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      Association between Vegetable Consumption and Blood Pressure, Stratified by BMI, among Chinese Adolescents Aged 13–17 Years: A National Cross-Sectional Study

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          Abstract

          The association between vegetable intake and blood pressure (BP) in adolescents is still inconsistent, and the description of the recommended daily vegetable consumption is abstract and nonfigurative. Here we aimed to investigate the association between vegetable consumption and BP and further look for a simple way to describe a satisfactory level of daily vegetable consumption for adolescents. We recruited 18,757 adolescents, aged 13–17 years, from seven provinces in China in 2013. A standard physical examination, including height, weight and BP was conducted. Information regarding vegetable intake was collected by questionnaire, and one serving of vegetables was defined as the size of an adult’s fist. Multivariable linear and logistic regression models were used for analysis after adjusting for covariates. Approximately 12.2%, 38.0%, 28.7%, and 21.1% of the adolescents reported daily vegetable consumption of <1, 1~2, 2~3, and ≥3 servings, respectively. Adolescents whose daily vegetable consumption was ≥3 servings showed a lower risk of high blood pressure (HBP) (OR = 0.74, 95%CI: 0.58~0.94, p = 0.013) compared to those with daily vegetable consumptions of < 1 serving. When stratified by body mass index (BMI), in overweight adolescents, participants with 2~3 or ≥3 servings/day had an OR of 0.66 (95%CI: 0.45~0.97) or 0.63 (95%CI: 0.42~0.95) compared with the reference group. Daily vegetable intake of at least three servings (three adult’s fists) is associated with a lower HBP risk in adolescents, which leads to a simple message: “consuming at least three fists of vegetables every day will improve your blood pressure profile”.

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          A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

          The Lancet, 380(9859), 2224-2260
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            Fruit and vegetable consumption and risk of coronary heart disease: a meta-analysis of cohort studies.

            The consumption of fruit and vegetables is associated with a reduced rate of coronary heart disease (CHD) in observational cohorts. The purpose of this study was to assess the strength of this association in a meta-analysis. Cohort studies were selected if they reported relative risks (RRs) and 95% CI for coronary heart disease or mortality and if they presented a quantitative assessment of fruit and vegetable intake. The pooled RRs were calculated for each additional portion of fruit and/or vegetables consumed per day, and the linearity of the associations were examined. Nine studies were eligible for inclusion in the meta-analysis that consisted of 91,379 men, 129,701 women, and 5,007 CHD events. The risk of CHD was decreased by 4% [RR (95% CI): 0.96 (0.93-0.99), P = 0.0027] for each additional portion per day of fruit and vegetable intake and by 7% [0.93 (0.89-0.96), P < 0.0001] for fruit intake. The association between vegetable intake and CHD risk was heterogeneous (P = 0.0043), more marked for cardiovascular mortality [0.74 (0.75-0.84), P < 0.0001] than for fatal and nonfatal myocardial infarction [0.95 (0.92-0.99), P = 0.0058]. Visual inspection of the funnel plot suggested a publication bias, although not statistically significant. Therefore, the reported RRs are probably overestimated. This meta-analysis of cohort studies shows that fruit and vegetable consumption is inversely associated with the risk of CHD. The causal mechanism of this association, however, remains to be demonstrated.
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              Increasing fruit and vegetable intake and decreasing fat and sugar intake in families at risk for childhood obesity.

              The goal of this study was to evaluate the effect of a parent-focused behavioral intervention on parent and child eating changes and on percentage of overweight changes in families that contain at least one obese parent and a non-obese child. Families with obese parents and non-obese children were randomized to groups in which parents were provided a comprehensive behavioral weight-control program and were encouraged to increase fruit and vegetable intake or decrease intake of high-fat/high-sugar foods. Child materials targeted the same dietary changes as their parents without caloric restriction. Changes over 1 year showed that treatment influenced targeted parent and child fruit and vegetable intake and high-fat/high-sugar intake, with the Increase Fruit and Vegetable group also decreasing their consumption of high-fat/high-sugar foods. Parents in the increased fruit and vegetable group showed significantly greater decreases in percentage of overweight than parents in the decreased high-fat/high-sugar group. These results suggest that focusing on increasing intake of healthy foods may be a useful approach for nutritional change in obese parents and their children.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                05 April 2018
                April 2018
                : 10
                : 4
                : 451
                Affiliations
                [1 ]Department of Preventive Medicine, Medical College of Hunan Normal University, Changsha 410013, China; yangyide@ 123456bjmu.edu.cn
                [2 ]Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing 100191, China; bindong@ 123456bjmu.edu.cn (B.D.); harveyzou2002@ 123456bjmu.edu.cn (Z.Z.); 1311110135@ 123456bjmu.edu.cn (S.W.); dongyanhui@ 123456bjmu.edu.cn (Y.D.); wangzhh2014@ 123456bjmu.edu.cn (Z.W.)
                Author notes
                [* ]Correspondence: majunt@ 123456bjmu.edu.cn ; Tel.: +86-10-8280-1624
                [†]

                These authors contributed equally to this work.

                Author information
                https://orcid.org/0000-0002-8123-4401
                Article
                nutrients-10-00451
                10.3390/nu10040451
                5946236
                29621144
                3bdeae9c-e837-4ae8-b429-ab140c725e18
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 01 March 2018
                : 02 April 2018
                Categories
                Article

                Nutrition & Dietetics
                blood pressure,obesity,adolescent,vegetables,body mass index
                Nutrition & Dietetics
                blood pressure, obesity, adolescent, vegetables, body mass index

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