Prospective cohort studies are best suited to evaluate the role
of fruit and vegetables in the development of CVD because
dietary assessment is conducted before the outcome and reporting
of intake is not biased by a recent CVD diagnosis. Several
prospective studies have related higher fruit and vegetable
intake to lower CVD mortality (12, 13) and morbidity (24, 25).
During an average of 12 y of follow-up of 15 220 men in the
Physicians’ Health Study, incidence of coronary heart disease
(CHD) was 25% lower in those who consumed ≥2.5 servings
of vegetables daily than in those who consumed < 1 serving/d.
The inverse relation between vegetable intake and CHD risk
was also more evident among men with a BMI > 25 (RR: 0.71;
95% CI: 0.51, 0.99) and among current smokers (RR: 0.40; 95%
CI: 0.18, 0.86).