TY - JOUR
TI - Variety in vegetable and fruit consumption and the risk of gastric and
esophageal cancer in the European prospective investigation into cancer
and nutrition
AU - Jeurnink, S. M.
AU - Buchner, F. L.
AU - Bueno-de-Mesquita, H. B. and
AU - Siersema, P. D.
AU - Boshuizen, H. C.
AU - Numans, M. E.
AU - Dahm, C. C.
AU - and Overvad, K.
AU - Tjonneland, A.
AU - Roswall, N.
AU - Clavel-Chapelon,
AU - F.
AU - Boutron-Ruault, M. C.
AU - Morois, S.
AU - Kaaks, R.
AU - Teucher,
AU - B.
AU - Boeing, H.
AU - Buijsse, B.
AU - Trichopoulou, A.
AU - Benetou, V.
AU - and Zylis, D.
AU - Palli, D.
AU - Sieri, S.
AU - Vineis, P.
AU - Tumino, R.
AU - and Panico, S.
AU - Ocke, M. C.
AU - Peeters, P. H. M.
AU - Skeie, G. and
AU - Brustad, M.
AU - Lund, E.
AU - Sanchez-Cantalejo, E.
AU - Navarro, C. and
AU - Amiano, P.
AU - Ardanaz, E.
AU - Ramon Quiros, J.
AU - Hallmans, G. and
AU - Johansson, I.
AU - Lindkvist, B.
AU - Regner, S.
AU - Khaw, K. T. and
AU - Wareham, N.
AU - Key, T. J.
AU - Slimani, N.
AU - Norat, T.
AU - Vergnaud,
AU - A. C.
AU - Romaguera, D.
AU - Gonzalez, C. A.
JO - International Journal  of Cancer
PY - 2012
VL - 131
TODO - 6
SP - E963-E973
PB - Wiley
SN - 0020-7136
TODO - 10.1002/ijc.27517
TODO - gastric cancer; esophageal cancer; vegetable and fruit; variety; EPIC
TODO - Diets high in vegetables and fruits have been suggested to be inversely
associated with risk of gastric cancer. However, the evidence of the
effect of variety of consumption is limited. We therefore investigated
whether consumption of a variety of vegetables and fruit is associated
with gastric and esophageal cancer in the European Prospective
Investigation into Cancer and Nutrition study. Data on food consumption
and follow-up on cancer incidence were available for 452,269
participants from 10 European countries. After a mean follow-up of 8.4
years, 475 cases of gastric and esophageal adenocarcinomas (180
noncardia, 185 cardia, gastric esophageal junction and esophagus, 110
not specified) and 98 esophageal squamous cell carcinomas were observed.
Diet Diversity Scores were used to quantify the variety in vegetable and
fruit consumption. We used multivariable Cox proportional hazard models
to calculate risk ratios. Independent from quantity of consumption,
variety in the consumption of vegetables and fruit combined and of fruit
consumption alone were statistically significantly inversely associated
with the risk of esophageal squamous cell carcinoma (continuous hazard
ratio per 2 products increment 0.88; 95% CI 0.790.97 and 0.76; 95% CI
0.620.94, respectively) with the latter particularly seen in ever
smokers. Variety in vegetable and/or fruit consumption was not
associated with risk of gastric and esophageal adenocarcinomas.
Independent from quantity of consumption, more variety in vegetable and
fruit consumption combined and in fruit consumption alone may decrease
the risk of esophageal squamous cell carcinoma. However, residual
confounding by lifestyle factors cannot be excluded.
ER -