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Production of Vegetables and Artichokes Is Associated with Lower Cardiovascular Mortality: An Ecological Study

Author

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  • Alberto Arnedo-Pena

    (Health Sciences Department, Public University Navarra, 31008 Pamplona, Spain
    Epidemiology Division Public Health Center, 12003 Castello de la Plana, Spain
    Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain)

  • Joan Puig-Barberà

    (Vaccines Research Area FISABIO, 46020 Valencia, Spain)

  • Juan Bellido-Blasco

    (Epidemiology Division Public Health Center, 12003 Castello de la Plana, Spain
    Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
    Epidemiology Department, Jaume I University, 12006 Castelló de la Plana, Spain)

  • MªAngeles Romeu-Garcia

    (Epidemiology Division Public Health Center, 12003 Castello de la Plana, Spain)

  • Mª Rosario Pac-Sa

    (Epidemiology Division Public Health Center, 12003 Castello de la Plana, Spain)

  • Francisco Guillen-Grima

    (Health Sciences Department, Public University Navarra, 31008 Pamplona, Spain)

Abstract

Mortality due to cardiovascular disease (CVD), including cerebrovascular disease (CED) and ischaemic heart disease (IHD), was considerably different in eight municipalities of the province of Castellón, Community of Valencia (Spain) during the period of 1991–2011. In addition, these villages showed differences in agricultural practices and production. Since high vegetable consumption has been linked to decreased all-cause, CVD, and CED mortalities, we hypothesized that the diversity in vegetable and artichoke production, used as proxies for their consumption, could be associated with the diversity of mortality rates. In order to test our hypothesis, we estimated the smoothed standardized mortality ratios (SMRs) of CVD, CED, and IHD mortalities and a directed, age-adjusted mortality rate (AMR). We used a multilevel linear regression analysis to account for the ecological nature of our study. After adjustment, the CVD and CED SMRs were inversely associated with vegetable and artichoke production, with a reduction in SMRs for CVD: −0.19 (95% Confidence Interval [CI] −0.31 to −0.07) and −0.42 (95% CI −0.70 to −0.15) per hectare/10 3 inhabitants, respectively. The SMRs for CED also decreased: −0.68 (95% CI −1.61 to −0.19) and −1.47 (95% CI −2.57 to −0.36) per hectare/10 3 inhabitants, respectively. The SMRs for IHD were not associated with vegetal and artichoke production. When the directed AMR was used, CED mortality was consistent with the previous results, whereas the CVD mortality association was lost. Our results indicate that vegetable and artichoke production may act as protective factors of CED and CVD mortalities.

Suggested Citation

  • Alberto Arnedo-Pena & Joan Puig-Barberà & Juan Bellido-Blasco & MªAngeles Romeu-Garcia & Mª Rosario Pac-Sa & Francisco Guillen-Grima, 2020. "Production of Vegetables and Artichokes Is Associated with Lower Cardiovascular Mortality: An Ecological Study," IJERPH, MDPI, vol. 17(18), pages 1-16, September.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:18:p:6583-:d:411326
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    References listed on IDEAS

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    1. Mireya Martínez-García & Magaly Salinas-Ortega & Iván Estrada-Arriaga & Enrique Hernández-Lemus & Rodrigo García-Herrera & Maite Vallejo, 2018. "A systematic approach to analyze the social determinants of cardiovascular disease," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-25, January.
    2. Mark J. Nieuwenhuijsen & Mireia Gascon & David Martinez & Anna Ponjoan & Jordi Blanch & Maria del Mar Garcia-Gil & Rafel Ramos & Maria Foraster & Natalie Mueller & Ana Espinosa & Marta Cirach & Haneen, 2018. "Air Pollution, Noise, Blue Space, and Green Space and Premature Mortality in Barcelona: A Mega Cohort," IJERPH, MDPI, vol. 15(11), pages 1-12, October.
    3. Matome M. Sekhotha & Kotsedi D. Monyeki & Masezi E. Sibuyi, 2016. "Exposure to Agrochemicals and Cardiovascular Disease: A Review," IJERPH, MDPI, vol. 13(2), pages 1-12, February.
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