title: Association of vegetable and fruit intake with gastric cancer risk among Japanese: a pooled analysis of four cohort studies.
abstract: BACKGROUND
  Prospective evidence is inconsistent regarding the association between vegetable/fruit intake and the risk of gastric cancer.
  
  
  METHODS
  In an analysis of original data from four population-based prospective cohort studies encompassing 191 232 participants, we used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of gastric cancer incidence according to vegetable and fruit intake and conducted a meta-analysis of HRs derived from each study.
  
  
  RESULTS
  During 2 094 428 person-years of follow-up, 2995 gastric cancer cases were identified. After adjustment for potential confounders, we found a marginally significant decrease in gastric cancer risk in relation to total vegetable intake but not total fruit intake: the multivariate-adjusted HR (95% CI; P for trend) for the highest versus the lowest quintile of total vegetable intake was 0.89 (0.77-1.03; P for trend = 0.13) among men and 0.83 (0.67-1.03; P for trend = 0.40) among women. For distal gastric cancer, the multivariate HR for the highest quintile of total vegetable intake was 0.78 (0.63-0.97; P for trend = 0.02) among men.
  
  
  CONCLUSIONS
  This pooled analysis of data from large prospective studies in Japan suggests that vegetable intake reduces gastric cancer risk, especially the risk of distal gastric cancer among men.
authors.affiliation: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo tshimazu@ncc.go.jp.
authors.forename: T
authors.initials: T
authors.lastname: Shimazu
authors.affiliation: Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya.
authors.forename: K
authors.initials: K
authors.lastname: Wakai
authors.affiliation: Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo.
authors.forename: A
authors.initials: A
authors.lastname: Tamakoshi
authors.affiliation: Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai.
authors.forename: I
authors.initials: I
authors.lastname: Tsuji
authors.affiliation: Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga.
authors.forename: K
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Preventive Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka.
authors.forename: K
authors.initials: K
authors.lastname: Matsuo
authors.affiliation: Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu.
authors.forename: C
authors.initials: C
authors.lastname: Nagata
authors.affiliation: Department of Epidemiology and Prevention, Clinical Research Center, National Center for Global Health and Medicine, Tokyo.
authors.forename: T
authors.initials: T
authors.lastname: Mizoue
authors.affiliation: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Inoue
authors.affiliation: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo.
authors.forename: S
authors.initials: S
authors.lastname: Tsugane
authors.affiliation: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo.
authors.forename: S
authors.initials: S
authors.lastname: Sasazuki
mesh_terms: D044466:Asian People; D015331:Cohort Studies; D004032:Diet; D004034:Diet Surveys; D005260:Female; D005638:Fruit; D006801:Humans; D015994:Incidence; D008297:Male; D016016:Proportional Hazards Models; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014675:Vegetables
keywords: epidemiology; fruit; pooled analysis; prospective studies; stomach neoplasms; vegetables