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Increased intake of vegetables, but not fruit, reduces risk for hepatocellular carcinoma: a meta-analysis.
Gastroenterology 2014; 147(5):1031-42G

Abstract

BACKGROUND & AIMS

The anti-cancer effects of vegetables and fruit have been investigated extensively, but the association between vegetable and fruit consumption and risk of hepatocellular carcinoma (HCC) has not been quantified. We performed a meta-analysis of observational studies to clarify the association.

METHODS

We identified eligible studies, published from 1956 through May 31, 2014, by searching PubMed, Web of Science, and EMBASE. Random-effects models were used to calculate summary relative risks (RRs) and dose-response analyses were conducted to quantify associations. Heterogeneity among studies was evaluated using Cochran's Q and I(2) statistics.

RESULTS

A total of 19 studies involving 1,290,045 participants and 3912 cases of HCC were included in the meta-analysis. The summary RR for HCC was 0.72 for individuals with high intake vs low intake of vegetables (95% confidence interval [CI]: 0.63-0.83) and 0.92 with a daily increase in vegetable intake (100 g/d) (95% CI: 0.88-0.95). Subgroup analyses showed that this inverse association did not change regardless of history of hepatitis, alcohol drinking, smoking, or energy intake. The summary RR for HCC among individuals with high vs low intake of fruit was 0.93 (95% CI: 0.80-1.09), and 0.99 with a daily increase in fruit intake (100 g/d) (95% CI: 0.94-1.05).

CONCLUSIONS

Based on a meta-analysis, increased intake of vegetables, but not fruit, is associated with lower risk for HCC. The risk of HCC decreases by 8% for every 100 g/d increase in vegetable intake. The findings should be confirmed by future studies with validated questionnaires and strict control of confounders.

Authors+Show Affiliations

Department of Radiation Therapy, Zhejiang Cancer Hospital, Hangzhou, China; Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, China. Electronic address: xyangyang1987@126.com.College of Pharmaceutical Science, Zhejiang Chinese Medical University, Hangzhou, China.Department of Ultrasound, Zhejiang Cancer Hospital, Hangzhou, China.Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China.Department of Radiation Therapy, Zhejiang Cancer Hospital, Hangzhou, China; Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, China.Department of Surgery, Zhejiang Cancer Hospital, Hangzhou, China.Department of Radiation Therapy, Zhejiang Cancer Hospital, Hangzhou, China; Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, China.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

25127680

Citation

Yang, Yang, et al. "Increased Intake of Vegetables, but Not Fruit, Reduces Risk for Hepatocellular Carcinoma: a Meta-analysis." Gastroenterology, vol. 147, no. 5, 2014, pp. 1031-42.
Yang Y, Zhang D, Feng N, et al. Increased intake of vegetables, but not fruit, reduces risk for hepatocellular carcinoma: a meta-analysis. Gastroenterology. 2014;147(5):1031-42.
Yang, Y., Zhang, D., Feng, N., Chen, G., Liu, J., Chen, G., & Zhu, Y. (2014). Increased intake of vegetables, but not fruit, reduces risk for hepatocellular carcinoma: a meta-analysis. Gastroenterology, 147(5), pp. 1031-42. doi:10.1053/j.gastro.2014.08.005.
Yang Y, et al. Increased Intake of Vegetables, but Not Fruit, Reduces Risk for Hepatocellular Carcinoma: a Meta-analysis. Gastroenterology. 2014;147(5):1031-42. PubMed PMID: 25127680.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased intake of vegetables, but not fruit, reduces risk for hepatocellular carcinoma: a meta-analysis. AU - Yang,Yang, AU - Zhang,Dan, AU - Feng,Na, AU - Chen,Guochong, AU - Liu,Jianjiang, AU - Chen,Guiping, AU - Zhu,Yuan, Y1 - 2014/08/13/ PY - 2014/06/04/received PY - 2014/07/22/revised PY - 2014/08/09/accepted PY - 2014/8/17/entrez PY - 2014/8/17/pubmed PY - 2015/1/31/medline KW - Cancer Prevention KW - Epidemiology KW - Hepatocellular Carcinoma KW - Nutrition SP - 1031 EP - 42 JF - Gastroenterology JO - Gastroenterology VL - 147 IS - 5 N2 - BACKGROUND & AIMS: The anti-cancer effects of vegetables and fruit have been investigated extensively, but the association between vegetable and fruit consumption and risk of hepatocellular carcinoma (HCC) has not been quantified. We performed a meta-analysis of observational studies to clarify the association. METHODS: We identified eligible studies, published from 1956 through May 31, 2014, by searching PubMed, Web of Science, and EMBASE. Random-effects models were used to calculate summary relative risks (RRs) and dose-response analyses were conducted to quantify associations. Heterogeneity among studies was evaluated using Cochran's Q and I(2) statistics. RESULTS: A total of 19 studies involving 1,290,045 participants and 3912 cases of HCC were included in the meta-analysis. The summary RR for HCC was 0.72 for individuals with high intake vs low intake of vegetables (95% confidence interval [CI]: 0.63-0.83) and 0.92 with a daily increase in vegetable intake (100 g/d) (95% CI: 0.88-0.95). Subgroup analyses showed that this inverse association did not change regardless of history of hepatitis, alcohol drinking, smoking, or energy intake. The summary RR for HCC among individuals with high vs low intake of fruit was 0.93 (95% CI: 0.80-1.09), and 0.99 with a daily increase in fruit intake (100 g/d) (95% CI: 0.94-1.05). CONCLUSIONS: Based on a meta-analysis, increased intake of vegetables, but not fruit, is associated with lower risk for HCC. The risk of HCC decreases by 8% for every 100 g/d increase in vegetable intake. The findings should be confirmed by future studies with validated questionnaires and strict control of confounders. SN - 1528-0012 UR - https://www.unboundmedicine.com/medline/citation/25127680/Increased_intake_of_vegetables_but_not_fruit_reduces_risk_for_hepatocellular_carcinoma:_a_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(14)01001-4 DB - PRIME DP - Unbound Medicine ER -