Frequency of fruit and vegetable consumption and coronary heart disease in France and Northern Ireland: the PRIME study

Fruit and vegetable consumption is associated with low CHD risk in the USA and Northern Europe. There is, in contrast, little information about these associations in other regions of Europe. The goal of the present study was to assess the relationship between frequency of fruit and vegetable intake and CHD risk in two European populations with contrasting cardiovascular incidence rates; France and Northern Ireland. The present prospective study was in men aged 50-59 years, free of CHD, who were recruited in France (n 5982) and Northern Ireland (n 2105). Fruit and vegetable intake was assessed by a food-frequency questionnaire. Incident cases of acute coronary events and angina were recorded over a 5-year follow-up. During follow-up there was a total of 249 ischaemic events. After adjustment on education level, smoking, physical activity, alcohol consumption, employment status, BMI, blood pressure, serum total and HDL-cholesterol, the relative risks (RR) of acute coronary events were 0·67 (95 % CI 0·44, 1·03) and 0·64 (95 % CI 0·41, 0·99) in the 2nd and 3rd tertiles of citrus fruit consumption, respectively (P for trend <0·03). Similar results were observed in France and Northern Ireland. In contrast, the RR of acute coronary events for ʹother fruitʹ consumption were 0·70 (95 % CI 0·31, 1·56) and 0·52 (95 % CI 0·24, 1·14) respectively in Northern Ireland (trend P<0·05) and 1·29 (95 % CI 0·69, 2·4) and 1·15 (95 % CI 0·68, 1·94) in France (trend P=0·5; interaction P<0·04). There was no evidence for any association between vegetable intake and total CHD events. In conclusion, frequency of citrus fruit, but not other fruits, intake is associated with lower rates of acute coronary events in both France and Northern Ireland, suggesting that geographical or related factors might affect the relationship between fruit consumption and CHD risk.