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. 2022 Jan 15:159:107024.
doi: 10.1016/j.envint.2021.107024. Epub 2021 Dec 8.

Intake of fruits and vegetables according to pesticide residue status in relation to all-cause and disease-specific mortality: Results from three prospective cohort studies

Helena Sandoval-Insausti  1 , Yu-Han Chiu  2 , Yi-Xin Wang  3 , Jaime E Hart  4 , Shilpa N Bhupathiraju  5 , Lidia Mínguez-Alarcón  6 , Ming Ding  3 , Walter C Willett  7 , Francine Laden  8 , Jorge E Chavarro  9
Affiliations

Intake of fruits and vegetables according to pesticide residue status in relation to all-cause and disease-specific mortality: Results from three prospective cohort studies

Helena Sandoval-Insausti et al. Environ Int. .

Abstract

Background: Intake of conventionally grown fruits and vegetables (FVs) is an important route of exposure to pesticide residues in the general population. However, whether health risk stemming from exposure to pesticides through diet could offset benefits of consuming FVs is unclear.

Objective: We assessed the association of FV intake, classified according to their pesticide residue status, with total and cause-specific mortality.

Methods: We followed 137,378 women (NHS, 1998-2019, and NHSII, 1999-2019) and 23,502 men (HPFS, 1998-2020) without cardiovascular disease, cancer, or diabetes at baseline. FV intake was assessed using validated food frequency questionnaires and categorized as having high- or low-pesticide-residues using data from the USDA Pesticide Data Program. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) for total and cause-specific mortality associated with high- and low-pesticide-residue FV intake.

Results: A total of 27,026 deaths, including 4,318 from CVD and 6,426 from cancer, were documented during 3,081,360 person-years of follow-up. In multivariable-adjusted analyses, participants who consumed ≥4 servings/day of low-pesticide-residue FVs had 36% (95% CI: 32%-41%) lower mortality risk compared to participants who consumed <1 serving/day. The corresponding estimate for high-pesticide residue FV intake was 0.93 (95% CI: 0.81-1.07). This pattern was similar across the three most frequent causes of death (cardiovascular disease, cancer and respiratory diseases).

Conclusions: High-pesticide-residue FV intake was unrelated whereas low-pesticide residue FV intake was inversely related to all-cause mortality, suggesting that exposure to pesticide residues through diet may offset the beneficial effect of FV intake on mortality.

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Conflict of interest statement

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1.
Fig. 1.
Fruit and vegetable intake, considering pesticide residue status, and total mortality (panels A and B), CVD mortality (panels C and D), cancer mortality (panels E and F), and respiratory mortality (panels G and H). Adjusted for age, body mass index (quintiles), ethnicity (white/non-white), physical activity (quintiles), family history of cancer (yes/no), family history of cardiovascular disease (yes/no), smoking in package-years (never smoker, 1–4.9, 5–19.9, 20–39.9, or ≥ 40), postmenopausal hormone use (premenopausal/never/past/current, in NHS and NHSII), baseline hypertension (yes/no), baseline hypercholesterolemia (yes/no), total energy intake (quintiles), alcohol intake (0, 0.1–4.9, 5.0–14.9, 15.0–29.9, or ≥ 30 g/day), and Alternate Healthy Eating Index score excluding criteria for intake of fruits and vegetables and alcohol (quintiles). Panels A,C,E,G are additionally adjusted for intakes of low-pesticide-residue fruits and vegetables (servings/day) and other fruits and vegetables with undetermined residues(servings/day). Panels B,D,F,H are additionally adjusted for intakes of high-pesticide-residue fruits and vegetables (servings/day) and other fruits and vegetables with undetermined residues(servings/day).
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