***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background It is estimated that disease burden due to low fruit and vegetable consumption is higher in Central and Eastern Europe ( CEE ) and the former Soviet Union ( FSU ) than any other parts of the world . However , no large scale studies have investigated the association between fruit and vegetable ( F&V ) intake and mortality in these regions yet . Design The Health , Alcohol and Psychosocial Factors in Eastern Europe ( HAPIEE ) study is a prospect i ve cohort study with participants recruited from the Czech Republic , Pol and and Russia . Methods  Dietary data was collected using food frequency question naire .  Mortality data was ascertained through linkage with death registers . Multivariable adjusted hazard ratios were calculated by Cox regression models . Results Among 19,333 disease-free participants at baseline , 1314 died over the mean follow-up of 7.1 years . After multivariable adjustment , we found statistically significant inverse association between cohort-specific quartiles of F&V intake and stroke mortality : the highest vs lowest quartile hazard ratio ( HR ) was 0.52 ( 95 % confidence interval ( CI ) : 0.28–0.98 ) . For total mortality , significant interaction ( p = 0.008 ) between F&V intake and smoking was found . The associations were statistically significant in smokers , with HR 0.70 ( 0.53–0.91 , p for trend : 0.011 ) for total mortality , and 0.62 ( 0.40–0.97 , p for trend : 0.037 ) for cardiovascular disease ( CVD ) mortality . The association was appeared to be mediated by blood pressure , and F&V intake explained a considerable proportion of the mortality differences between the Czech and Russian cohorts . Conclusions Our results suggest that increasing F&V intake may reduce CVD mortality in CEE and FSU , particularly among smokers and hypertensive individuals BACKGROUND Red meat consumption has been associated with an increased risk of chronic diseases . However , its relationship with mortality remains uncertain . METHODS We prospect ively observed 37 698 men from the Health Professionals Follow-up Study ( 1986 - 2008 ) and 83 644 women from the Nurses ' Health Study ( 1980 - 2008 ) who were free of cardiovascular disease ( CVD ) and cancer at baseline .  Diet was assessed by vali date d food frequency question naires and up date d every 4 years . RESULTS We documented 23 926 deaths ( including 5910 CVD and 9464 cancer deaths ) during 2.96 million person-years of follow-up . After multivariate adjustment for major lifestyle and dietary risk factors , the pooled hazard ratio ( HR ) ( 95 % CI ) of total mortality for a 1-serving-per-day increase was 1.13 ( 1.07 - 1.20 ) for unprocessed red meat and 1.20 ( 1.15 - 1.24 ) for processed red meat . The corresponding HRs ( 95 % CIs ) were 1.18 ( 1.13 - 1.23 ) and 1.21 ( 1.13 - 1.31 ) for CVD mortality and 1.10 ( 1.06 - 1.14 ) and 1.16 ( 1.09 - 1.23 ) for cancer mortality . We estimated that substitutions of 1 serving per day of other foods ( including fish , poultry , nuts , legumes , low-fat dairy , and whole grains ) for 1 serving per day of red meat were associated with a 7 % to 19 % lower mortality risk . We also estimated that 9.3 % of deaths in men and 7.6 % in women in these cohorts could be prevented at the end of follow-up if all the individuals consumed fewer than 0.5 servings per day ( approximately 42 g/d ) of red meat . CONCLUSIONS Red meat consumption is associated with an increased risk of total , CVD , and cancer mortality . Substitution of other healthy protein sources for red meat is associated with a lower mortality risk Despite a proposed protective effect of fish intake on the risk of cardiovascular disease , epidemiologic evidence on fish intake and mortality is inconsistent . We investigated associations of fish intake , assessed through a vali date d food frequency question naire , with risks of total and cause-specific mortality in 2 prospect i ve cohort studies of 134,296 Chinese men and women ( 1997 - 2009 ) . Vital status and date and cause of death were ascertained through annual linkage to the Shanghai Vital Statistics Registry data base and biennial home visits . Cox regression was used to calculate hazard ratios and corresponding 95 % confidence intervals . After excluding the first year of observation , the analysis included 3,666 deaths among women and 2,170 deaths among men .  