Fruit, vegetable, and fiber intake in relation to cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC)

Bradbury, Kathryn E.; Appleby, Paul N.; Key, Timothy J.

doi:10.3945/ajcn.113.071357

Cited by 277 publications

(191 citation statements)

References 31 publications

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“…However, individuals with higher intakes of vegetables and fruit which are rich in vitamin C are likely to have other healthy behaviors, such as a lower prevalence of overweight/obesity and tobacco smoking as well as lower intakes of alcohol. 43,44 Hence, we could not fully exclude the possible impact on esophageal cancer risk of these confounding factors.…”

Section: Discussionmentioning

confidence: 99%

Association between dietary vitamin C intake and risk of esophageal cancer: A dose–response meta‐analysis

Lü²,

Zhao

et al. 2015

Intl Journal of Cancer

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While several epidemiological studies have investigated the association between vitamin C and risk of esophageal cancer, the results remain inconsistent. In the present study, a meta-analysis was conducted to assess the impact of dietary vitamin C intake on esophageal cancer risk. Online databases were searched up to March 29, 2015, for studies on the association between dietary vitamin C intake and esophageal cancer risk. Pooled risk ratios (RRs) or odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Dose-response analyses were performed using the method of restricted cubic splines with four knots at percentiles of 5, 35, 65 and 95% of the distribution. Publication bias was estimated using Egger's tests and funnel plots. In all, 15 articles were included in this meta-analysis, including 20 studies, containing 7063 controls and 3955 cases of esophageal cancer. By comparing the highest vs. the lowest categories of vitamin C intake, we found that vitamin C was inversely associated with the risk of esophageal cancer [overall OR 5 0.58, 95% CI 5 0.49-0.68, I 2 5 56%]. A linear dose-response relationship was found. With an increase in dietary vitamin C intake of 50 mg/day, the risk of esophageal cancer statistically decreased by 13% (OR 5 0.87, 95% CI 5 0.80-0.93, p linearity 5 0.0002). In conclusion, our analysis suggested that the higher intake of dietary vitamin C might have a protective effect against esophageal cancer.Esophageal cancer ranks the tenth most common malignancy and the eighth leading cause of cancer-related deaths worldwide. 1 In 2012, [mt]456,000 newly diagnosed cases and 400,000 related deaths were reported. 2 Most esophageal cancer patients are diagnosed at the advanced stages, and the 5-year survival rate is <20%. 3 Thus, primary prevention of esophageal cancer is becoming critical.A large proportion of cases are induced by the action of chemical carcinogens. The epidemiological evidence suggests that alcohol consumption, smoking tobacco, N-nitroso compound and micronutrient deficiency are among the major risk factors for esophageal cancer. [4][5][6] The ultimate reactive and carcinogenic forms of most chemical carcinogens are strong electrophiles. 7 However, vitamin C can prevent carcinogenesis of esophageal cells by blocking the formation of Nnitroso compounds. [8][9][10][11][12] Since the first study that explored the association between vitamin C and esophageal cancer in 1987, 13 a number of epidemiological studies have investigated the relationship between vitamin C intake and esophageal cancer risk. However, these results are controversial. Therefore, we conducted a meta-analysis to assess the association of dietary vitamin C intake and the risk of esophageal cancer, and to evaluate the dose-response relationship of esophageal cancer and vitamin C intake. Material and Methods Search strategyA comprehensive literature search of Pubmed, and Web of Knowledge was conducted before March 2015. The following keywords were used: "esophageal cancer" or...

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Section: Discussionmentioning

confidence: 99%

Association between dietary vitamin C intake and risk of esophageal cancer: A dose–response meta‐analysis

Lü²,

Zhao

et al. 2015

Intl Journal of Cancer

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“…Small cell GI LSA closely resembles feline inflammatory bowel disease (IBD) in its clinical presentation,2 with both diseases having poorly defined etiologies. Various risk factors including genetic and molecular alterations,3, 4, 5 diet,3, 6, 7 and chronic inflammation8, 9, 10 have been linked to the development of both disorders. Still other studies have suggested an association between chronic mucosal inflammation and the progression of IBD to pronounced dysplasia in the GI tract 11, 12, 13, 14…”

Section: Introductionmentioning

confidence: 99%

Relationship of the mucosal microbiota to gastrointestinal inflammation and small cell intestinal lymphoma in cats

