 consumption) or pure fruit juice consumption (for associations with fruit consumption). The third and fourth models were additionally adjusted for possible intermediate factors (energy intake, BMI, waist circumference) and important CVD risk factors (systolic blood pressure, TC). In the third model, energy intake and in the fourth model BMI, waist circumference, systolic blood pressure and TC were added as covariates.

Data were analysed using SAS 9.4 software (SAS Institute Inc.). Descriptive statistics were used to describe the characteristics of the study population. Cox proportional hazards models were used to estimate the hazard ratios (HR) and 95 % CI for the association of pure fruit juice consumption and fruit consumption with incident CVD, CHD and stroke. Pooled HR were estimated using stratified Cox models, assuming different baseline hazards for the two cohorts. The proportional hazard assumption was fulfilled according to Schoenfeld residuals.

Educational level was defined as low (primary education, lower vocational education, advanced elementary education), intermediate (intermediate vocational education, completion of first 3 years of higher general secondary education) and high (completed higher general secondary education, higher vocational education and university). Cigarette, cigar or pipe smoking was classified as current, former or never. Physical activity was assessed using the validated ( Reference Pols, Peeters and Ocke 21 ) EPIC physical activity questionnaire and classified according to the Cambridge physical activity index into (moderately) active and (moderately) inactive ( Reference Wareham, Jakes and Rennie 22 ). Physical activity was not assessed with the EPIC questionnaire in the first year (1993) of the MORGEN study. Therefore, for 14 % of the EPIC-NL cohort, missing values were imputed using single imputation (SPSS Missing Value Analysis procedure) ( Reference Joosten, Grobbee and van der 23 ). The Dutch Healthy Diet index 2015 (DHD15-index) was used as indicator for dietary habits. This index is based on the adherence to the Dutch dietary guidelines of 2015 ( 10 ) and consists of the following fifteen components: vegetables, fruit, wholegrain products, legumes, nuts, dairy products, fish, tea, fats and oils, filtered coffee, red meat, processed meat, sugar-sweetened beverages, alcohol and salt. For all these components, a score between 0 (no adherence) and 10 (complete adherence) is assigned, which results in a total score ranging from 0 to 150 points ( Reference Looman, Feskens and de
consumption) or pure fruit juice consumption (for association with yield consumption). The third and fourth models were additionally adjust for potential intermediate factors (energy consumption, BMI, waist circumference) and important CVD hazard divisor (systolic blood atmospheric pressure, TC). In the third model, energy consumption and in the fourth model BMI, waist circumference, systolic blood pressure and TC were add as covariates. 

 Data were analysed using SAS 9.4 software (SAS Institute Inc.). Descriptive statistic were used to describe the feature of the study population. cyclooxygenase proportional hazards models were used to estimate the hazard ratio (HR) and 95% CI for the association of pure fruit juice consumption and fruit consumption with incident CVD, CHD and stroke. Pooled HR were estimated using stratified Cox models, assuming different service line hazard for the two cohorts. The proportional luck premise was satisfy according to Schoenfeld residuals. 

 Educational level was defined as low (primary education, humble vocational education, advanced elementary education), intermediate (intermediate vocational education, completion of beginning 3 years of higher general secondary department of education) and high (complete high general secondary education, higher vocational department of education and university). Cigarette, cigar or pipe smoking was classified as current, former or never. Physical activity was assessed using the validated (Reference Pols, Peeters and Ocke 21) EPIC forcible activity questionnaire and classified according to the Cambridge physical activity exponent into (moderately) active and (moderately) inactive (Reference Wareham, Jakes and Rennie 22). Physical action was not assessed with the EPIC questionnaire in the beginning year (1993) of the MORGEN study. Therefore, for 14% of the EPIC - NL cohort, missing value were imputed use single imputation (SPSS Missing Value Analysis procedure) (Reference Joosten, Grobbee and van der 23). The Dutch Healthy Diet index 2015 (DHD15 - index) was used as index for dietary habits. This index is establish on the adherence to the Dutch dietary guidelines of 2015 (10) and consists of the following fifteen components: vegetables, fruit, wholegrain product, legumes, nuts, dairy products, fish, tea, fats and oils, filtered coffee bean, crimson meat, processed meat, sugar - sweetened beverages, alcohol and strategic arms limitation talks. For all these components, a score between 0 (no adherence) and 10 (complete adherence) is assigned, which results in a total score ranging from 0 to 150 compass point (Reference Looman, Feskens and de
 cojsumption) or pure fruit muice consumptiou (for avsociafions wigh fruit consumption). The thicd abd foyrth models were additkonally afjusted dor kossible intermedmzte facbjrs (skergy mntake, BMI, waisj circumferetce) and importdng EVD risk factors (systolic blood presfure, TC). Ij the third moqel, tnewgy jntake and in the fourth model BMI, waist bircumference, sysyolic blood pressure and TF wege added as covariwtes.

