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

Abstract

The number of cancer survivors is growing rapidly worldwide, especially long-term survivors. Although a healthy diet with a high vegetable and fruit consumption is a key factor in primary cancer prevention, there is a lack of specific dietary recommendations for cancer survivors, except in the case of breast cancer [World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) report]. We have therefore carried out a systematic review and meta-analysis of cohort studies reporting on the associations between vegetable and fruit intake with cancer recurrence and mortality and all-cause mortality in cancer patients. After a comprehensive search of PubMed and Scopus databases, the results of 28 selected articles were analyzed. A high vegetable intake before diagnosis was inversely associated with overall mortality in survivors of head and neck (HR: 0.75; 95% CI: 0.65, 0.87) and ovarian cancer (HR: 0.78; 95% CI: 0.66, 0.91). In ovarian cancer patients, prediagnosis fruit intake was also inversely associated with all-cause mortality (HR: 0.82; 95% CI: 0.70, 0.96). The evidence was insufficient for survivors of other cancers, although these associations generally tended to be protective. Therefore, more studies are needed to clarify the association between vegetable and fruit consumption and the prognosis of these different types of cancer. To date, the general recommendation to consume ≥5 servings of vegetables and fruit per day (∼400 g/d) could underestimate the needs of cancer survivors, particularly those with ovarian tumors, in which the recommendation could increase to ∼600 g/d (i.e., 300 g/d of vegetables and 300 g/d of fruit).

Onco-Preventive and Chemo-Protective Effects of Apple Bioactive Compounds

“…Studies have shown differences in fruit consumption across the world based on the socioeconomic status, sex, and geographic location. From these studies, cancer incidence was estimated to decrease by 14% with consumption of 550-600 g of fruit and vegetable per day, which is greater than the current recommendations made by WHO [34,35]. These results suggest that a healthy diet such as one high in fruits and vegetables has protective effects against different types of cancer.…”

The Role of Diet, Alcohol, BMI, and Physical Activity in Cancer Mortality: Summary Findings of the EPIC Study

“…In contrast, in another review, higher intake of vegetables was inversiley associated with overall mortality, though among cancer survivors only, at both cancer pre-and postdiagnosis [19]. Importantly, when considering cancer-specific mortality, it has been shown that intake of vegetables could reduce cancer mortaltiy in survivors of head and neck cancer and of ovarian cancer, but not other cancer types [80]. In the EPIC study, only a few cancer-specific associations were evaluated and, for instance, there was a non-significant association between intake of fruits and vegetables and mortality related to prostate cancer [35].…”

Effects of Different Solvents Extractions on Total Polyphenol Content, HPLC Analysis, Antioxidant Capacity, and Antimicrobial Properties of Peppers (Red, Yellow, and Green (Capsicum annum L.))

“…Plants with a variety of bioactive compounds and antioxidant components are gaining popularity as a result of their efficacy in enhancing human health and nutrition [ 3 , 4 ]. They have been linked to lower cancer and heart disease incidence and in turn the mortality rates [ 5 , 6 ].…”