Daily Adequate Intake of Fruit and Vegetables and All-Cause, Cardiovascular Disease, and Cancer Mortalities in Malaysian Population: A Retrospective Cohort Study

Abstract

Background/Objective: We investigated the relationship between daily adequate FV intake and risk of all-cause, cardiovascular disease (CVD), and cancer mortalities among Malaysian adults. Methods: Data from a total of 18,211 Malaysian adults aged 18 years and above whom participated in the National Health and Morbidity Survey 2011 were analyzed. The participants were followed up for approximately 11 years, and mortality data were ascertained through record linkages with the death registry from the Malaysian National Registration Department. Multiple Cox regression was applied to assess the association between daily adequate FV intake and risk of all-cause, CVD, and cancer mortalities, adjusting for sociodemographic, lifestyle, and health conditions. Results: During the follow-up period, we observed a total of 1809 all-cause, 374 CVD, and 216 cancer mortalities. No significant association between daily adequate FV intake with all-cause mortality (adjusted hazard ratio (aHR): 1.01, 95% confidence interval (CI: 0.79–1.31), CVD mortality (aHR: 0.91, 95% CI: 0.57–1.47), and cancer mortality (aHR: 1.27, 95% CI: 0.74–2.17) were observed, even after excluding deaths that occurred in the first two years of observation. Conclusions: Further investigation on the type of FV intake and its preparation method with risk of mortality will provide a holistic insight into the causal relationship between FV intake and mortality.

Keywords

• daily adequate fruit and vegetable intake
• all-cause mortality
• CVD mortality
• cancer mortality
• Malaysian population