Fruit and vegetable intake and breast cancer prognosis: a meta-analysis of prospective cohort studies

Abstract

The effect of fruit and vegetable intake on breast cancer prognosis is controversial. Thus, a meta-analysis was carried out to explore their associations. A comprehensive search was conducted in PubMed, Web of Science, OVID, ProQuest and Chinese databases from inception to April 2016. The summary hazard ratios (HR) and 95 % CI were estimated using a random effects model if substantial heterogeneity existed and using a fixed effects model if not. Subgroup analyses and sensitivity analyses were also performed. In total, twelve studies comprising 41 185 participants were included in the meta-analysis. Comparing the highest with the lowest, the summary HR for all-cause mortality were 1·01 (95 % CI 0·72, 1·42) for fruits and vegetables combined, 0·96 (95 % CI 0·83, 1·12) for total vegetable intake, 0·99 (95 % CI 0·89, 1·11) for cruciferous vegetable intake and 0·88 (95 % CI 0·74, 1·05) for fruit intake; those for breast cancer-specific mortality were 1·05 (95 % CI 0·77, 1·43) for total vegetable intake and 0·94 (95 % CI 0·69, 1·26) for fruit intake; and those for breast cancer recurrence were 0·89 (95 % CI 0·53, 1·50) for total vegetable intake and 0·98 (95 % CI 0·76, 1·26) for cruciferous vegetable intake. This meta-analysis found no significant associations between fruit and vegetable intake and breast cancer prognosis.

Association of low plasma antioxidant levels with all-cause mortality and coronary events in healthy middle-aged men from France and Northern Ireland in the PRIME study

“…All other evaluated micronutrients were not significantly associated with reduced CVD risk, following adjustment for potential confounders. These findings largely support previous observational reports of inverse associations between all-cause mortality, cardiovascular risk and serum micronutrient status [5,32,33], supported by higher fruit and vegetable consumption and antioxidant intake [34][35][36].…”

Vegetable and Fruit Consumption and Prognosis Among Cancer Survivors: A Systematic Review and Meta-Analysis of Cohort Studies

“…Although in our review we did not include breast cancer survivors, it is important to highlight that a previous meta-analysis in 2017, including 12 studies, showed null results with the intake of total fruit and vegetables combined (HR: 1.01; 95% CI: 0.72, 1.42), total vegetables (HR: 0.99; 95% CI: 0.89, 1.11), and total fruit (HR: 0.88; 95% CI: 0.74, 1.05) ( 21 ). Similar results were also reported in another meta-analysis, including 10 studies ( 22 ).…”

“…Vegetable consumption has been associated with a reduced overall cancer mortality among cancer survivors ( 19 ). Although vegetable and fruit intake was not related to cancer survival in breast cancer patients in 2 similar meta-analyses ( 21 , 22 ); the WCRF/AICR report concluded that there is limited suggestive evidence linking a higher consumption of foods containing fiber with increased breast cancer survival ( 2 ). Among vegetable classes, the strongest associations with reduced cancer incidence have been found for green-yellow and cruciferous vegetables ( 23 ), which may be due to the chemopreventive properties of carotenoids and isothiocyanates, respectively ( 24 ).…”

Mediterranean Diet Affects Blood Circulating Lipid-Soluble Micronutrients and Inflammatory Biomarkers in a Cohort of Breast Cancer Survivors: Results from the SETA Study

“…Several reports have investigated the association between specific food groups and the risk of BC. A meta-analysis of prospective studies concluded that a high intake of fruit, and fruit and vegetables together, but not only vegetables, is associated with a slight reduction of BC risk [ 37 ], while no significant associations between fruit and vegetable intake and BC prognosis were found [ 52 ]. A very recent study on the EPIC cohort demonstrated a positive association of alcohol consumption and suggested an inverse association of dietary fiber and possibly fruit intake with the risk of BC [ 53 ].…”