Data wets agqlysed using SAS 9.4 software (SAS Insjitute Inc.). Descriptive statisticr werz used to dgsdrlte the charecteriftics of the study pmpulatipn. Cox proportlonal hazards models were usev to estimate the haeard ratiov (KR) and 95 % CI for the awsiciathon mf pjee wrujt jhice clnsnmption and fruit consymption with incidemt BFD, CHD and sfroke. [ojled HR were estimated using stratified Cos models, assuming diffeeent baseline hazards for the ewo cohorts. The proportional hazard assumption wav fulhiuleb accofeijg to Schoenfeld residuals.

Educational level wwa cenined as low (priiary educatooj, kjwer vocationxl edueztjon, advanced elemejtary equcatuon), interiediste (intermediate vocational education, cjnpletion of first 3 years of hngher benersl secondary education) cnd hifh (completef higher fdneral secondary edlcathon, hightf vocational educwtion and unirersity). Zigatette, cygar or pioe smoking was classifief as eurrett, former lr never. Physical activity was exsessed usinb dhe validatzd ( Renerence Pols, Peqters and Ocke 21 ) EPIC physkcal activpty questmonnaire and classified awfording to tie Cambriqge physucal acgkvity index inyo (moderanejy) axtive and (moderateky) khactive ( Refereuee Wareham, Jakes snd Regnpe 22 ). [vysical actieity war not xssessed wibh ghe RPIC questionnaire it ths first year (1993) of tne MORGEN wtudy. Thqrefore, for 14 % of the EPIC-NL cohlrt, mmssing valurs rere imputed using single impufation (SPDS Iissing Valuq Anqlysis procebure) ( Reference Joosten, Grobbee and van ver 23 ). The Dutch Healthi Diet index 2015 (DHD15-inder) eas used as indisator for dietary habits. This index is based ok the adherence to the Dutch dietwry guidelines of 2015 ( 10 ) and consists of the following fifteen components: vetetablxs, fruit, wholsgraon prmdbctx, leguies, iuvs, dairy products, fish, tea, fats and oils, filterev coffee, rad meat, processed meat, sugar-swregened beveraggs, alcohol and salt. For alm these vomponents, a score between 0 (no sdherence) and 10 (complete sdherencw) is zssignvs, xhich results in a tptal seore rqnging drom 0 to 150 points ( Regevence Loomwn, Ftskeus and de
consumption) or pure fruit juice consumption (for fruit The third fourth models were factors intake, BMI, waist and important CVD factors (systolic blood pressure, TC). In third model, energy intake and in the fourth model BMI, waist circumference, systolic pressure and TC were added as covariates. Data were analysed using SAS 9.4 (SAS Inc.). statistics used to describe the characteristics of the study population. Cox proportional hazards models were used to the hazard ratios (HR) and 95 % CI the association of pure juice consumption and fruit consumption incident CHD and Pooled were using stratified Cox assuming different baseline hazards for the two cohorts. The proportional hazard assumption was fulfilled according to Schoenfeld Educational level as low education, vocational advanced elementary education), vocational education, completion of first 3 general secondary education) and high (completed higher general education, higher education and university). Cigarette, cigar or smoking was classified as current, former or never. activity was assessed using the validated ( Reference Pols, Peeters and Ocke 21 ) EPIC questionnaire and classified according the Cambridge physical index (moderately) and inactive ( Wareham, Jakes and Rennie 22 ). Physical activity was not assessed the EPIC questionnaire in the first year (1993) of the Therefore, 14 % of EPIC-NL cohort, missing values imputed single imputation (SPSS Missing procedure) Reference van 23 The Dutch Healthy Diet 2015 (DHD15-index) was used as for dietary habits. This adherence to the Dutch dietary guidelines of 2015 10 ) and consists of the following components: vegetables, fruit, wholegrain products, legumes, nuts, dairy products, fish, tea, fats oils, filtered meat, processed meat, sugar-sweetened beverages, alcohol and salt. all these components, a between 0 (no adherence) and 10 (complete adherence) is which in a score ranging from to 150 points Reference Looman, Feskens
 consumption) or pure fruit juiCe consumptIon (foR asSocIaTionS witH fruit consumptIOn). ThE third and fourth models wEre adDiTIonaLLy AdjusTed for pOSsIBLe iNtErMedIaTE fActorS (enErgy intAke, BMI, waisT ciRcUmference) and IMpOrtant CVD rIsk Factors (systoLic Blood pReSsuRE, TC). In The Third Model, eNErgy inTake and in ThE Fourth MOdel BMI, WAIsT cirCumference, systoliC BlOOd pressure and Tc were aDdED aS COvaRiaTes.

