Fruit and Vegetable Intake, Physical Activity, and Mortality in Older Community-Dwelling Women

Authors

  • Emily J. Nicklett PhD, MSW,

    Corresponding author
    • School of Social Work, University of Michigan, Ann Arbor, Michigan
    Search for more papers by this author
  • Richard D. Semba MD, MPH,

    1. Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
    Search for more papers by this author
  • Qian-Li Xue PhD,

    1. Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
    2. Division of Geriatric Medicine and Gerontology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
    Search for more papers by this author
  • Jing Tian MS,

    1. Department of Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
    Search for more papers by this author
  • Kai Sun PhD, MS,

    1. Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
    Search for more papers by this author
  • Anne R. Cappola MD, ScM,

    1. Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
    Search for more papers by this author
  • Eleanor M. Simonsick PhD,

    1. Division of Geriatric Medicine and Gerontology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
    2. Intramural Research Program, National Institute on Aging, Bethesda, Maryland
    Search for more papers by this author
  • Luigi Ferrucci MD, PhD,

    1. Division of Geriatric Medicine and Gerontology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
    2. Intramural Research Program, National Institute on Aging, Bethesda, Maryland
    Search for more papers by this author
  • Linda P. Fried MD, MPH

    1. Mailman School of Public Health, College of Physicians and Surgeons, Columbia University, New York, New York
    2. Division of Epidemiology, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York
    Search for more papers by this author

Address corresponding to Emily J. Nicklett, University of Michigan School of Social Work, 1080 S. University Avenue, Rm. 2773, Ann Arbor, MI 48109. E-mail: enicklet@umich.edu

Abstract

Objectives

To examine the relationship between fruit and vegetable intake, physical activity, and all-cause mortality in older women.

Design

Six Cox proportional hazards models examined independent and additive relationships between physical activity, carotenoids, and all-cause mortality. Additional models tested whether physical activity and carotenoids were conjointly related to mortality. Models were adjusted for age, education, and race and ethnicity.

Setting

Baltimore, Maryland.

Participants

Seven hundred thirteen women aged 70 to 79 participating in the Women's Health and Aging Studies.

Measurements

Total serum carotenoids, a marker of fruit and vegetable intake, and physical activity were measured at baseline. Physical activity was measured according to kilocalorie expenditure.

Results

During 5 years of follow-up, 82 (11.5%) participants died. Measured continuously, physical activity improved survival (HR = 0.52, 95% CI = 0.41–0.66, P < .001). The most active women were more likely to survive than the least physically active women (HR = 0.28, 95% CI = 0.13–0.59, P < .001). Continuous measures of carotenoids improved survival (HR = 0.67, 95% CI = 0.51–0.89, P = .01). Women in the highest tertile of total carotenoids were more likely to survive those in the lowest (HR = 0.50, 95% CI = 0.27–0.91, P = .03). When examined in the same model, continuous measures of physical activity (HR = 0.54, 95% CI = 0.42–0.68, P < .001) and carotenoids (HR = 0.76, 95% CI = 0.59–0.98, P = .04) predicted survival during follow-up.

Conclusion

The combination of low total serum carotenoids and low physical activity, both modifiable risk factors, strongly predicted earlier mortality. These findings provide preliminary support that higher fruit and vegetable intake and exercise improve survival.

Ancillary