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Vegetable and fruit consumption and lung cancer risk in the Netherlands : cohort study on diet and cancer

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Author: Voorrips, L.E. · Goldbohm, R.A. · Verhoeven, D.T.H. · Poppel, G.A.F.C. van · Sturmans, F. · Hermus, R.J.J. · Brandt, P.A. van den
Institution: Centraal Instituut voor Voedingsonderzoek TNO TNO Voeding
Source:Cancer Causes and Control, 2, 11, 101-115
Identifier: 86976
doi: doi:10.1023/A:1008906706084
Keywords: Nutrition · Adenocarcinoma · Adult · Age · Brassica · Cancer risk · Cohort analysis · Diet · Education · Family history · Gender · Lung cancer · Major clinical study · Model · Questionnaire · Smoking · Statistical concepts · Age Distribution · Aged · Cohort Studies · Confidence Intervals · Confounding Factors (Epidemiology) · Female · Fruit · Humans · Incidence · Lung Neoplasms · Male · Middle Aged · Multivariate Analysis · Netherlands · Nutrition Surveys · Prospective Studies · Risk Assessment · Sex Distribution · Vegetables


Objective: The purpose was to study the association between vegetable and fruit consumption and lung cancer incidence using 1074 cases after 6.3 years of follow-up in the Netherlands Cohort Study. Methods: Dietary intake was assessed using a 150-item food-frequency questionnaire. Multivariate models were used including age, sex, family history of lung cancer, highest educational level attained, and smoking history. Results: Statistically significant inverse associations were found with total vegetables and most vegetable groups. Rate ratios (RRs) based on consumption frequency showed the strongest effect of vegetables from the Brassica group (RR 0.5, 95% confidence interval (95% CI) 0.3-0.9, for consumption ≥ 3 times per week versus ≤ once a month). RR of highest versus lowest quintile of total vegetable consumption was 0.7 (95% CI 0.5-1.0, p-trend 0.001). Statistically significant inverse associations were found for all fruits listed in the questionnaire. RRs for quintiles of total fruit intake were 1.0, 0.7, 0.6, 0.6 and 0.8 respectively (p-trend < 0.0001). Protective effects of fruits and vegetables were stronger in current than in former smokers, and weaker for adenocarcinomas than for other types of tumors. Conclusions: Inverse associations with lung cancer are found for both vegetable and fruit intake, but no specific type of vegetable or fruit seems to be particularly responsible.