Quantity and Variety in Fruit and Vegetable Intake and Risk of Coronary Heart Disease

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Introduction
Bhupathiraju et al. conducted a study investigating the relationship between the quantity and variety of fruit and vegetable intake and the risk of developing coronary heart disease (CHD). The study aimed to understand whether consuming a higher amount and type of fruits and vegetables would decrease the risk of CHD (Bhupathiraju et al., 2013). This paper aims to critically evaluate the study design, methodology, statistical analyses, results, and potential policy implications of the study.
Research Question, Study Population, and Study Design
The study population comprised 84,251 female nurses from the Nurses' Health Study (NHS) II cohort. The study was conducted over a period of 14 years from 1991 to 2005. The research question was whether the quantity and variety of fruit and vegetable intake are inversely associated with the risk of developing CHD (Bhupathiraju et al., 2013). The study design was a prospective cohort study appropriate for addressing this research question. The cohort study design allowed the researchers to observe the relationship between the exposure (fruit and vegetable intake) and the outcome (CHD) over time.
Dietary Assessment Method
The dietary assessment method used in this study was a food frequency questionnaire (FFQ). The FFQ was completed by the participants every four years during the study period. The participants were asked about their consumption of fruits and vegetables, among other dietary factors, over the previous year. While FFQ is a commonly used dietary assessment method, it has limitations, such as recall bias and imprecision (Bhupathiraju et al., 2013). However, the researchers used a validated FFQ, an appropriate method for this study as it can measure dietary intake over a long period.
Main Dietary Exposure(s) and Outcome
The primary dietary exposures in thi...