title: Fruit and vegetable intake and risk of cancer: a prospective cohort study.
abstract: 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.
  
  
  METHODS
  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) = 0.99; 95% CI: 0.94, 1.05; P trend = 0.059) or men (RR(Q5 vs Q1) = 0.98; 95% CI: 0.95, 1.02; P for trend = 0.17). Vegetable intake was not associated with risk of total cancer among women (RR(Q5 vs Q1) = 1.04; 95% CI: 0.98, 1.09; P for trend = 0.084), but was associated with a significant decrease in risk in men (RR(Q5 vs Q1) = 0.94; 95% CI: 0.91, 0.97; P trend = 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) = 0.97; 95% CI: 0.91, 1.04; P for trend = 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.
authors.affiliation: Yale School of Public Health, New Haven, CT, USA.
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: George
authors.forename: Yikyung
authors.initials: Y
authors.lastname: Park
authors.forename: Michael F
authors.initials: MF
authors.lastname: Leitzmann
authors.forename: Neal D
authors.initials: ND
authors.lastname: Freedman
authors.forename: Emily C
authors.initials: EC
authors.lastname: Dowling
authors.forename: Jill
authors.initials: J
authors.lastname: Reedy
authors.forename: Arthur
authors.initials: A
authors.lastname: Schatzkin
authors.forename: Albert
authors.initials: A
authors.lastname: Hollenbeck
authors.forename: Amy F
authors.initials: AF
authors.lastname: Subar
mesh_terms: D000368:Aged; D015331:Cohort Studies; D016001:Confidence Intervals; D004034:Diet Surveys; D005260:Female; D005638:Fruit; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology; D016017:Odds Ratio; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014675:Vegetables