title: Vegetables, fruit, and antioxidant-related nutrients and risk of non-Hodgkin lymphoma: a National Cancer Institute-Surveillance, Epidemiology, and End Results population-based case-control study.
abstract: BACKGROUND
  Factors related to DNA damage and altered immunologic responses, such as reactive oxygen species production, are associated with the risk of non-Hodgkin lymphoma (NHL).
  
  
  OBJECTIVE
  The aim was to evaluate NHL risk with intakes of vegetables, fruit, and nutrients involved in antioxidant activities.
  
  
  METHODS
  Incident case subjects aged 20-74 y were identified between 1998 and 2000 from a National Cancer Institute-sponsored study by using four Surveillance, Epidemiology, and End Results registries. Control subjects, who were selected by random dialing (< 65 y) and from Medicare files (> or = 65 y), were matched to cases by age, center, race, and sex. Of 1321 case and 1057 control subjects who enrolled, dietary data were collected on a subset (466 cases and 391 controls). Carotenoid intakes were estimated by using updated values from the US Department of Agriculture nutrient databases. Unconditional logistic regression models were used to estimate odds ratios (ORs) and 95% CIs.
  
  
  RESULTS
  NHL risk was inversely associated with higher number of weekly servings of all vegetables (multivariable OR for highest compared with lowest quartile: 0.58; 95% CI: 0.35, 0.95; P for trend = 0.04), green leafy vegetables (OR: 0.59; 95% CI: 0.36, 0.96; P for trend = 0.01), and cruciferous vegetables (OR: 0.62; 95% CI: 0.39, 1.00; P for trend = 0.05) and with higher daily intakes of lutein and zeaxanthin (OR: 0.54; 95% CI: 0.32, 0.91; P for trend = 0.06) and zinc (OR: 0.58; 95% CI: 0.36, 0.91; P for trend = 0.02). An effect modification by exercise and NHL subtype was observed with some food groups and nutrients.
  
  
  CONCLUSIONS
  Higher intakes of vegetables, lutein and zeaxanthin, and zinc are associated with a lower NHL risk.
authors.affiliation: Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
authors.forename: Linda E
authors.initials: LE
authors.lastname: Kelemen
authors.forename: James R
authors.initials: JR
authors.lastname: Cerhan
authors.forename: Unhee
authors.initials: U
authors.lastname: Lim
authors.forename: Scott
authors.initials: S
authors.lastname: Davis
authors.forename: Wendy
authors.initials: W
authors.lastname: Cozen
authors.forename: Maryjean
authors.initials: M
authors.lastname: Schenk
authors.forename: Joanne
authors.initials: J
authors.lastname: Colt
authors.forename: Patricia
authors.initials: P
authors.lastname: Hartge
authors.forename: Mary H
authors.initials: MH
authors.lastname: Ward
mesh_terms: D000328:Adult; D000368:Aged; D016588:Anticarcinogenic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use*; D016022:Case-Control Studies; D004032:Diet; D004034:Diet Surveys; D005260:Female; D006801:Humans; D016015:Logistic Models; D008228:Lymphoma, Non-Hodgkin / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D012307:Risk Factors; D018426:SEER Program; D014481:United States; D014675:Vegetables
chemical_list: D016588:Anticarcinogenic Agents; D000975:Antioxidants