Intake of fruit, vegetables, and carotenoids in relation to risk of uterine leiomyomata

Abstract

Background: US black women have higher rates of uterine leiomyomata (UL) and lower intakes of fruit and vegetables than do white women. Whether fruit and vegetable intake is associated with UL in black women has not been studied. Objective: We assessed the association of dietary intake of fruit, vegetables, carotenoids, folate, fiber, and vitamins A, C, and E with UL in the Black Women's Health Study. Design: In this prospective cohort study, we followed 22,583 premenopausal women for incident UL (1997UL ( -2009). Diet was estimated by using food-frequency questionnaires in 1995 and 2001. Cox regression was used to derive incidence rate ratios (IRRs) and 95% CIs for the association between each dietary variable (in quintiles) and UL. Results: There were 6627 incident cases of UL diagnosed by ultrasonography (n = 4346) or surgery (n = 2281). Fruit and vegetable intake was inversely associated with UL (4 compared with ,1 serving/d; IRR: 0.90; 95% CI: 0.82, 0.98; P-trend = 0.03). The association was stronger for fruit (2 servings/d compared with ,2 servings/wk; IRR: 0.89; 95% CI: 0.81, 0.98; P-trend = 0.07) than for vegetables (2 servings/d compared with ,4 servings/wk: IRR: 0.97; 95% CI: 0.89, 1.05; P-trend = 0.51). Citrus fruit intake was inversely associated with UL (3 servings/wk compared with ,1 serving/mo: IRR: 0.92; 95% CI: 0.86, 1.00; P-trend = 0.01). The inverse association for dietary vitamin A (upper compared with lower quintiles: IRR: 0.89; 95% CI: 0.83, 0.97; P-trend = 0.01) appeared to be driven by preformed vitamin A (animal sources), not provitamin A (fruit and vegetable sources). UL was not materially associated with dietary intake of vitamins C and E, folate, fiber, or any of the carotenoids, including lycopene. Conclusion: These data suggest a reduced risk of UL among women with a greater dietary intake of fruit and preformed vitamin A.

Role of Endocrine Disrupting Chemicals in the Occurrence of Benign Uterine Leiomyomata: Special Emphasis on AhR Tissue Levels

“…Previous data suggest a reduced risk of LMA among women with a greater dietary intake of fruit and preformed vitamin A (Wise, 2011) but this result was not repeated in this study.…”

Epidemiology of Uterine Fibroids

“…The study showed no association with isoflavones, consistent with two subsequent studies of soy intake (measured by food frequency questionnaire) and UL risk [110, 120], even in populations where soy intake was high [110]. Lignans, found in fruits and vegetables, were associated with a lower risk of UL in TULEP, consistent with results from the Italian case-control study [111] and the BWHS [118]. …”

“…Subsequently, several studies on diet and UL have been published in which validated food frequency questionnaires or nutrient biomarkers were used. The BWHS found that higher intakes of fruits and vegetables was associated with a reduced risk of UL [118]. In a subset of participants from The Uterine Leiomyomata Epidemiology Project (TULEP), urinary isoflavones and lignans were measured as biomarkers of soy intake [119].…”

“…Although experimental animal data show a protective effect of dietary supplementation with lycopene—a carotenoid found in tomato products and other fruits and vegetables—on incidence of UL, epidemiologic data from the NHS II and BWHS show no associations between intake of lycopene, or any other carotenoids, and risk of UL [36, 118, 121, 122]. …”

The health disparities of uterine fibroid tumors for African American women: a public health issue

“…Some data suggest that fibroid growth differs by race, especially as women approach menopause (12). Although some evidence links environmental factors such as diet and history of abuse to this increased risk, most of this information comes from studies such as the Black Women's Health Study (12–14). A recent study has linked vitamin D insufficiency with increased fibroid risk in black women (15).…”