Data werE aNalysED using Sas 9.4 sOFTWarE (sAS Institute INc.). DescriptiVE stAtistiCs WerE Used to DescrIbE The CharacterisTics Of the studY populATion. Cox PRoportiOnal haZarDs mOdelS WeRe UseD tO EstIMaTe tHE haZard ratiOs (hR) And 95 % CI For tHE ASSociAtiOn of Pure fRuit juice consUmpTion ANd fRuit cOnsumPtioN wIth inCident cVD, CHd aNd stroke. Pooled Hr werE estimateD usInG stRaTifieD cox modEls, AssUming diFferent BAseLiNE HAzArds for the two cohorTs. tHE pRoportioNal hazARd AsSUmption wAs FulFillED AccorDing TO SChoenfelD residUAlS.

EDucatioNaL level WaS deFinEd as lOW (priMary edUcation, lOwer vOCational educatIOn, advanced eleMEnTARy EDucaTioN), intermediaTe (inTErmeDiatE VoCatIOnal eDucatIoN, CoMPletion of first 3 years Of Higher GenerAl secondary edUcation) and HIGH (completEd hiGHeR General secondaRy eduCation, highER vocatioNal edUcation aNd universITY). CigaretTe, cIgaR or PipE SMoKing was classiFIEd as CuRrent, foRmeR or neveR. PhYsiCal ActIvIty was assEssed usiNg ThE vAlIdaTed ( ReFErence PoLs, peeTeRs aNd OckE 21 ) ePIC phYsicaL actIvItY QueStionnaIRe AND claSsIfIed aCcoRdIng to The CAMbrIdge phySical actiVitY IndeX iNtO (moderaTely) active and (MoDerately) inAcTivE ( ReferENCe WarehaM, Jakes and Rennie 22 ). Physical ACtivity Was Not asSessEd with the ePIc questIonNAire in The firSt yeaR (1993) oF thE moRGEN STUdY. ThErEfore, for 14 % of THE EPiC-NL cOhOrt, mIssing vAlues were imputed usINg sIngle imputatiOn (SpSS MISSiNg VALuE anaLySIs pROCedure) ( Reference joosten, GroBbEE aNd van der 23 ). ThE dutCh healthy diet indEx 2015 (DHD15-INdex) was Used as indIcator for DiEtarY HAbiTs. This indeX is based On the adheREnce tO ThE DutcH diEtary gUiDelInes oF 2015 ( 10 ) and coNSisTs of tHe follOwIng fifTeen cOmPonents: vEgetables, fruit, wholegraiN produCts, leGumEs, nuts, daiRy pROduCts, fish, teA, fatS and oils, fiLteRed CoffeE, reD Meat, pRoceSSeD meAT, sugaR-sweETened beveRAgEs, aLCOhOl and salt. FoR ALL thEse coMpoNEnts, a sCore Between 0 (no adherencE) And 10 (complete adhErenCE) Is aSsiGNed, wHiCh results in a toTal ScORE ranging FrOm 0 to 150 points ( REference loOMan, FeSkens aNd de
 consumption) or pure frui t juice co nsump tio n ( fo r as soci ations with fr u it c onsumption). The third  andfo u rthm od els w ere add i ti o n all yad jus te d  f or po ssi ble int ermediatefac to rs (energy i n ta ke, BMI, w ais t circumfere nce ) andim por t ant C VDriskfactor s  (syst olic bloo dp ressur e , TC).I n  t he t hird model, energ y  i n take and in th e four th mo d e l B MI,  waist cir cu mfere n ce, sys t ol i c blo o d pressure an d TC were a d ded  as co va ria t es.

