Fresh Fruit Intake For Long-term Risk Of Esophageal Cancers And Cardiovascular Diseases Mortality

Objectives:To investigate the long-term risk of esophageal cancer and cardiovascular diseases mortality in the Linxian Nutrition Intervention Trail follow-up cohort study.Methods:In 1985,a population of 29 479 aged 40-69 years were enrolled into the Linxian Nutrition Intervention Trial,China.Demographics information,food frequency questionnaire including fresh fruits were collected at baseline and the nutrition intervention lasted for 5.25 years.Monthly follow-up were conducted thereafter to collect cancer incidences and deaths for more than 30 years.The primary endpoint was death of esophageal cancer,total death,cardiovascular disease,and other disease deaths were secondary endpoints.Hazards ratios and 95%confidence interval were calculated using Cox proportional hazard model for risk.Results:Up to September 31,2015,there have been a total of 19541 deaths,including 2569 esophageal cancers,6796 cardiovascular diseases and 5939 other diseases.At baseline,never or rarely consumption of fruits,monthly,1-3 times per week,4-6 times per week,and daily consumption with rates of 18.9%.49.9%、24.8%、3.4%and 2.9%,respectively.Compared with never consumers,daily consumers had 15%(HR=0.85,95%CIs:0.77-0.93)lower all-cause mortality,23%lower esophageal cancers mortality(HR=0.77,95%CIs:0.59-1.00),9%lower cardiovascular diseases mortality(HR=0.81,95%CIs:0.71-0.92)and 5%lower other disease mortality(HR=0.95,95%CIs:0.81-1.11).With the increasing frequency of fresh fruits intake,the 30-year cumulative mortality rates decreased,all-cause mortality and deaths from cardiovascular disease had a statistically significant decreased(P<0.001).Among those whose intake of fresh fruits were more than 1 time per week,the risk of esophageal cancers mortality decreased by 13%(HR = 0.93,95%CIs:0.85-1.01),especially among males(HR = 0.89,95%CIs:0.79-1.00)and smokers(HR=0.87,95%CIs:0.75-1.00).Conclusion:In nutritionally deprived population,fresh fruits consumption were probably associated with a lower risk of esophageal cancer and cardiovascular disease mortality.