@article{saglimbene_fruit_2019,
	abstract = {Background and objectives 
              Higher fruit and vegetable intake is associated with lower cardiovascular and all-cause mortality in the general population. It is unclear whether this association occurs in patients on hemodialysis, in whom high fruit and vegetable intake is generally discouraged because of a potential risk of hyperkalemia. We aimed to evaluate the association between fruit and vegetable intake and mortality in hemodialysis. 
             
             
              Design, setting, participants, \& measurements 
              Fruit and vegetable intake was ascertained by the Global Allergy and Asthma European Network food frequency questionnaire within the Dietary Intake, Death and Hospitalization in Adults with ESKD Treated with Hemodialysis study, a multinational cohort study of 9757 adults on hemodialysis, of whom 8078 (83\%) had analyzable dietary data. Adjusted Cox regression analyses clustered by country were conducted to evaluate the association between tertiles of fruit and vegetable intake with all-cause, cardiovascular, and noncardiovascular mortality. Estimates were calculated as hazard ratios with 95\% confidence intervals (95\% CIs). 
             
             
              Results 
              During a median follow up of 2.7 years (18,586 person-years), there were 2082 deaths (954 cardiovascular). The median (interquartile range) number of servings of fruit and vegetables was 8 (4--14) per week; only 4\% of the study population consumed at least four servings per day as recommended in the general population. Compared with the lowest tertile of servings per week (0--5.5, median 2), the adjusted hazard ratios for the middle (5.6--10, median 8) and highest ({\textgreater}10, median 17) tertiles were 0.90 (95\% CI, 0.81 to 1.00) and 0.80 (95\% CI, 0.71 to 0.91) for all-cause mortality, 0.88 (95\% CI, 0.76 to 1.02) and 0.77 (95\% CI, 0.66 to 0.91) for noncardiovascular mortality and 0.95 (95\% CI, 0.81 to 1.11) and 0.84 (95\% CI, 0.70 to 1.00) for cardiovascular mortality, respectively. 
             
             
              Conclusions 
              Fruit and vegetable intake in the hemodialysis population is low and a higher consumption is associated with lower all-cause and noncardiovascular death.},
	author = {Saglimbene, Valeria M. and Wong, Germaine and Ruospo, Marinella and Palmer, Suetonia C. and Garcia-Larsen, Vanessa and Natale, Patrizia and Teixeira-Pinto, Armando and Campbell, Katrina L. and Carrero, Juan-Jesus and Stenvinkel, Peter and Gargano, Letizia and Murgo, Angelo M. and Johnson, David W. and Tonelli, Marcello and Gelfman, Rub{\'e}n and Celia, Eduardo and Ecder, Tevfik and Bernat, Amparo G. and Del Castillo, Domingo and Timofte, Delia and T{\"o}r{\"o}k, Marietta and Bednarek-Skublewska, Anna and Du{\l}awa, Jan and Stroumza, Paul and Hoischen, Susanne and Hansis, Martin and Fabricius, Elisabeth and Felaco, Paolo and Wollheim, Charlotta and Hegbrant, J{\"o}rgen and Craig, Jonathan C. and Strippoli, Giovanni F.M.},
	date-added = {2023-07-24 21:18:22 +0100},
	date-modified = {2023-07-24 21:19:25 +0100},
	doi = {10.2215/CJN.08580718},
	issn = {1555-9041, 1555-905X},
	journal = {Clinical Journal of the American Society of Nephrology},
	keywords = {Fruits, Vegetables, Mortality},
	language = {en},
	month = feb,
	number = {2},
	pages = {250--260},
	title = {Fruit and {Vegetable} {Intake} and {Mortality} in {Adults} undergoing {Maintenance} {Hemodialysis}},
	url = {https://journals.lww.com/01277230-201902000-00014},
	urldate = {2023-07-24},
	volume = {14},
	year = {2019},
	bdsk-url-1 = {https://journals.lww.com/01277230-201902000-00014},
	bdsk-url-2 = {https://doi.org/10.2215/CJN.08580718}}