Fruit and vegetable intake and esophageal cancer in a large prospective cohort study

Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
International Journal of Cancer (Impact Factor: 5.09). 12/2007; 121(12):2753-60. DOI: 10.1002/ijc.22993
Source: PubMed


Changing patterns of esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) incidence worldwide suggest distinct etiologies. Although associations between fruit and vegetable intake and both ESCC and EAC have been found in multiple ecological and case-control studies, few prospective studies have investigated these associations. We prospectively examined these associations in 490,802 participants of the National Institutes of Health (NIH)-AARP Diet and Health Study using Cox models adjusted for age, alcohol intake, body mass index, cigarette smoking, education, physical activity and total energy intake. We present hazard ratios and 95% confidence intervals per serving per 1,000 calories. During 2,193,751 person years of follow-up, 103 participants were diagnosed with ESCC and 213 participants with EAC. We found a significant inverse association between total fruit and vegetable intake and ESCC risk (HR: 0.78, 95% CI: 0.67-0.91), but not EAC risk (0.98, 0.90-1.08). In models mutually adjusted for fruit and vegetable intake, the protective association with ESCC was stronger for fruits (0.73, 0.57-0.93) than for vegetables (0.84, 0.66-1.07). When we examined botanical subgroups, we observed significant protective associations for ESCC and intake of Rosacea (apples, peaches, nectarines, plums, pears and strawberries) and Rutaceae (citrus fruits). A significant inverse association between EAC and Chenopodiaceae (spinach) intake was observed. Results from our study suggest that the relation of fruit and vegetable intake and esophageal cancer risk may vary by histologic type.

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Available from: Neal Freedman, Jan 02, 2015
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    • "In another study, they found that the people have a lower risk of 40– 50% of esophageal cancer with relatively high intakes of fruit and vegetables than people with low intakes of fruit and vegetables [22]. It is also suggested that fruits and vegetables are inversely related with the risk for squamous cell carcinoma, but not with the risk for adenocarcinoma [23] [24]. Similalry, in Linxian, China, fruits and vegetables consumption had a protective effect in numerous control cases and cohort studies. "
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    ABSTRACT: Vitamin E (Vit E) has enormous potential for cancer growth inhibition and cancer prevention. It has been studied widely for its antioxidant, anti-inflammatory and anti-cancerous activity. The aim of this review is to provide a summary of the research so far in regards to Vit E and its role in the prevention of human esophageal squamous cell cancer (ESCC), which is among the most malignant types of cancers. Its prevalence is high in China and poses a serious threat to the health of the residents. Therefore, finding new strategies to prevent and lessen the risk of ESCC and comprehensive understanding of carcinogenesis is essential. This review will provide the brief guidelines in understanding of Vit E in the prevention of ESCC. The data suggest that the combination of tocopherols like γ-tocopherol-rich mixture of tocopherols (γ-TmT) would be highly effective to use in the future for the prevention of cancers.
    Full-text · Article · Jan 2015
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    • "The healthy pattern defined in this systematic review referred to a higher loading of fruits , fresh vegetables , dietary fibre and antioxidants and a lower loading of fat dairy , processed food and meat . Fruits , fresh vegetables , dietary fibre , and antioxidants were found to have critical roles in reducing the risk of oesophageal cancer ( Terry et al , 2000 ; Freedman et al , 2007 ; Liu et al , 2013 ) . This pooled result suggested that healthy pattern had a protective effect against ESCC , which was consistent with results found in all of the nine included articles . "
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    ABSTRACT: Background/Objective: Dietary patterns, which represent a complex integration of food and nutrients, have been used to explore the association between dietary factors and the risk of oesophageal cancer. However, the association remains unclear. This systematic review was performed to evaluate the relationship between dietary patterns and oesophageal squamous cell carcinoma (ESCC) by pooling available data from existing studies. Methods: Pertinent articles published up to the end of 2013 were systematically searched and retrieved. The most common dietary patterns with high loadings of foods/nutrients were selected. Adjusted odds ratios (ORs) were derived by comparing the highest with the lowest categories of dietary pattern scores and by using a random-effect model. Heterogeneity was tested using I2 statistic. Results: From nine available case–control studies, in which smoking and other confounding factors were considered, three most common dietary patterns were selected: western pattern, healthy pattern, and drinker/alcohol pattern. Healthy pattern was significantly associated with a decreased risk of ESCC (OR=0.36, 95% confidence interval (CI): 0.23, 0.49); drinker/alcohol pattern was related to a significantly increased risk (OR=2.34, 95% CI: 1.22, 3.45), while no significant association with western pattern was observed (OR=1.29, 95% CI: 0.83, 1.75). Conclusions: Based on available studies, though limited in number, this meta-analysis suggests that some dietary patterns may be associated with the risk of ESCC.
    Full-text · Article · Apr 2014 · British Journal of Cancer
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    • "In a larger five-year prospective cohort study (n = 2,193,751 person-years), higher consumption of Rosaceae botanical subgroup , including strawberries, was associated with a protective effect against esophageal squamous cell carcinoma versus those in the lower quintiles of this fruit group (Freedman et al., 2007). "
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    ABSTRACT: Emerging research provides substantial evidence to classify strawberries as a functional food with several preventive and therapeutic health benefits. Strawberries, a rich source of phytochemicals (ellagic acid, anthocyanins, quercetin, and catechin) and vitamins (ascorbic acid and folic acid), have been highly ranked among dietary sources of polyphenols and antioxidant capacity. It should however be noted that these bioactive factors can be significantly affected by differences in strawberry cultivars, agricultural practices, storage, and processing methods: freezing versus dry heat has been associated with maximum retention of strawberry bioactives in several studies. Nutritional epidemiology shows inverse association between strawberry consumption and incidence of hypertension or serum C-reactive protein; controlled feeding studies have identified the ability of strawberries to attenuate high-fat diet induced postprandial oxidative stress and inflammation, or postprandial hyperglycemia, or hyperlipidemia in subjects with cardiovascular risk factors. Mechanistic studies have elucidated specific biochemical pathways that might confer these protective effects of strawberries: upregulation of endothelial nitric oxide synthase (eNOS) activity, downregulation of NF-kB activity and subsequent inflammation, or inhibitions of carbohydrate digestive enzymes. These health effects may be attributed to the synergistic effects of nutrients and phytochemicals in strawberries. Further studies are needed to define the optimal dose and duration of strawberry intake in affecting levels of biomarkers or pathways related to chronic diseases.
    Full-text · Article · Jan 2014 · Critical reviews in food science and nutrition
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