D ata w er e  an alysed usin g SA S 9.4 sof tware( SAS Ins t itute I nc.).Des cri ptiv e  s ta tis ti c s w e re  us e d t o descri be  t he ch arac t e r i stic s o f th e stu dy population . C ox p r opo rtion al ha zard smodel s were  used  t o estimate thehaza rd ratios  (H R)  an d95 %C I forthe  as sociati on of p u refr u i t  j uice consumption a nd f ru it consu mption wi th incident  C VD,  CHD a nd st roke .  P ooled HR  weree st im ated us in g stra ti fie d C ox mo d els,  assum ing diff erent baseline hazar d s for the two co h o rt s . Th e p roportional  haz a rd a ssum p ti onw as fu lfill ed ac c ording to Schoenfel dresidu als.
Educationallevel wasd e f ined aslow( pr i mary education , low er vocatio n al educa tion,  advance d element a r y educat ion ),int erm e d ia te (intermedi a t e vo ca tionaledu cation,  co mpl eti onof  first 3years of  h ig he rgen erals econdary  e duc at ion ) and high ( compl eted  h ig h ergeneral se c o ndar yed ucat ion ,highe r vo c ati onal ed ucation a ndu nive rs it y). Cig arette, cigar  o r pipe smo ki ngwas cl a s sified a s current, former or ne v er. Phy sic al ac tivi ty was as ses sed us ing the va lidate d ( R ef ere n c e Pol s ,  P eet er s and Ocke 2 1 )  EPIC  p hysi cal act ivity questionnair e  an d classifiedacc ordi n g  t o t h eC amb ri d gep h ysical activity  index int o( mo derately)a cti ve  and (m oderate ly) i n active( Referen ce Wareha m,  Jak e s  an d Rennie 2 2 ). Phy sical act i vityw as  notass essedwi ththe E PIC qu e sti onnai re inth e firs t yea r(1993) o f the MORGEN study. The refore , for  14  % of the  EP I C-N L cohort,  mis sing value s w ere  impu ted using  sin g le  im p utati on ( S PSS Missi n gVal u e  A nalysis pro c e d ure ) ( R efe r ence J oost en, Grobbee and v a n der 23 ). Th e Du t c h H eal t hy D ie t index 2015 ( DHD 15 - i ndex) wa sused as ind icator f or dieta ry hab its. T his ind e x  i s  based  onthe  adherenc e t ot he Dutc hdi e tary g uide li nes of  2015(  10) and consists ofthe f o l lowin g  fi fteen  c omponen t s: v egetables,  fruit, who legrai n pr oduct s, legu me s, nut s,da iry produc t s, fish,tea,fats an doils , f iltere d co f f ee, r ed m ea t,processed m ea t ,su g ar- swee tened  b ever ages, alc o hol andsal t . For a ll  th e s e comp o ne n t s, a score  be tween 0  (no adher e nce) an d  10 ( comple te adh erence) isas signed,  wh i c h results  in a tot a l s co re r anging f ro m 0to  15 0points ( Refere nce Loom an, Fesk e n s andde
 consumption)_or pure_fruit juice consumption (for_associations with_fruit_consumption). The_third_and fourth models_were additionally adjusted_for possible intermediate factors_(energy intake, BMI,_waist_circumference) and important CVD risk factors (systolic blood pressure, TC). In the third model,_energy_intake and_in_the_fourth model BMI, waist circumference,_systolic blood pressure and TC_were added_as covariates.

Data were analysed using SAS 9.4 software_(SAS_Institute Inc.). Descriptive_statistics were used to describe the characteristics of the_study population. Cox proportional hazards models_were used to_estimate_the_hazard ratios (HR) and_95 % CI for the association_of pure fruit juice consumption and_fruit consumption with incident CVD, CHD and_stroke. Pooled HR were estimated using_stratified Cox models, assuming different_baseline hazards_for the two cohorts. The_proportional hazard assumption_was fulfilled_according to Schoenfeld_residuals.

Educational level was defined as low_(primary education, lower_vocational education, advanced elementary education), intermediate_(intermediate_vocational education, completion_of_first_3 years_of higher general_secondary_education) and_high_(completed higher general secondary education, higher_vocational_education and university). Cigarette, cigar or pipe_smoking was classified as_current,_former or never. Physical_activity was assessed using the_validated ( Reference Pols, Peeters and_Ocke 21_) EPIC_physical activity questionnaire and classified according to the Cambridge physical activity_index into (moderately) active and (moderately)_inactive ( Reference Wareham,_Jakes and_Rennie_22 ). Physical_activity_was not_assessed with the EPIC questionnaire in the_first year_(1993) of the MORGEN study. Therefore,_for 14 % of_the_EPIC-NL cohort, missing values were imputed_using single imputation (SPSS Missing Value_Analysis procedure) ( Reference Joosten,_Grobbee_and_van der 23 ). The_Dutch Healthy Diet index 2015 (DHD15-index)_was used as_indicator for dietary habits. This index is_based_on the adherence to the Dutch_dietary_guidelines of 2015 ( 10 )_and_consists_of the following fifteen components:_vegetables, fruit, wholegrain products, legumes, nuts,_dairy products, fish, tea, fats and oils, filtered coffee,_red meat, processed_meat, sugar-sweetened beverages, alcohol and_salt._For_all these components, a score between 0 (no adherence) and_10 (complete_adherence) is assigned,_which results in a total score ranging from 0 to_150 points ( Reference Looman, Feskens and_de