Fish intake was inversely associated with risks of total , ischemic stroke , and diabetes mortality ; the corresponding hazard ratios for the highest quintiles of intake compared with the lowest were 0.84 ( 95 % confidence interval ( CI ) : 0.76 , 0.92 ) , 0.63 ( 95 % CI : 0.41 , 0.94 ) , and 0.61 ( 95 % CI : 0.39 , 0.95 ) , respectively . No associations with cancer or ischemic heart disease mortality were observed . Further analyses suggested that the inverse associations with total , ischemic stroke , and diabetes mortality were primarily related to consumption of saltwater fish and intake of long-chain n-3 fatty acids . Overall , our findings support the postulated health benefits of fish consumption In the last 20 years , many prospect i ve cohort studies have assessed the relationships between food consumption and mortality . Result interpretation is mainly hindered by the limited adjustment for confounders and , to a lesser extent , the small sample sizes . The aim of this study was to investigate the association between  dietary habits and all-cause mortality in a multicentre prospect i ve cohort that included non-institutionalised , community-based elderly individuals ( Three-City Study ) . A brief FFQ was administered at baseline . Hazard ratios ( HR ) and 95 % CI for all-cause mortality were estimated relative to the consumption frequency of several food groups , using Cox proportional hazards models adjusted for sex , centre , socio-demographic characteristics and health status indicators . Among the 8937 participants ( mean age : 74·2 years , 60·7 % women ) , 2016 deaths were recorded during an average follow-up of 9 years . The risk of death was significantly lower among subjects with the highest fruit and vegetable consumption ( HR 0·90 ; 95 % CI 0·82 , 0·99 , P=0·03 ) and with regular fish consumption ( HR 0·89 ; 95 % CI 0·81 , 0·97 , P=0·01 ) . The benefit of olive oil use was found only in women ( moderate olive oil use : HR 0·80 ; 95 % CI 0·68 , 0·94 , P=0·007 ; intensive use : HR 0·72 ; 95 % CI 0·60 , 0·85 , P=0·0002 ) . Conversely , daily meat consumption increased the mortality risk ( HR 1·12 ; 95 % CI , 1·01 , 1·24 , P=0·03 ) . No association was found between risk of death and diet diversity and use of various fats . These findings suggest that fruits/vegetables , olive oil and regular fish consumptions have a beneficial effect on the risk of death , independently of the socio-demographic features and the number of medical conditions Background A healthy diet , as defined by the US Dietary Guidelines for Americans ( DGA ) , has been associated with lower morbidity and mortality from major chronic diseases in studies conducted in predominantly non-Hispanic white individuals . It is unknown whether this association can be extrapolated to African-Americans and low-income population s. Methods and Findings We examined the associations of adherence to the DGA with total and cause-specific mortality in the Southern Community Cohort Study , a prospect i ve study that recruited 84,735 American adults , aged 40–79 y , from 12 southeastern US states during 2002–2009 , mostly through community health centers that serve low-income population s. The present analysis included 50,434 African-Americans , 24,054 white individuals , and 3,084 individuals of other racial/ethnic groups , among whom 42,759 participants had an annual household income less than US$ 15,000 .  