Garraway

Johannes

Bryan

et al. 2018

Veterinary Internal Medicne

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BackgroundThe gastrointestinal (GI) microbiota in healthy cats is altered in IBD. Little research has been performed to identify whether specific bacterial groups are associated with small cell GI lymphoma (LSA).HypothesisMucosal bacteria, including Enterobacteriaceae and Fusobacterium spp., are abundant in intestinal biopsies of cats with small cell GI LSA compared to cats with IBD.AnimalsFourteen cats with IBD and 14 cats with small cell GI LSA.MethodsRetrospective case control study. A search of the medical records was performed to identify cats diagnosed with IBD and with GI LSA. Bacterial groups identified by FISH in GI biopsies were compared between cohorts and correlated to CD11b+ and NF‐κB expression.Results Fusobacterium spp. (median; IQR bacteria/region) were higher in cats with small cell GI LSA in ileal (527; 455.5 – 661.5; P = .046) and colonic (404.5; 328.8 – 455.5; P = .016) adherent mucus, and combined colonic compartments (free mucus, adherent mucus, attaching to epithelium) (8; 0 – 336; P = .017) compared to cats with IBD (ileum: 67; 31.5 – 259; colon: 142.5; 82.3 – 434.5; combined: 3; 0 – 34). Bacteroides spp. were higher in ileal adherent mucus (P = .036) and 3 combined ileal compartments (P = .034) of cats with small cell GI LSA. There were significant correlations between Fusobacterium spp. totals and CD11b+ cell (P = .009; rs .476) and NF‐κB expression (P = .004; rs .523).ConclusionsThe bacterial alterations appreciated might be influential in development of small cell GI LSA, and should drive further studies to elucidate the effects of microbial‐mediated inflammation on GI cancer progression.

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“…Diet may also play a role in lung cancer etiology 4, 5, 6. Among dietary factors, fruits, and vegetables are of much interest due to their potential anti‐inflammatory and antioxidant properties 7.…”

Section: Introductionmentioning

confidence: 99%

Blood concentrations of carotenoids and retinol and lung cancer risk: an update of the WCRF–AICR systematic review of published prospective studies

et al. 2016

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Carotenoids and retinol are considered biomarkers of fruits and vegetables intake, and are of much interest because of their anti‐inflammatory and antioxidant properties; however, there is inconsistent evidence regarding their protective effects against lung cancer. We conducted a meta‐analysis of prospective studies of blood concentrations of carotenoids and retinol, and lung cancer risk. We identified relevant prospective studies published up to December 2014 by searching the PubMed and several other databases. We calculated summary estimates of lung cancer risk for the highest compared with lowest carotenoid and retinol concentrations and dose–response meta‐analyses using random effects models. We used fractional polynomial models to assess potential nonlinear relationships. Seventeen prospective studies (18 publications) including 3603 cases and 458,434 participants were included in the meta‐analysis. Blood concentrations of α‐carotene, β‐carotene, total carotenoids, and retinol were significantly inversely associated with lung cancer risk or mortality. The summary relative risk were 0.66 (95% confidence interval [CI]: 0.55–0.80) per 5 μg/100 mL of α‐carotene (studies [n] = 5), 0.84 (95% CI: 0.76–0.94) per 20 μg/100 mL of β‐carotene (n = 9), 0.66 (95% CI: 0.54–0.81) per 100 μg/100 mL of total carotenoids (n = 4), and 0.81 (95% CI: 0.73–0.90) per 70 μg/100 mL of retinol (n = 8). In stratified analysis by sex, the significant inverse associations for β‐carotene and retinol were observed only in men and not in women. Nonlinear associations were observed for β‐carotene, β‐cryptoxanthin, and lycopene, with stronger associations observed at lower concentrations. There were not enough data to conduct stratified analyses by smoking. In conclusion, higher blood concentrations of several carotenoids and retinol are associated with reduced lung cancer risk. Further studies in never and former smokers are needed to rule out confounding by smoking.

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Fruit, vegetable, and fiber intake in relation to cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC)

Cited by 277 publications

References 31 publications

Association between dietary vitamin C intake and risk of esophageal cancer: A dose–response meta‐analysis

Association between dietary vitamin C intake and risk of esophageal cancer: A dose–response meta‐analysis

Relationship of the mucosal microbiota to gastrointestinal inflammation and small cell intestinal lymphoma in cats

Blood concentrations of carotenoids and retinol and lung cancer risk: an update of the WCRF–AICR systematic review of published prospective studies

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