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Rapid response to:

Research

Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g4490 (Published 29 July 2014) Cite this as: BMJ 2014;349:g4490

Rapid Response:

I have read the response from Dr Wei Bao et al. about the publication on fruit and vegetable intake and mortality. However, two questions were not addressed.

Firat, the authors emphasized the linear dose-response association in their orginal publication but simply described the non-linear assocaiton in both the Abstract and Results section. In my opinion, it was wrong and the results on the linear dose-response association should be deleted as there was evidence of curvilinear associations between fruit and vegetable combined or alone and all cause, cardiovascular, and cancer mortality (all P less than 0.05 for non-linearity). However, in their response, the authors still stick with the results on linear dose-response association.

Second, the marginal association (the upper limit of confidence interval for hazard ratios ranged from 0.98 to 0.99, approximately equal to 1. ) might be due to confounding factors or residual error. However, the authors did not mention this point in their response.

References
1. Authors' reply on the systematic review and does-response meta-analysis of fruit and vegetable consumption in relation to mortality.http://www.bmj.com/content/349/bmj.g4490/rr/762968

Competing interests: No competing interests

21 August 2014
Chibo Liu
Doctor
Department of Clinical Laboratory, Taizhou Municipal Hospital
381 Zhongshandong Road