Vegetable and fruit intakes and risk of Barrett's esophagus in men and women (original) (raw)
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International Journal of Cancer, 2006
It is considered that fruit and vegetable (F&V) protect against oesophagus and gastric cancer (GC). However, 2 recent meta-analyses suggest that the strength of association on GC seems to be weaker for vegetables than for fruit and weaker in cohort than in case-control studies. No evidence exists from cohort studies about adenocarcinoma of oesophagus (ACO). In 521,457 men and women participating in the EPIC cohort in 10 European countries, information of diet and lifestyle was collected at baseline. After an average of 6.5 years of follow-up, a total of 330 GC and 65 ACO, confirmed and classified by a panel of pathologists, was used for the analysis. We examined the relation between F&V intake and GC and ACO. A calibration study in a sub-sample was used to control diet measurement errors. In a sub-sample of cases and a random sample of controls, antibodies against Helicobacter pylori (Hp) were measured and interactions with F&V were examined in a nested case-control study. We observed no association with total vegetable intake or specific groups of vegetables and GC risk, except for the intestinal type, where a negative association is possible regarding total vegetable (calibrated HR 0.66; 95% CI 0.35–1.22 per 100 g increase) and onion and garlic intake (calibrated HR 0.70; 95% CI 0.38–1.29 per 10 g increase). No evidence of association between fresh fruit intake and GC risk was observed. We found a negative but non significant association between citrus fruit intake and the cardia site (calibrated HR 0.77; 95% CI 0.47–1.22 per 100 g increase) while no association was observed with the non-cardia site. Regarding ACO, we found a non significant negative association for vegetable intake and for citrus intake (calibrated HRs 0.72; 95% CI 0.32–1.64 and 0.77; 95% CI 0.46–1.28 per 100 and 50 g increase, respectively). It seems that Hp infection does not modify the effect of F&V intake. Our study supports a possible protective role of vegetable intake in the intestinal type of GC and the ACO. Citrus fruit consumption may have a role in the protection against cardia GC and ACO. © 2005 Wiley-Liss, Inc.
ARTICLES Fruit and Vegetable Intake and Risk of Major Chronic Disease
2000
Background: Studies of fruit and vegetable consumption in relation to overall health are limited. We evaluated the relationship between fruit and vegetable intake and the incidence of cardiovascular disease and cancer and of deaths from other causes in two prospective cohorts. Methods: A total of 71 910 female participants in the Nurses' Health study and 37 725 male participants in the Health Professionals' Follow-up Study who were free of major chronic disease completed baseline semiquantitative food-frequency questionnaires in 1984 and 1986, respectively. Dietary information was updated in 1986, 1990, and 1994 for women and in 1990 and 1994 for men. Participants were followed up for incidence of cardiovascular disease, cancer, or death through May 1998 (women) and January 1998 (men). Multivariable-adjusted relative risks were calculated with Cox proportional hazards analysis. Results: We ascertained 9329 events (1964 cardiovascular, 6584 cancer, and 781 other deaths) in women and 4957 events (1670 cardiovascular diseases, 2500 cancers, and 787 other deaths) in men during follow-up. For men and women combined, participants in the highest quintile of total fruit and vegetable intake had a relative risk for major chronic disease of 0.95 (95% confidence interval [CI] ؍ 0.89 to 1.01) times that of those in the lowest. Total fruit and vegetable intake was inversely associated with risk of cardiovascular disease but not with overall cancer incidence, with relative risk for an increment of five servings daily of 0.88 (95% CI ؍ 0.81 to 0.95) for cardiovascular disease and 1.00 (95% CI ؍ 0.95 to 1.05) for cancer. Of the food groups analyzed, green leafy vegetable intake showed the strongest inverse association with major chronic disease and cardiovascular disease. For an increment of one serving per day of green leafy vegetables, relative risks were 0.95 (95% CI ؍ 0.92 to 0.99) for major chronic disease and 0.89 (95% CI ؍ 0.83 to 0.96) for cardiovascular disease.
