Consumption of fruits and vegetables is associated with a lower overall mortality. The aim of this study was to identify causes of death through which this association is established. More than 450,000 participants from the European Prospective Investigation into Cancer and Nutrition study were included, of which 25,682 were reported deceased after 13 years of follow-up. Information on lifestyle, diet and vital status was collected through questionnaires and population registries. Hazard ratios (HR) with 95% confidence intervals (95% CI) for death from specific causes were calculated from Cox regression models, adjusted for potential confounders. Participants reporting consumption of more than 569 g/day of fruits and vegetables had lower risks of death from diseases of the circulatory (HR for upper fourth 0.85, 95% CI 0.77-0.93), respiratory (HR for upper fourth 0.73, 95% CI 0.59-0.91) and digestive system (HR for upper fourth 0.60, 95% CI 0.46-0.79) when compared with participants consuming less than 249 g/day. In contrast, a positive association with death from diseases of the nervous system was observed. Inverse associations were generally observed for vegetable, but not for fruit consumption. Associations were more pronounced for raw vegetable consumption, when compared with cooked vegetable consumption. Raw vegetable consumption was additionally inversely associated with death from neoplasms and mental and behavioral disorders. The lower risk of death associated with a higher consumption of fruits and vegetables may be derived from inverse associations with diseases of the circulatory, respiratory and digestive system, and may depend on the preparation of vegetables and lifestyle factors.

中文翻译：

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EPIC 研究中的水果和蔬菜摄入量和特定原因死亡率。

水果和蔬菜的消费与较低的总体死亡率有关。本研究的目的是确定建立这种关联的死亡原因。超过 450,000 名来自欧洲癌症和营养前瞻性调查研究的参与者被纳入其中，其中 25,682 人在 13 年的随访后报告死亡。通过问卷和人口登记收集有关生活方式、饮食和生命状态的信息。根据 Cox 回归模型计算特定原因死亡的 95% 置信区间 (95% CI) 的风险比 (HR)，并针对潜在的混杂因素进行了调整。报告每天食用超过 569 克水果和蔬菜的参与者死于循环系统疾病的风险较低（上四分之一的 HR 0.85，95% CI 0.77-0.93），与每天摄入少于 249 克的参与者相比，呼吸系统（上四分之一的 HR 0.73，95% CI 0.59-0.91）和消化系统（上四分的 HR 0.60，95% CI 0.46-0.79）。相反，观察到与神经系统疾病死亡呈正相关。通常在蔬菜中观察到反向关联，但在水果消费中没有观察到。与熟蔬菜消费相比，生蔬菜消费的关联更为明显。此外，生蔬菜消费与肿瘤和精神和行为障碍的死亡呈负相关。与较高的水果和蔬菜消费量相关的较低死亡风险可能源于与循环系统、呼吸系统和消化系统疾病的负相关，