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Rapid response to:


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: (Published 29 July 2014) Cite this as: BMJ 2014;349:g4490

Rapid Response:

To the editor,

Although Dr Bao Wei et al. answered some of my questions (1), I still have concerns.

First, although the authors explained the reasons why three studies (2-4) we mentioned were excluded, it is still unclear why many studies on the relationship between fruit or vegetable intake and specific cancer mortality were finally excluded.

Second, as there was publication bias for their results, I still question whether the trim and fill method used by the authors can address the publication bias simply from a statistical perspective.


1. Authors' reply on the systematic review and does-response meta-analysis of fruit and vegetable consumption in relation to mortality.
2. Mann JI, Appleby PN, Key TJ, Thorogood M. Dietary determinants of ischaemic heart disease in health conscious individuals. Heart. 1997;78:450-5.
3. Ness AR, Maynard M, Frankel S, Smith GD, Frobisher C, Leary SD, Emmett PM, Gunnell D. Diet in childhood and adult cardiovascular and all cause mortality: The boyd orr cohort. Heart. 2005;91:894-8.
4. Lo YT, Chang YH, Wahlqvist ML, Huang HB, Lee MS. Spending on vegetable and fruit consumption could reduce all-cause mortality among older adults. Nutr J. 2012;11:113.

Competing interests: No competing interests

21 August 2014
Zhihao Liu
Jiangsu Centers for Disease Control and Prevention
No. 172 Jiangsu Road