Cancer Causes & Control, 2006
Epidemiologic studies suggest that a high intake of fruits and vegetables is associated with decreased risk of cancers of the upper aero-digestive tract. We studied data from 345,904 subjects of the prospective European Investigation into Cancer and Nutrition (EPIC) recruited in seven European countries, who had completed a dietary questionnaire in 1992-1998. During 2,182,560 person years of observation 352 histologically verified incident squamous cell cancer (SCC) cases (255 males; 97 females) of the oral cavity, pharynx, larynx, and esophagus were identified. Linear and restricted cubic spline Cox regressions were fitted on variables of intake of fruits and vegetables and adjusted for potential confounders. We observed a significant inverse association with combined total fruits and vegetables intake (estimated relative risk (RR) = 0.91; 95% confidence interval (95% CI) 0.83-1.00 per 80 g/d of consumption), and nearly significant inverse associations in separate analyses with total fruits and total vegetables intake (RR: 0.97 (95% CI: 0.92-1.02) and RR = 0.89 (95% CI: 0.78-1.02) per 40 g/d of consumption). Overall, vegetable subgroups were not related to risk with the exception of intake of root vegetables in men. Restricted cubic spline regression did not improve the linear model fits except for total fruits and vegetables and total fruits with a significant decrease in risk at low intake levels (<120 g/d) for fruits. Dietary recommendations should consider the potential benefit of increasing fruits and vegetables consumption for reducing the risk of cancers of the upper aero-digestive tract, particularly at low intake.
Fruit and vegetable intake and the risk of stomach and oesophagus …
… Journal of Cancer, 2006
Contract grant sponsor: Spanish Ministry of Health; Contract grant number: (RCESP-C03/09) ; European Commission; Contract grant number: QLG1-CT- 2001-01049; European Commission (SANCO); Ligue contre le Cancer (France); Société 3M (France); Mutuelle Générale de l' ...
Fruit and vegetable intake and cause-specific mortality in the EPIC study
Consumption of fruits and vegetables is associated with a lower overall mortality. The aim of this study was to identify causes of death through which this association is established. More than 450,000 participants from the European Prospective Investigation into Cancer and Nutrition study were included, of which 25,682 were reported deceased after 13 years of follow-up. Information on lifestyle, diet and vital status was collected through questionnaires and population registries. Hazard ratios (HR) with 95 % confidence intervals (95 % CI) for death from specific causes were calculated from Cox regression models, adjusted for potential confounders. Participants reporting consumption of more than 569 g/day of fruits and vegetables had lower risks of death from diseases of the Electronic supplementary material The online version of this article (circulatory (HR for upper fourth 0.85, 95 % CI 0.77-0.93), respiratory (HR for upper fourth 0.73, 95 % CI 0.59-0.91) and digestive system (HR for upper fourth 0.60, 95 % CI 0.46-0.79) when compared with participants consuming less than 249 g/day. In contrast, a positive association with death from diseases of the nervous system was observed. Inverse associations were generally observed for vegetable, but not for fruit consumption. Associations were more pronounced for raw vegetable consumption, when compared with cooked vegetable consumption. Raw vegetable consumption was additionally inversely associated with death from neoplasms and mental and behavioral disorders. The lower risk of death associated with a higher consumption of fruits and vegetables may be derived from inverse associations with diseases of the circulatory, respiratory and digestive system, and may depend on the preparation of vegetables and lifestyle factors.
Fruit and vegetable intake and risk of cancer: a prospective cohort study
The American Journal of Clinical Nutrition, 2008
Background: There is probable evidence that some types of fruit and vegetables provide protection against many cancers. Objective: We hypothesized that fruit and vegetable intakes are inversely related to the incidence of total cancers among women and men aged .50 y. Design: We performed a prospective study among the cohort of the National Institutes of Health-AARP Diet and Health Study. We merged the MyPyramid Equivalents Database (version 1.0) with food-frequency-questionnaire data to calculate cup equivalents for fruit and vegetables. From 1995 to 2003, we identified 15,792 and 35,071 cancer cases in 195,229 women and 288,109 men, respectively. We used Cox proportional hazards models to estimate multivariate relative risks (RRs) and 95% CIs associated with the highest compared with the lowest quintile (Q) of fruit and vegetable intakes. Results: Fruit intake was not associated with the risk of total cancer among women (RR Q5 vs Q1 ¼ 0.99; 95% CI: 0.94, 1.05; P trend ¼ 0.059) or men (RR Q5 vs Q1 ¼ 0.98; 95% CI: 0.95, 1.02; P for trend ¼ 0.17). Vegetable intake was not associated with risk of total cancer among women (RR Q5 vs Q1 ¼ 1.04; 95% CI: 0.98, 1.09; P for trend ¼ 0.084), but was associated with a significant decrease in risk in men (RR Q5 vs Q1 ¼ 0.94; 95% CI: 0.91, 0.97; P trend ¼ 0.004). This significant finding among men was no longer evident when we limited the analysis to men who never smoked (RR Q5 vs Q1 ¼ 0.97; 95% CI: 0.91, 1.04; P for trend ¼ 0.474). Conclusions: Intake of fruit and vegetables was generally unrelated to total cancer incidence in this cohort. Residual confounding by smoking is a likely explanation for the observed inverse association with vegetable intake among men.
