Role of fruits and vegetables in adolescent cardiovascular health: a systematic review

Context: Levels of fruit and vegetable consumption are low among adolescents, and the possible effect of this on cardiovascular health in this age group is undefined. Objective: The aim of this systematic review was to investigate the potential role of fruit and vegetable consumption in adolescent cardiovascular health. Data Sources: Six electronic databases (BioMed Central, MEDLINE, Web of Science, CINAHL, Scopus, PsycINFO) were searched from database inception to December 2015. Study Selection: The search strategy used the following sets of descriptors: adolescents; fruits and vegetables; cardiovascular risk indicators; cross-sectional and cohort studies. Data Extraction: Potentially eligible articles were selected independently by 2 reviewers. Results: Eleven articles meeting the inclusion criteria were included (10 cross-sectional, 1 cohort). The main reasons for study exclusion (n = 71) were misclassification of individuals as adolescents, an unspecified outcome that was incongruent with the definitions provided, and assessment of fruits and vegetables as part of a food pattern. Articles evaluated fruit and vegetable intake (separately, together, only vegetables, or with fruit juice) in diverse units, using food frequency questionnaires, 24-hour dietary recalls, and food records. One-third of the studies showed significant inverse associations of fruit and vegetable intake with systolic blood pressure, abdominal obesity, triglycerides, high-density lipoprotein cholesterol, and metabolic syndrome. Conclusions: The associations between fruit and vegetable consumption and indicators of cardiovascular risk in adolescents are inconsistent, likely because of heterogeneity in the methods used to assess and classify consumption and to define cardiovascular risk in adolescents.