Fruit, vegetables, and olive oil and risk of coronary heart disease in Italian women: the EPICOR Study1,2,3
Benedetta Bendinelli, Giovanna Masala, Calogero Saieva, Simonetta Salvini, Carmela Calonico, Carlotta Sacerdote, Claudia Agnoli, Sara Grioni, Graziella Frasca, Amalia Mattiello, Paolo Chiodini, Rosario Tumino, Paolo Vineis, Domenico Palli, and Salvatore Panico
1From the Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute, Florence, Italy (BB, GM, C Sai, SS, CC, and DP); the Institute for Scientific Interchange Foundation, Turin, Italy (C Sac); the Department of Genetics, Biology and Biochemistry, University of Turin, Turin, Italy (C Sac); the Nutritional Epidemiology Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy (CA and SG); the Cancer Registry, ASP 7, Ragusa, Italy (GF and RT); the Department of Clinical and Experimental Medicine, University Federico II, Naples, Italy (AM and SP); the Department of Medicine and Public Health, Second University of Naples, Naples, Italy (PC); the Imperial College, London, United Kingdom (PV); and the University of Turin, Turin, Italy (PV).
↵2 The EPICOR Study is supported by the Compagnia di San Paolo. The Italian EPIC collaboration is supported by Associazione Italiana per la Ricerca sul Cancro and Programma Integrato Oncologia, Regione Toscana, Ministero della Salute.
↵3 Address correspondence to D Palli, Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute, Via Cosimo il Vecchio 2, 50139 Florence, Italy. E-mail: d.palli@ispo.toscana.it.
Abstract
Background: Many observational studies support the recommendation to eat sufficient amounts of fruit and vegetables as part of a healthy diet.
Objective: The present study aimed to investigate the association between consumption of fruit, vegetables, and olive oil and the incidence of coronary heart disease (CHD) in 29,689 women enrolled between 1993 and 1998 in 5 European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts in northern (Turin and Varese), central (Florence), and southern (Naples and Ragusa) Italy.
Design: Baseline dietary, anthropometric, and lifestyle characteristics were collected. Major events of CHD (fatal and nonfatal myocardial infarction and coronary revascularization) were identified through a review of clinical records. Analyses were stratified by center and adjusted for hypertension, smoking, education, menopause, physical activity, anthropometric measures, nonalcohol energy, alcohol, total meat, vegetables in analyses for fruit, and fruit in analyses for vegetables.
Results: During a mean follow-up of 7.85 y, 144 major CHD events were identified. A strong reduction in CHD risk among women in the highest quartile of consumption of leafy vegetables (hazard ratio: 0.54; 95% CI: 0.33, 0.90; P for trend = 0.03) and olive oil (hazard ratio: 0.56; 95% CI: 0.31, 0.99; P for trend = 0.04) was found. In contrast, no association emerged between fruit consumption and CHD risk.
Conclusion: An inverse association between increasing consumption of leafy vegetables and olive oil and CHD risk emerged in this large cohort of Italian women.
Received July 28, 2010.
Accepted November 29, 2010.
Comentario de Sandra Farré Schneider:
El consumo de frutas y vegetales (ojalá orgánicos) es imprescindible para gozar de una buena salud, no sólo por su contenido en vitaminas, minerales y oligoelementos sino principalmente por su riqueza en fitoquímicos, que ha demostrado combatir y disminuir riesgo de padecer enfermedades crónico-degenerativas. Algunos de los elementos fitoquímicos más estudiados son los flavonoides (actualmente se menciona mucho el resveratrol que contiene la uva por ejemplo), los carotenoides (betacaroteno, luteína y zeaxantina). los antocianos o prontocianidinas (que dan color rojo o morado a los berries) o los terpenos (encontrados principalmente en plantas aromáticas como el perejil). Se recomienda que mínimo 1/3 de la comida diaria esté formada de alimentos crudos (vegetales principalmente), además de frutas y verduras (cocinadas ojalá al vapor para mantener intactas todas sus propiedades). Es muy recomendable adicionar a las ensaladas germinados de soya, alfalfa u otros, por su alto valor nutricional.
El aceite de oliva más indicado es el "virgen de primera presión en frío" y su uso, obviamente "natural o crudo, sin calentar", pues la calidad es un factor que influye en sus propiedades entre las que podemos destacar: 1) Prevenir la trombosis (disminución nivel de fibrinógeno en la sangre); 2) Prevenir arteriosclerosis (evita oxidación lipoproteínas que transportan colesterol); 3) Mejora funcionamiento hepático. Por supuesto el mejor aceite a utilizar si queremos hacer algo a la plancha es el de aceite de oliva antes que otros como el de girasol.
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