… American journal of …, 2009
Background: A high consumption of fruit and vegetables is possibly associated with a decreased risk of colorectal cancer (CRC). However, the findings to date are inconsistent. Objective: We examined the relation between self-reported usual consumption of fruit and vegetables and the incidence of CRC. Design: In the European Prospective Investigation into Cancer and Nutrition (EPIC), 452,755 subjects (131,985 men and 320,770 women) completed a dietary questionnaire in 1992-2000 and were followed up for cancer incidence and mortality until 2006. A multivariate Cox proportional hazard model was used to estimate adjusted hazard ratios (HRs) and 95% CIs. Results: After an average follow-up of 8.8 y, 2,819 incident CRC cases were reported. Consumption of fruit and vegetables was inversely associated with CRC in a comparison of the highest with the lowest EPIC-wide quintile of consumption (HR: 0.86; 95% CI: 0.75, 1.00; P for trend ¼ 0.04), particularly with colon cancer risk (HR: 0.76; 95% CI: 0.63, 0.91; P for trend , 0.01). Only after exclusion of the first 2 y of follow-up were these findings corroborated by calibrated continuous analyses for a 100-g increase in consumption: HRs of 0.95 (95% CI: 0.91, 1.00; P ¼ 0.04) and 0.94 (95% CI: 0.89, 0.99; P ¼ 0.02), respectively. The association between fruit and vegetable consumption and CRC risk was inverse in never and former smokers, but positive in current smokers. This modifying effect was found for fruit and vegetables combined and for vegetables alone (P for interaction , 0.01 for both). Conclusions: These findings suggest that a high consumption of fruit and vegetables is associated with a reduced risk of CRC, especially of colon cancer. This effect may depend on smoking status.
The Association between Fruit and Vegetable Intake and Chronic Disease Risk Factors
Epidemiology, 1996
BACKGROUND: Intake of fiber and antioxidants and following hypocaloric diets has beneficial effects on reduction of the liver enzymes. Fruits and vegetables are low in calorie and rich in fiber and antioxidants. There are few studies about special dietary effects on liver function. The aim of this study was to evaluate the association between fruit and vegetables intake and liver function enzymes. METHODS: This cross-sectional study was conducted on 265 Tehrani healthy adults. Fruit and vegetable intake was assessed by a 147-items semi-quantitative food frequency questionnaire. Serum glucose, lipids, liver enzymes (alanine aminotransferase (ALT), aspartate aminotransferase (AST)), hs-Crp and body composition were measured in a fasting state. RESULTS: The mean age (± SD) of the participants was 35 ± 8.78. In the higher quartiles of vegetable intake, low-density lipoprotein (LDL) serum and total cholesterol (TC) levels were lower after adjusting for confounders (p = 0.03 and 0.02 respectively). Individuals in the upper quartile of vegetable intake were less likely to have elevated ALT (OR=0.21; 95% CI =0.08-0.49) and AST (OR=0.33; 95% CI =0.15-0.75) levels before adjusting for confounders. After controlling for potential confounders, only the association between vegetable intake and ALT level remained significant (OR=0.32; 95% CI =0.12-0.90). Liver enzymes had no significant relationship with the quartiles of fruit intake. In the higher quartiles of fruit intake, the visceral fat rating was lower after adjustment (p = 0.04) but not in the higher vegetable intake (p = 0.50). CONCLUSIONS: The results of this study showed that vegetable intake is reversely associated with LDL, TC and ALT level in Tehrani healthy adults, whereas fruit intake is only associated with lower visceral fat rating.