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Fruit and vegetable consumption in adolescence and early adulthood and risk of breast cancer: population based cohort study.
BMJ. 2016 05 11; 353:i2343.BMJ

Abstract

OBJECTIVE

To evaluate the association between fruit and vegetable intake during adolescence and early adulthood and risk of breast cancer.

DESIGN

Prospective cohort study.

SETTING

Health professionals in the United States.

PARTICIPANTS

90 476 premenopausal women aged 27-44 from the Nurses' Health Study II who completed a questionnaire on diet in 1991 as well as 44 223 of those women who completed a questionnaire about their diet during adolescence in 1998.

MAIN OUTCOME MEASURE

Incident cases of invasive breast cancer, identified through self report and confirmed by pathology report.

RESULTS

There were 3235 cases of invasive breast cancer during follow-up to 2013. Of these, 1347 cases were among women who completed a questionnaire about their diet during adolescence (ages 13-18). Total fruit consumption during adolescence was associated with a lower risk of breast cancer. The hazard ratio was 0.75 (95% confidence interval 0.62 to 0.90; P=0.01 for trend) for the highest (median intake 2.9 servings/day) versus the lowest (median intake 0.5 serving/day) fifth of intake. The association for fruit intake during adolescence was independent of adult fruit intake. There was no association between risk and total fruit intake in early adulthood and total vegetable intake in either adolescence or early adulthood. Higher early adulthood intake of fruits and vegetables rich in α carotene was associated with lower risk of premenopausal breast cancer. The hazard ratio was 0.82 (0.70 to 0.96) for the highest fifth (median intake 0.5 serving/day) versus the lowest fifth (median intake 0.03 serving/day) intake. The association with adolescent fruit intake was stronger for both estrogen and progesterone receptor negative cancers than estrogen and progesterone receptor positive cancers (P=0.02 for heterogeneity). For individual fruits and vegetables, greater consumption of apple, banana, and grapes during adolescence and oranges and kale during early adulthood was significantly associated with a reduced risk of breast cancer. Fruit juice intake in adolescence or early adulthood was not associated with risk.

CONCLUSION

There is an association between higher fruit intake and lower risk of breast cancer. Food choices during adolescence might be particularly important.

Authors+Show Affiliations

Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA Harvard/Massachusetts General Hospital Center on Genomics, Vulnerable Populations, and Health Disparities, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA mfarvid@hsph.harvard.edu.Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA Obstetrics and Gynecology Epidemiology Center, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA.Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27170029

Citation

Farvid, Maryam S., et al. "Fruit and Vegetable Consumption in Adolescence and Early Adulthood and Risk of Breast Cancer: Population Based Cohort Study." BMJ (Clinical Research Ed.), vol. 353, 2016, p. i2343.
Farvid MS, Chen WY, Michels KB, et al. Fruit and vegetable consumption in adolescence and early adulthood and risk of breast cancer: population based cohort study. BMJ. 2016;353:i2343.
Farvid, M. S., Chen, W. Y., Michels, K. B., Cho, E., Willett, W. C., & Eliassen, A. H. (2016). Fruit and vegetable consumption in adolescence and early adulthood and risk of breast cancer: population based cohort study. BMJ (Clinical Research Ed.), 353, i2343. https://doi.org/10.1136/bmj.i2343
Farvid MS, et al. Fruit and Vegetable Consumption in Adolescence and Early Adulthood and Risk of Breast Cancer: Population Based Cohort Study. BMJ. 2016 05 11;353:i2343. PubMed PMID: 27170029.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fruit and vegetable consumption in adolescence and early adulthood and risk of breast cancer: population based cohort study. AU - Farvid,Maryam S, AU - Chen,Wendy Y, AU - Michels,Karin B, AU - Cho,Eunyoung, AU - Willett,Walter C, AU - Eliassen,A Heather, Y1 - 2016/05/11/ PY - 2016/5/13/entrez PY - 2016/5/14/pubmed PY - 2017/2/6/medline SP - i2343 EP - i2343 JF - BMJ (Clinical research ed.) JO - BMJ VL - 353 N2 - OBJECTIVE: To evaluate the association between fruit and vegetable intake during adolescence and early adulthood and risk of breast cancer. DESIGN: Prospective cohort study. SETTING: Health professionals in the United States. PARTICIPANTS: 90 476 premenopausal women aged 27-44 from the Nurses' Health Study II who completed a questionnaire on diet in 1991 as well as 44 223 of those women who completed a questionnaire about their diet during adolescence in 1998. MAIN OUTCOME MEASURE: Incident cases of invasive breast cancer, identified through self report and confirmed by pathology report. RESULTS: There were 3235 cases of invasive breast cancer during follow-up to 2013. Of these, 1347 cases were among women who completed a questionnaire about their diet during adolescence (ages 13-18). Total fruit consumption during adolescence was associated with a lower risk of breast cancer. The hazard ratio was 0.75 (95% confidence interval 0.62 to 0.90; P=0.01 for trend) for the highest (median intake 2.9 servings/day) versus the lowest (median intake 0.5 serving/day) fifth of intake. The association for fruit intake during adolescence was independent of adult fruit intake. There was no association between risk and total fruit intake in early adulthood and total vegetable intake in either adolescence or early adulthood. Higher early adulthood intake of fruits and vegetables rich in α carotene was associated with lower risk of premenopausal breast cancer. The hazard ratio was 0.82 (0.70 to 0.96) for the highest fifth (median intake 0.5 serving/day) versus the lowest fifth (median intake 0.03 serving/day) intake. The association with adolescent fruit intake was stronger for both estrogen and progesterone receptor negative cancers than estrogen and progesterone receptor positive cancers (P=0.02 for heterogeneity). For individual fruits and vegetables, greater consumption of apple, banana, and grapes during adolescence and oranges and kale during early adulthood was significantly associated with a reduced risk of breast cancer. Fruit juice intake in adolescence or early adulthood was not associated with risk. CONCLUSION: There is an association between higher fruit intake and lower risk of breast cancer. Food choices during adolescence might be particularly important. SN - 1756-1833 UR - https://www.unboundmedicine.com/medline/citation/27170029/Fruit_and_vegetable_consumption_in_adolescence_and_early_adulthood_and_risk_of_breast_cancer:_population_based_cohort_study_ L2 - http://www.bmj.com/cgi/pmidlookup?view=long&pmid=27170029 DB - PRIME DP - Unbound Medicine ER -