Relationship Between Fruit Intake And Abdominal Aortic Calcification In A Random Sample Of U.S. Adults

Abdominal aortic calcification (AAC) has been established as a strong predictor of cardiovascular disease. It can be identified accurately on lateral spine images through dual-energy X-ray absorptiometry (DXA). PURPOSE: The aim of the present study was to determine the extent to which total fruit consumption was associated with AAC in U.S. men and women. METHODS: A total of 2,298 randomly selected adults aged ≥40 years from the National Health and Nutrition Examination Survey (NHANES) were included. AAC was measured by NHANES during the years 2013-2014. AAC was measured by DXA and the Instant Vertebral Assessment in vertebrae’s L1-L4. The scans and assessments were conducted in the NHANES mobile examination center. The AAC results were categorized into three groups: None, Some, and Severe. Fruit intake was defined as the average intake of all sources of fruit, excluding fruit juice, from 2 non-consecutive 24-hour recall surveys. Fruit intake was then indexed as the percentage of total energy derived from fruit (fruit%). The following variables were controlled statistically: age, sex, race, body mass index (BMI), total minutes of moderate to vigorous physical activity per day (MVPA), smoking (current smoker, past smoker, never smoker), alcohol use (non-drinker, moderate drinker, heavy drinker), and average energy intake (mean energy intake based on two 24 hr recall assessments). RESULTS: The median age, MVPA, fruit%, and energy intake were 54.5 years, 17.6 minutes, 4.4%, and 8,192 total kilojoules (1958 total kcals), respectively. Prevalence (±SE) of adults ≥40 years with no AAC was 75.4% ± 1.4%, some AAC 9.7% ± 1.0%, or severe AAC 14.9% ± 1.4%. The relationship between fruit% and AAC was significant (F = 6.1, P = 0.0114) with all the covariates controlled statistically. Specifically, adults with no AAC had a mean (± SE) fruit intake of 10.3 ± 1.4% of total energy. Adults with some AAC derived 10.5 ± 1.8% of their energy from fruit, and those with severe AAC consumed only 7.7 ± 1.5% of their total energy from fruit. The fruit% difference between adults with no AAC and those with severe AAC was significantly different (P = 0.0032). The other differences were not statistically significant. CONCLUSION: The average percentage of total energy derived from fruit in U.S. adults ≥40 years old appears to be a significant predictor of AAC.