Open Access

Christian Koeder, Andreas Hahn, Heike Englert

• Background Common carotid intima-media thickness (ccIMT) is an established risk marker for cardiovascular events, including myocardial infarction and stroke, which are of high public health relevance. While a higher fruit intake is generally considered beneficial for cardiovascular health, recent studies have shown that a fruit intake of > 2 portions per day may be harmful. Therefore, we tested if there is an association between categories of fruit intake and mean ccIMT. Methods We conducted an exploratory, non-prespecified, cross-sectional analysis of baseline values of 167 mostly middle-aged participants of a controlled lifestyle intervention, recruited from the general population in rural northwest Germany (male: n = 58; female: n = 109). Fruit intake was classified into low (<1 portion of fruit/day), intermediate (1-2 portions of fruit/day), and high (>2 portions of fruit/day). Mean ccIMT was measured in accordance with the Mannheim consensus. Between-group differences in mean ccIMT were assessed with analysis of covariance. Results Mean age was 57.3 ± 0.7 years (mean ± SEM). Mean fruit intake was 1.6 ± 0.1 portions/day. Average mean ccIMT was 0.679 ± 0.010 mm. There was a significant difference in mean ccIMT between subjects with low (0.676 ± 0.020 mm; n = 50), intermediate (0.653 ± 0.014 mm; n = 72), and high fruit intake (0.724 ± 0.019 mm; n = 45; p = 0.016). But this difference was attenuated when adjusting for age, sex, and homocysteine (p = 0.418). Conclusions We found only a non-significant association between consuming >2 portions of fruit per day and ccIMT. Thus, our study could not confirm a negative effect of fruit intake on ccIMT. Age, sex, and homocysteine may confound this association. Key messages Current recommendations of 2 portions of fruit per day seem adequate and do not negatively influence carotid intima-media thickness. Future studies should address confounding of the association between fruit intake and cardiovascular risk markers.