Fruit and vegetables consumption and breast cancer risk: the EPIC Italy study.
The role of fruit and vegetables in breast cancer (BC) development has long been debated. A large variety of vegetables and fruit are consumed by Mediterranean populations, a favourable setting for evaluating the effects of these foods. The association between vegetables and fruit consumption, overall and by specific types, and BC risk was studied in the Italian section of the European Prospective Investigation into Cancer and Nutrition study. Over 31,000 women, aged 36-64 years, recruited in five Italian centers between 1993 and 1998, were available for analyses with dietary and lifestyle information and anthropometric measurements. After a median follow-up of 11.25 years, 1,072 invasive and in situ incident BC cases were identified. Cox proportional hazard models (adjusted for education, anthropometry, reproductive history, hormone replacement therapy, physical activity, alcohol consumption and smoking habits) showed an inverse association between consumption of all vegetables and BC risk (highest vs. lowest quintile HR 0.65; 95% CI 0.53-0.81, P for trend = 0.003). According to subtypes of vegetables, an inverse association emerged for increasing consumption of leafy vegetables (highest vs. lowest quintile HR 0.70; 95% CI 0.57-0.86, P for trend = 0.0001) and fruiting vegetables (highest vs. lowest quintile HR 0.75; 95% CI 0.60-0.94, P for trend = 0.01). An inverse association also emerged with increasing consumption of raw tomatoes (P for trend = 0.03). In contrast, no association of fruit, overall or by subtypes, with BC risk was found. In this Mediterranean population, a clear protective role of increasing vegetables consumption, mainly leafy and fruiting vegetables, on BC risk emerged.
Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Ponte Nuovo Palazzina 28 A, Via delle Oblate 4, 50141 Florence, Italy.
Giovanna
G
Masala
Melania
M
Assedi
Benedetta
B
Bendinelli
Ilaria
I
Ermini
Sabina
S
Sieri
Sara
S
Grioni
Carlotta
C
Sacerdote
Fulvio
F
Ricceri
Salvatore
S
Panico
Amalia
A
Mattiello
Rosario
R
Tumino
Maria Concetta
MC
Giurdanella
Franco
F
Berrino
Calogero
C
Saieva
Domenico
D
Palli
D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology*; D038441:Diet, Mediterranean; D005260:Female; D005638:Fruit; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D014675:Vegetables