Young adults who eat the most fruits and vegetables have the least calcified plaque buildup in their arteries decades later, which indicates a reduced risk of heart disease, according to a new study.

“Most dietary studies out there on things like fruits and vegetables or healthy fats are all in an older population,” said lead author Dr. Michael D. Miedema, of the Minneapolis Heart Institute in Minnesota.

It seems intuitive that the same dietary advice would hold for younger people, but there hadn’t been a direct study of youthful diet and coronary plaque decades later, he told Reuters Health by phone.

The new analysis involved participants in the government-funded Coronary Artery Risk Development in Young Adults (CARDIA) study. At the start, in 1985, researchers collected diet history and other health-related data from blacks and whites ages 18 to 30.

For the long-term study, the researchers divided 2,506 study participants into three groups based on their fruit and vegetable consumption. Those in the top third ate an average of seven to nine servings per day as young adults, while the bottom third got two to three daily servings.

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The U.S. Department of Health and Human Services recommends four servings of vegetables and three servings of fruits daily for active women and most men.

In 2005, the participants had computed tomography (CT) scans to check for buildup of calcium in the arteries of the heart.

Those in the top third of fruit and veggie consumption at the start were 26 percent less likely to have calcified plaque in their arteries 20 years later, compared to those in the lower third, the researchers reported in Circulation.

The relationship was only significant for women, although other studies have linked fruit and vegetables to heart health for both women and men.

Fruit and vegetable intake is likely a marker for a life-long healthy diet and lifestyle, said Alice H. Lichtenstein of Tufts University in Boston, who wrote an editorial accompanying the new results.

“The data suggest dietary patterns higher in fruits and vegetables may be protective with respect to cardiovascular disease,” she told Reuters Health by email.

“That does not mean adding fruits and vegetables to a diet high in animal fats and refined carbohydrate will lower risk,” she added.

Making a habit of choosing fruit instead of cookies and veggies instead of pretzels, not all the time, but most of the time, will likely decrease cardiovascular disease risk, she said.

“We were able to adjust for education and income, smoking, weight and alcohol intake,” and the association with fruits and vegetables remained, Miedema said.

But this was still an observational study, so it can’t prove that fruit and vegetable intake caused changes in calcified plaque risk, he said.

“We know there are multiple things about fruits and vegetables that are healthy,” he said. “You can’t wait until you’re 50 to establish these dietary patterns.”

Cost and access can be barriers to getting enough fruits and vegetables, especially in “food deserts,” Miedema said. This study further supports incentives to make fruits and vegetables available to as many people as possible, he said.