Eating an apple a day is uncommon in China, but people who do eat fresh fruit regularly may see a significant drop in their risk of heart disease, researchers said Wednesday.
Similar studies have been done on Western populations, but rarely have researchers examined how eating fruit affects heart health in China, where diet and disease patterns are quite different than in the West.
The study in the New England Journal of Medicine enrolled nearly half a million healthy adults in China and followed them for seven years. Those who ate fresh fruit daily -- such as apples, pears or oranges -- had a 40 percent lower risk of cardiovascular death and a 34 percent lower risk of major coronary events such as heart attack and stroke than those who rarely or never consumed fresh fruit.
Fruit is known to contain potassium, fiber and antioxidants that can lower both blood pressure and blood sugar.
Researchers found that the impact of fruit-eating in China -- where some 230 million people suffer from cardiovascular diseases such as high blood pressure, stroke and heart failure -- was even more beneficial than seen in previous studies in Western populations.
For instance, a recent meta-analysis of six studies involving nearly 680,000 people in the West found that each additional serving of fruit per day "was associated with a five percent lower risk of cardiovascular death, which is not good evidence of a real protective effect," said the study.
Only 18 percent of those surveyed in China said they ate raw fruit on a daily basis.
"The association between fruit consumption and cardiovascular risk seems to be stronger in China, where many still eat little fruit, than in high-income countries where daily consumption of fruit is more common," said study author Huaidong Du, a researcher at the University of Oxford.
The study enrolled people aged 35 to 74 in 10 urban and rural locations across China. Those accepted had no history of cardiovascular disease or high blood pressure.
The study did not examine which kind of fruit people ate, though the most common fruits in China are apples, pears and oranges. Nor were researchers able to determine if fruit was truly causing the beneficial effects against heart disease and stroke.
Nearly all (95 percent) of those in the study reported eating fresh vegetables daily.
"It's difficult to know whether the lower risk in people who eat more fresh fruit is because of a real protective effect," said senior author Zhengming Chen, a professor at the University of Oxford.
"If it is, then widespread consumption of fresh fruit in China could prevent about half a million cardiovascular deaths a year, including 200,000 before age 70, and even larger numbers of non-fatal strokes and heart attacks."
