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Fruit and vegetable intake and overall cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC).

Abstract

BACKGROUND

It is widely believed that cancer can be prevented by high intake of fruits and vegetables. However, inconsistent results from many studies have not been able to conclusively establish an inverse association between fruit and vegetable intake and overall cancer risk.

METHODS

We conducted a prospective analysis of the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort to assess relationships between intake of total fruits, total vegetables, and total fruits and vegetables combined and cancer risk during 1992-2000. Detailed information on the dietary habit and lifestyle variables of the cohort was obtained. Cancer incidence and mortality data were ascertained, and hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox regression models. Analyses were also conducted for cancers associated with tobacco and alcohol after stratification for tobacco smoking and alcohol drinking.

RESULTS

Of the initial 142 605 men and 335 873 women included in the study, 9604 men and 21 000 women were identified with cancer after a median follow-up of 8.7 years. The crude cancer incidence rates were 7.9 per 1000 person-years in men and 7.1 per 1000 person-years in women. Associations between reduced cancer risk and increased intake of total fruits and vegetables combined and total vegetables for the entire cohort were similar (200 g/d increased intake of fruits and vegetables combined, HR = 0.97, 95% CI = 0.96 to 0.99; 100 g/d increased intake of total vegetables, HR = 0.98, 95% CI = 0.97 to 0.99); intake of fruits showed a weaker inverse association (100 g/d increased intake of total fruits, HR = 0.99, 95% CI = 0.98 to 1.00). The reduced risk of cancer associated with high vegetable intake was restricted to women (HR = 0.98, 95% CI = 0.97 to 0.99). Stratification by alcohol intake suggested a stronger reduction in risk in heavy drinkers and was confined to cancers caused by smoking and alcohol.

CONCLUSIONS

A very small inverse association between intake of total fruits and vegetables and cancer risk was observed in this study. Given the small magnitude of the observed associations, caution should be applied in their interpretation.

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  • Authors+Show Affiliations

    ,

    The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY 10029, USA. paolo.boffetta@mssm.edu

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    Source

    Journal of the National Cancer Institute 102:8 2010 Apr 21 pg 529-37

    MeSH

    Adult
    Aged
    Alcohol Drinking
    Europe
    Feeding Behavior
    Female
    Fruit
    Humans
    Incidence
    Life Style
    Male
    Middle Aged
    Neoplasms
    Observer Variation
    Odds Ratio
    Prospective Studies
    Registries
    Research Design
    Risk Assessment
    Risk Factors
    Surveys and Questionnaires
    Vegetables

    Pub Type(s)

    Journal Article
    Multicenter Study
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    20371762

    Citation

    Boffetta, Paolo, et al. "Fruit and Vegetable Intake and Overall Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC)." Journal of the National Cancer Institute, vol. 102, no. 8, 2010, pp. 529-37.
    Boffetta P, Couto E, Wichmann J, et al. Fruit and vegetable intake and overall cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). J Natl Cancer Inst. 2010;102(8):529-37.
    Boffetta, P., Couto, E., Wichmann, J., Ferrari, P., Trichopoulos, D., Bueno-de-Mesquita, H. B., ... Trichopoulou, A. (2010). Fruit and vegetable intake and overall cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). Journal of the National Cancer Institute, 102(8), pp. 529-37. doi:10.1093/jnci/djq072.
    Boffetta P, et al. Fruit and Vegetable Intake and Overall Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC). J Natl Cancer Inst. 2010 Apr 21;102(8):529-37. PubMed PMID: 20371762.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Fruit and vegetable intake and overall cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). AU - Boffetta,Paolo, AU - Couto,Elisabeth, AU - Wichmann,Janine, AU - Ferrari,Pietro, AU - Trichopoulos,Dimitrios, AU - Bueno-de-Mesquita,H Bas, AU - van Duijnhoven,Fränzel J B, AU - Büchner,Frederike L, AU - Key,Tim, AU - Boeing,Heiner, AU - Nöthlings,Ute, AU - Linseisen,Jakob, AU - Gonzalez,Carlos A, AU - Overvad,Kim, AU - Nielsen,Michael R S, AU - Tjønneland,Anne, AU - Olsen,Anja, AU - Clavel-Chapelon,Françoise, AU - Boutron-Ruault,Marie-Christine, AU - Morois,Sophie, AU - Lagiou,Pagona, AU - Naska,Androniki, AU - Benetou,Vassiliki, AU - Kaaks,Rudolf, AU - Rohrmann,Sabine, AU - Panico,Salvatore, AU - Sieri,Sabina, AU - Vineis,Paolo, AU - Palli,Domenico, AU - van Gils,Carla H, AU - Peeters,Petra H, AU - Lund,Eiliv, AU - Brustad,Magritt, AU - Engeset,Dagrun, AU - Huerta,José María, AU - Rodríguez,Laudina, AU - Sánchez,Maria-José, AU - Dorronsoro,Miren, AU - Barricarte,Aurelio, AU - Hallmans,Göran, AU - Johansson,Ingegerd, AU - Manjer,Jonas, AU - Sonestedt,Emily, AU - Allen,Naomi E, AU - Bingham,Sheila, AU - Khaw,Kay-Tee, AU - Slimani,Nadia, AU - Jenab,Mazda, AU - Mouw,Traci, AU - Norat,Teresa, AU - Riboli,Elio, AU - Trichopoulou,Antonia, Y1 - 2010/04/06/ PY - 2010/4/8/entrez PY - 2010/4/8/pubmed PY - 2010/5/1/medline SP - 529 EP - 37 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 102 IS - 8 N2 - BACKGROUND: It is widely believed that cancer can be prevented by high intake of fruits and vegetables. However, inconsistent results from many studies have not been able to conclusively establish an inverse association between fruit and vegetable intake and overall cancer risk. METHODS: We conducted a prospective analysis of the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort to assess relationships between intake of total fruits, total vegetables, and total fruits and vegetables combined and cancer risk during 1992-2000. Detailed information on the dietary habit and lifestyle variables of the cohort was obtained. Cancer incidence and mortality data were ascertained, and hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox regression models. Analyses were also conducted for cancers associated with tobacco and alcohol after stratification for tobacco smoking and alcohol drinking. RESULTS: Of the initial 142 605 men and 335 873 women included in the study, 9604 men and 21 000 women were identified with cancer after a median follow-up of 8.7 years. The crude cancer incidence rates were 7.9 per 1000 person-years in men and 7.1 per 1000 person-years in women. Associations between reduced cancer risk and increased intake of total fruits and vegetables combined and total vegetables for the entire cohort were similar (200 g/d increased intake of fruits and vegetables combined, HR = 0.97, 95% CI = 0.96 to 0.99; 100 g/d increased intake of total vegetables, HR = 0.98, 95% CI = 0.97 to 0.99); intake of fruits showed a weaker inverse association (100 g/d increased intake of total fruits, HR = 0.99, 95% CI = 0.98 to 1.00). The reduced risk of cancer associated with high vegetable intake was restricted to women (HR = 0.98, 95% CI = 0.97 to 0.99). Stratification by alcohol intake suggested a stronger reduction in risk in heavy drinkers and was confined to cancers caused by smoking and alcohol. CONCLUSIONS: A very small inverse association between intake of total fruits and vegetables and cancer risk was observed in this study. Given the small magnitude of the observed associations, caution should be applied in their interpretation. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/20371762/Fruit_and_vegetable_intake_and_overall_cancer_risk_in_the_European_Prospective_Investigation_into_Cancer_and_Nutrition__EPIC__ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djq072 DB - PRIME DP - Unbound Medicine ER -