Yu-Han Chiu1, Helena Sandoval-Insausti2, Sylvia H Ley3, Shilpa N Bhupathiraju4, Russ Hauser5, Eric B Rimm6, JoAnn E Manson7, Qi Sun4, Jorge E Chavarro8. 1. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Electronic address: yuc187@mail.harvard.edu. 2. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz, CIBERESP, Madrid, Spain. 3. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA. 4. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 5. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 6. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 7. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 8. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: jchavarr@hsph.harvard.edu.
Abstract
BACKGROUND: Fruit and vegetable (FV) intake is recommended for the prevention of coronary heart disease (CHD). FVs are also an important source of exposure to pesticide residues. Whether the relations of FV intake with CHD differ according to pesticide residue status is unknown. OBJECTIVE: To examine the associations of high- and low-pesticide-residue FVs with the risk of CHD. METHODS: We followed 145,789 women and 24,353 men free of cardiovascular disease and cancer (excluding non-melanoma skin cancer) at baseline and participating in three ongoing prospective cohorts: the Nurses' Health Study (NHS: 1998-2012), the NHS-II (1999-2013), and the Health Professionals Follow-up Study (HPFS: 1998-2012). FV intake was assessed via food frequency questionnaires. We categorized FVs as having high- or low-pesticide-residues using a validated method based on pesticide surveillance data from the US Department of Agriculture. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95%CI) of CHD in relation to high- and low-pesticide-residue FV intake. RESULTS: A total of 3707 incident CHD events were identified during 2,241,977 person-years of follow-up. In multivariable-adjusted models, a greater intake of low-pesticide-residue FVs was associated with a lower risk of CHD whereas high-pesticide-residue FV intake was unrelated to CHD risk. Specifically, compared with individuals consuming <1 serving/day of low-pesticide-residue FVs, those consuming ≥4 servings/day had 20% (95CI: 4%, 33%) lower risk of CHD. The corresponding HR (comparing ≥4 servings/day to <1 serving/day) for high-pesticide-residue FV intake and CHD was 0.97 (95%CI: 0.72, 1.30). CONCLUSIONS: Our data suggested exposure to pesticide residues through FV intake may modify some cardiovascular benefits of FV consumption. Further confirmation of these findings, especially using biomarkers for assessment of pesticide exposure, is needed.
BACKGROUND: Fruit and vegetable (FV) intake is recommended for the prevention of coronary heart disease (CHD). FVs are also an important source of exposure to pesticide residues. Whether the relations of FV intake with CHD differ according to pesticide residue status is unknown. OBJECTIVE: To examine the associations of high- and low-pesticide-residue FVs with the risk of CHD. METHODS: We followed 145,789 women and 24,353 men free of cardiovascular disease and cancer (excluding non-melanoma skin cancer) at baseline and participating in three ongoing prospective cohorts: the Nurses' Health Study (NHS: 1998-2012), the NHS-II (1999-2013), and the Health Professionals Follow-up Study (HPFS: 1998-2012). FV intake was assessed via food frequency questionnaires. We categorized FVs as having high- or low-pesticide-residues using a validated method based on pesticide surveillance data from the US Department of Agriculture. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95%CI) of CHD in relation to high- and low-pesticide-residue FV intake. RESULTS: A total of 3707 incident CHD events were identified during 2,241,977 person-years of follow-up. In multivariable-adjusted models, a greater intake of low-pesticide-residue FVs was associated with a lower risk of CHD whereas high-pesticide-residue FV intake was unrelated to CHD risk. Specifically, compared with individuals consuming <1 serving/day of low-pesticide-residue FVs, those consuming ≥4 servings/day had 20% (95CI: 4%, 33%) lower risk of CHD. The corresponding HR (comparing ≥4 servings/day to <1 serving/day) for high-pesticide-residue FV intake and CHD was 0.97 (95%CI: 0.72, 1.30). CONCLUSIONS: Our data suggested exposure to pesticide residues through FV intake may modify some cardiovascular benefits of FV consumption. Further confirmation of these findings, especially using biomarkers for assessment of pesticide exposure, is needed.
Authors: Shanthi Mendis; Kristian Thygesen; Kari Kuulasmaa; Simona Giampaoli; Markku Mähönen; Kathleen Ngu Blackett; Liu Lisheng Journal: Int J Epidemiol Date: 2010-10-05 Impact factor: 7.196
Authors: Carly Hyland; Asa Bradman; Roy Gerona; Sharyle Patton; Igor Zakharevich; Robert B Gunier; Kendra Klein Journal: Environ Res Date: 2019-02-12 Impact factor: 6.498
Authors: Shile B Dayton; Dale P Sandler; Aaron Blair; Michael Alavanja; Laura E Beane Freeman; Jane A Hoppin Journal: J Occup Environ Med Date: 2010-07 Impact factor: 2.162
Authors: Y H Chiu; M C Afeiche; A J Gaskins; P L Williams; J C Petrozza; C Tanrikut; R Hauser; J E Chavarro Journal: Hum Reprod Date: 2015-03-30 Impact factor: 6.918
Authors: Cynthia L Curl; Jessica Porter; Ian Penwell; Rachel Phinney; Maria Ospina; Antonia M Calafat Journal: Environ Int Date: 2019-07-16 Impact factor: 9.621
Authors: Aaron Blair; Dale P Sandler; Robert Tarone; Jay Lubin; Kent Thomas; Jane A Hoppin; Claudine Samanic; Joseph Coble; Freya Kamel; Charles Knott; Mustafa Dosemeci; Shelia Hoar Zahm; Charles F Lynch; Nathaniel Rothman; Michael C R Alavanja Journal: Ann Epidemiol Date: 2005-04 Impact factor: 3.797
Authors: David J Cote; Alaina M Bever; Yu-Han Chiu; Helena Sandoval-Insausti; Stephanie A Smith-Warner; Jorge E Chavarro; Meir J Stampfer Journal: Am J Epidemiol Date: 2022-03-24 Impact factor: 5.363
Authors: Helena Sandoval-Insausti; Yu-Han Chiu; Yi-Xin Wang; Jaime E Hart; Shilpa N Bhupathiraju; Lidia Mínguez-Alarcón; Ming Ding; Walter C Willett; Francine Laden; Jorge E Chavarro Journal: Environ Int Date: 2021-12-08 Impact factor: 9.621
Authors: Helena Sandoval-Insausti; Yu-Han Chiu; Dong Hoon Lee; Siwen Wang; Jaime E Hart; Lidia Mínguez-Alarcón; Francine Laden; Andres V Ardisson Korat; Brenda Birmann; A Heather Eliassen; Walter C Willett; Jorge E Chavarro Journal: Environ Int Date: 2021-07-10 Impact factor: 9.621