Abstract
BACKGROUND: Tomatoes have full of nutritional value as well as antioxidant, anti-inflammatory, and anticancer properties. It contains substances such as lycopene and micronutrients that are beneficial to human health. Tomato consumption has been associated with reduced mortality, but the role of seasonal intake is not well understood. To address this gap, we investigated the association between in-season and off-season tomato consumption and all-cause as well as cardio-cerebrovascular mortality. METHODS: This prospective study enrolled 6,260 adults from the National Health and Nutrition Examination Survey (NHANES). The endpoint events were all-cause and cardio-cerebrovascular mortality within 10 years. Cox proportional hazards analyses and competing risk modeling were employed to evaluate the influences of total and seasonal tomato consumption. Further studies were conducted on the relationship between lycopene intake and all-cause and cardio-cerebrovascular mortality over 10 years. RESULTS: Fresh tomato consumption was significantly associated with lower all-cause mortality (hazard ratio [HR] = 0.63, 95% confidence interval [CI]: 0.45-0.87, P = 0.005). Moderate in-season consumption (once a week to once a day) was linked to a further reduction in all-cause mortality (HR = 0.48, 95% CI: 0.24-0.95, P = 0.034). Conversely, off-season consumption was associated with decreased cardio-cerebrovascular mortality (subhazard ratio [SHE] = 0.43, 95%CI: 0.23-0.79, P = 0.006). Moderate ketchup intake (< 1 time/day) lowered both all-cause and cardio-cerebrovascular mortality, whereas tomato juice conferred no significant survival benefit, and higher daily consumption may negate potential advantages. Elevated total and trans lycopene concentrations were also correlated with reduced mortality risks. CONCLUSION: Tomato consumption in different seasons shows different results with mortality: in-season intake corresponds to decreased all-cause mortality, whereas off-season intake is related to a lower risk of cardio-cerebrovascular mortality. These findings underscore the importance of considering seasonal dietary patterns in nutritional recommendations.