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Divisions of Preventive Medicine and Aging, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School (H.D.S., J.M.G., J.E.B)
Department of Ambulatory Care and Prevention, Harvard Medical School (J.E.B)
Department of Epidemiology, Harvard School of Public Health (H.D.S., J.E.B.), Boston, MA
Clinical Nutrition and Risk Factor Modification Center, St Michael’s Hospital (D.J.A.J.), Toronto, Ontario, CANADA
Address reprint requests to: Howard D. Sesso, ScD, Brigham and Women’s Hospital, 900 Commonwealth Avenue East, Boston MA 02215-1204. E-mail: hsesso{at}hsph.harvard.edu
Objective: There is indirect evidence suggesting that strawberries, containing several key nutrients, may be associated with the risk of cardiovascular disease (CVD). In the Women’s Health Study, we examined strawberry intake for both its prospective association with CVD risk in 38,176 women and its cross-sectional association with lipids and C-reactive protein (CRP) in a subset of 26,966 women.
Methods: Strawberry intake was assessed from a baseline semiquantitative food frequency questionnaire, along with other self-reported lifestyle, clinical and dietary factors. Participants returned baseline bloods which were assayed for lipids and CRP. We computed the relative risks (RRs) for total CVD (1,004 cases) (including confirmed myocardial infarction, stroke, revascularization, and cardiovascular death) occurring during 10.9 years of follow-up.
Results: At baseline, 25.6%, 41.9%, 24.8%, and 7.7% of women reported corresponding strawberry intake of none, 1–3 servings/month, 1 serving/week, and 
2 servings/week. For total CVD, the multivariate RRs (95% confidence intervals) for increasing categories of strawberry intake were 1.00 (ref), 1.01 (0.85–1.19), 0.95 (0.77–1.17), and 1.27 (0.94–1.72) (P, trend = 0.06). We found a similar lack of an association for individual cardiovascular endpoints and comparing mean levels of lipids and CRP by category of strawberry intake. However, women consuming 2 servings/week versus none had a borderline significant, multivariate 14% lower likelihood of an elevated CRP of 3 mg/L.
Conclusions: Strawberry intake was unassociated with the risk of incident CVD, lipids, or CRP in middle-aged and older women, though higher strawberry intake may slightly reduce the likelihood of having elevated CRP levels. Additional epidemiologic data are needed to clarify any role of strawberries in CVD prevention.
Key words: strawberries, cardiovascular disease, lipids, inflammation, cohort
Abbreviations: BMI = body mass index • CI = confidence interval • CVD = cardiovascular disease • HDL = high-density lipoprotein • LDL = low-density lipoprotein • MI = myocardial infarction • RR = relative risk • SFFQ = semiquantitative food frequency questionnaire • TC = total cholesterol • US = United States • WHS = Women’s Health Study
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