0.70 (0.56-0.87; P = 0.0014) for the highest vs lowest tertile of consumption.
Amount specific data (serving frequency):
0-1/week: RH = 1.
2-4/week: RH = 0.87 (0.71-1.08).
almost daily: RH = 0.70 (0.56-0.87).
|
RH = 0.79 (0.66-0.94; P = 0.0008) for the highest vs lowest tertile of consumption.
Amount specific data (serving frequency):
0-1/week: RH = 1.
2-4/week: RH = 1.01 (0.85-1.21).
almost daily: RH = 0.79 (0.66-0.94).
|
Death from cerebral hemorrhage:
| Men | Women |
RH = 0.82 (0.51-1.31; P = 0.3630) for the highest vs lowest tertile of consumption.
Amount specific data (serving frequency):
0-1/week: RH = 1.
2-4/week: RH = 1.11 (0.71-1.72).
almost daily: RH = 0.82 (0.51-1.31).
|
RH = 0.73 (0.51-1.04; P = 0.0130) for the highest vs lowest tertile of consumption.
Amount specific data (serving frequency):
0-1/week: RH = 1.
2-4/week: RH = 1.20 (0.84-1.72).
almost daily: RH = 0.73 (0.51-1.04).
|
Death from cerebral infarction:
| Men | Women |
RH = 0.67 (0.49-0.92; P = 0.0091) for the highest vs lowest tertile of consumption.
Amount specific data (serving frequency):
0-1/week: RH = 1.
2-4/week: RH = 0.93 (0.69-1.26).
almost daily: RH = 0.67 (0.49-0.92).
|
RH = 0.77 (0.60-0.99; P = 0.0283) for the highest vs lowest tertile of consumption.
Amount specific data (serving frequency):
0-1/week: RH = 1.
2-4/week: RH = 0.92 (0.71-1.20).
almost daily: RH = 0.77 (0.60-0.99).
|
RH = Relative Hazard.
Adjustment for intake of green-yellow vegetables did not alter the results (data not shown).Age-stratified. And adjusted for radiation dose, city, BMI, smoking status, alcohol habits, education level, medical history of hypertension, MI, diabetes, and consumption of animal products (egg, dairy, fish). |
| 16) Ross RK (1997) | No cohort name defined | 18,244 men aged 45-64 from Shanghai.
(China) | 1986-89 to 1994 | 245? | Stroke/cerebrovascular accident death | Fresh fruit of any kind | No significant association was found when evaluated either as median levels of daily intake or as tertiles of intake frequencies (No data shown). | Education, marital status, BMI, lifetime cigarette smoking, lifetime ethanol intake, and history of hypertension. |
| 12) Appleby PN. (2002) | The Health Food Shoppers Study. | 10,741 subjects, aged 16-89 (4,325 men, 6,416 women. 8,675 non-smokers).
(UK) | 1973-79 to 1997 | 356 (142 men, and 214 women. 303 non-smokers) | Cerebrovascular disease mortality | Fresh fruit (not defined) |
| All subjects | Men | Women | Non-smokers |
RR = 0.83 (0.64-1.07).
Additional adjustment for wholemeal bread, nuts/dried fruit, raw vegetable salads, and bran cereals: RR = 0.85 (0.64-1.12). | RR = 0.89 (0.61-1.31). | RR = 0.78 (0.55-1.09). | RR = 0.87 (0.65-1.17). |
RRs are for daily consumption vs less frequent consumption.Age at recruitment, sex, and smoking. |
| 12) Key TJ. (1996) | The Health Food Shoppers Study. | 10.771 (4.336 men and 6.435 women) aged > or = 16, recruited through health food shops, vegeterian societies, and magazines.
(UK) | 16.8
(1973-79 to 1995) | 147? (68 men, 79 women) | Cerebrovascular disease mortality | fresh fruit (not defined) | RR = 0.68 (0.47-0.98; P = < 0.05) for consumption at least daily vs < daily. | age, sex, and smoking |
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