Production of vegetables and artichokes is associated with lower cardiovascular mortality: an ecological study

dc.contributor.authorArnedo Pena, Alberto
dc.contributor.authorPuig Barberà, Joan
dc.contributor.authorBellido Blasco, Juan
dc.contributor.authorRomeu García, María Ángeles
dc.contributor.authorGuillén Grima, Francisco
dc.contributor.departmentCiencias de la Saludes_ES
dc.contributor.departmentOsasun Zientziakeu
dc.date.accessioned2021-02-02T09:41:10Z
dc.date.available2021-02-02T09:41:10Z
dc.date.issued2020
dc.description.abstractMortality 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/103 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/103 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.en
dc.format.extent16 p.
dc.format.mimetypeapplication/pdfen
dc.identifier.doi10.3390/ijerph17186583
dc.identifier.issn1660-4601 (Electronic)
dc.identifier.urihttps://academica-e.unavarra.es/handle/2454/39130
dc.language.isoengen
dc.publisherMDPIen
dc.relation.ispartofInternational Journal of Environmental Research and Public Health, 2020, 17(18), 6583en
dc.relation.publisherversionhttps://doi.org/10.3390/ijerph17186583
dc.rights© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.en
dc.rights.accessRightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectMortalityen
dc.subjectCardiovascularen
dc.subjectCerebrovascularen
dc.subjectVegetablesen
dc.subjectArtichokesen
dc.subjectAgricultureen
dc.subjectMunicipalitiesen
dc.subjectMultilevelen
dc.subjectEcologyen
dc.titleProduction of vegetables and artichokes is associated with lower cardiovascular mortality: an ecological studyen
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dspace.entity.typePublication
relation.isAuthorOfPublicationdfbf180f-dd66-42b9-ba45-2de0b3a334d5
relation.isAuthorOfPublication.latestForDiscoverydfbf180f-dd66-42b9-ba45-2de0b3a334d5

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