Usual dietary intakes were assessed using a vali date d food frequency question naire at baseline . Adherence to the DGA was measured by the  Healthy Eating Index ( HEI ) , 2010 and 2005 editions ( HEI-2010 and HEI-2005 , respectively ) . During a mean follow-up of 6.2 y , 6,906 deaths were identified , including 2,244 from cardiovascular disease , 1,794 from cancer , and 2,550 from other diseases . A higher HEI-2010 score was associated with lower risks of disease death , with adjusted hazard ratios ( HRs ) of 0.80 ( 95 % CI , 0.73–0.86 ) for all-disease mortality , 0.81 ( 95 % CI , 0.70–0.94 ) for cardiovascular disease mortality , 0.81 ( 95 % CI , 0.69–0.95 ) for cancer mortality , and 0.77 ( 95 % CI , 0.67–0.88 ) for other disease mortality , when comparing the highest quintile with the lowest ( all p-values for trend < 0.05 ) . Similar inverse associations between HEI-2010 score and mortality were observed regardless of sex , race , and income ( all p-values for interaction > 0.50 ) . Several component scores in the HEI-2010 , including whole grains , dairy , seafood and plant proteins , and ratio of unsaturated to saturated fatty acids , showed significant inverse associations with total mortality . HEI-2005 score was also associated with lower disease mortality , with a HR of 0.86 ( 95 % CI , 0.79–0.93 ) when comparing extreme quintiles . Given the observational study design , however , residual confounding can not be completely ruled out . In addition , future studies are needed to evaluate the generalizability of these findings to African-Americans of other socioeconomic status . Conclusions Our results showed , to our knowledge for the first time , that adherence to the DGA was associated with lower total and cause-specific mortality in a low-income population , including a large proportion of African-Americans , living in the southeastern US BACKGROUND Because egg yolk has a high cholesterol concentration , limited egg consumption is often suggested to help prevent ischemic heart disease ( IHD ) . OBJECTIVE We epidemiologically examined the validity of this recommendation . DESIGN We analyzed the relations of egg consumption to serum cholesterol and cause-specific and all-cause mortality by using the NIPPON DATA 80 ( National Integrated Project for Prospect i ve Observation of Non-communicable Disease And its Trends in the Aged , 1980 ) data base . At the baseline examination in 1980 , a nutritional survey was performed by using the food-frequency method in Japanese subjects aged > or = 30 y. We followed 5186 women and 4077 men for 14 y. RESULTS The subjects were categorized into 5 egg consumption groups on the basis of their responses to a question naire ( > or = 2/d , 1/d , 1/2 d , 1 - 2/wk , and seldom ) . There were 69 , 1396 , 1667 , 1742 , and 315 women in each of the 5 groups , respectively . Age-adjusted total cholesterol ( 5.21 , 5.04 , 4.95 , 4.91 , and 4.92 mmol/L in the 5 egg consumption categories , respectively ) was related to egg consumption ( P < 0.0001 , analysis of covariance ) . In women , unadjusted IHD mortality and all-cause mortality differed significantly between the groups [ IHD mortality : 1.1 , 0.5 , 0.4 , 0.5 , and 2.0 per 1000 person-years , respectively ( P = 0.008 , chi-square test ) ; all-cause mortality : 14.8 , 8.0 , 7.5 , 7.5 , and 14.5 per 1000 person-years , respectively ( P < 0.0001 , chi-square test ) ] . In men , egg consumption was not related to age-adjusted total cholesterol . Cox analysis found that , in women , all-cause mortality in the 1 - 2-eggs/wk group was significantly lower than that in the 1-egg/d group , whereas no such relations were noted in men . CONCLUSION Limiting egg consumption may have some health benefits , at least in women in geographic areas where egg consumption makes a relatively large contribution to total dietary cholesterol intake BACKGROUND Prospect i ve studies suggested that substituting whole-grain products for refined-grain products lowers the risks of type 2 diabetes and cardiovascular disease ( CVD 
    Output:
    
A clear indication of nonlinearity was seen for the relations between vegetables , fruits , nuts , and dairy and all-cause mortality .
Optimal consumption of risk-decreasing foods results in a 56 % reduction of all-cause mortality , whereas consumption of risk-increasing foods is associated with a 2-fold increased risk of all-cause mortality .
Conclusion : Selecting specific optimal intakes of the investigated food groups can lead to a considerable change in the risk of premature death