Vegetable and fruit consumption and the risk of hormone receptor-defined breast cancer in the EPIC cohort

Marleen J Emaus; Petra Hm Peeters; Marije F Bakker; Kim Overvad; Anne Tjønneland; Anja Olsen; Isabelle Romieu; Pietro Ferrari; Laure Dossus; Marie Christine Boutron-Ruault; Laura Baglietto; Renée T Fortner; Rudolf Kaaks; Heiner Boeing; Antonia Trichopoulou; Pagona Lagiou; Dimitrios Trichopoulos; Giovanna Masala; Valeria Pala; Salvatore Panico; Rosario Tumino; Silvia Polidoro; Guri Skeie; Eiliv Lund; Elisabete Weiderpass; J Ramón Quirós; Noémie Travier; María-José Sánchez; Maria-Dolores Chirlaque; Eva Ardanaz; Miren Dorronsoro; Anna Winkvist; Maria Wennberg; H Bas Bueno-de-Mesquita; Kay-Tee Khaw; Ruth C Travis; Timothy J Key; Dagfinn Aune; Marc Gunter; Elio Riboli; Carla H van Gils

doi:10.3945/ajcn.114.101436

Vegetable and fruit consumption and the risk of hormone receptor-defined breast cancer in the EPIC cohort

Marleen J Emaus, Petra Hm Peeters, Marije F Bakker, Kim Overvad, Anne Tjønneland, Anja Olsen, Isabelle Romieu, Pietro Ferrari, Laure Dossus, Marie Christine Boutron-Ruault, Laura Baglietto, Renée T Fortner, Rudolf Kaaks, Heiner Boeing, Antonia Trichopoulou, Pagona Lagiou, Dimitrios Trichopoulos, Giovanna Masala, Valeria Pala, Salvatore PanicoRosario Tumino, Silvia Polidoro, Guri Skeie, Eiliv Lund, Elisabete Weiderpass, J Ramón Quirós, Noémie Travier, María-José Sánchez, Maria-Dolores Chirlaque, Eva Ardanaz, Miren Dorronsoro, Anna Winkvist, Maria Wennberg, H Bas Bueno-de-Mesquita, Kay-Tee Khaw, Ruth C Travis, Timothy J Key, Dagfinn Aune, Marc Gunter, Elio Riboli, Carla H van Gils

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: The recent literature indicates that a high vegetable intake and not a high fruit intake could be associated with decreased steroid hormone receptor-negative breast cancer risk.

OBJECTIVE: This study aimed to investigate the association between vegetable and fruit intake and steroid hormone receptor-defined breast cancer risk.

DESIGN: A total of 335,054 female participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort were included in this study (mean ± SD age: 50.8 ± 9.8 y). Vegetable and fruit intake was measured by country-specific questionnaires filled out at recruitment between 1992 and 2000 with the use of standardized procedures. Cox proportional hazards models were stratified by age at recruitment and study center and were adjusted for breast cancer risk factors.

RESULTS: After a median follow-up of 11.5 y (IQR: 10.1-12.3 y), 10,197 incident invasive breast cancers were diagnosed [3479 estrogen and progesterone receptor positive (ER+PR+); 1021 ER and PR negative (ER-PR-)]. Compared with the lowest quintile, the highest quintile of vegetable intake was associated with a lower risk of overall breast cancer (HRquintile 5-quintile 1: 0.87; 95% CI: 0.80, 0.94). Although the inverse association was most apparent for ER-PR- breast cancer (ER-PR-: HRquintile 5-quintile 1: 0.74; 95% CI: 0.57, 0.96; P-trend = 0.03; ER+PR+: HRquintile 5-quintile 1: 0.91; 95% CI: 0.79, 1.05; P-trend = 0.14), the test for heterogeneity by hormone receptor status was not significant (P-heterogeneity = 0.09). Fruit intake was not significantly associated with total and hormone receptor-defined breast cancer risk.

CONCLUSION: This study supports evidence that a high vegetable intake is associated with lower (mainly hormone receptor-negative) breast cancer risk.

Original language	English
Pages (from-to)	168-177
Number of pages	10
Journal	American Journal of Clinical Nutrition
Volume	103
Issue number	1
DOIs	https://doi.org/10.3945/ajcn.114.101436
Publication status	Published - Jan 2016

Keywords

Breast cancer
Estrogen receptor
Fruit
Progesterone receptor
Vegetables

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Emaus, M. J., Peeters, P. H., Bakker, M. F., Overvad, K., Tjønneland, A., Olsen, A., Romieu, I., Ferrari, P., Dossus, L., Boutron-Ruault, M. C., Baglietto, L., Fortner, R. T., Kaaks, R., Boeing, H., Trichopoulou, A., Lagiou, P., Trichopoulos, D., Masala, G., Pala, V., ... van Gils, C. H. (2016). Vegetable and fruit consumption and the risk of hormone receptor-defined breast cancer in the EPIC cohort. American Journal of Clinical Nutrition, 103(1), 168-177. https://doi.org/10.3945/ajcn.114.101436

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title = "Vegetable and fruit consumption and the risk of hormone receptor-defined breast cancer in the EPIC cohort",

abstract = "BACKGROUND: The recent literature indicates that a high vegetable intake and not a high fruit intake could be associated with decreased steroid hormone receptor-negative breast cancer risk.OBJECTIVE: This study aimed to investigate the association between vegetable and fruit intake and steroid hormone receptor-defined breast cancer risk.DESIGN: A total of 335,054 female participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort were included in this study (mean ± SD age: 50.8 ± 9.8 y). Vegetable and fruit intake was measured by country-specific questionnaires filled out at recruitment between 1992 and 2000 with the use of standardized procedures. Cox proportional hazards models were stratified by age at recruitment and study center and were adjusted for breast cancer risk factors.RESULTS: After a median follow-up of 11.5 y (IQR: 10.1-12.3 y), 10,197 incident invasive breast cancers were diagnosed [3479 estrogen and progesterone receptor positive (ER+PR+); 1021 ER and PR negative (ER-PR-)]. Compared with the lowest quintile, the highest quintile of vegetable intake was associated with a lower risk of overall breast cancer (HRquintile 5-quintile 1: 0.87; 95% CI: 0.80, 0.94). Although the inverse association was most apparent for ER-PR- breast cancer (ER-PR-: HRquintile 5-quintile 1: 0.74; 95% CI: 0.57, 0.96; P-trend = 0.03; ER+PR+: HRquintile 5-quintile 1: 0.91; 95% CI: 0.79, 1.05; P-trend = 0.14), the test for heterogeneity by hormone receptor status was not significant (P-heterogeneity = 0.09). Fruit intake was not significantly associated with total and hormone receptor-defined breast cancer risk.CONCLUSION: This study supports evidence that a high vegetable intake is associated with lower (mainly hormone receptor-negative) breast cancer risk.",

keywords = "Breast cancer, Estrogen receptor, Fruit, Progesterone receptor, Vegetables",

author = "Emaus, {Marleen J} and Peeters, {Petra Hm} and Bakker, {Marije F} and Kim Overvad and Anne Tj{\o}nneland and Anja Olsen and Isabelle Romieu and Pietro Ferrari and Laure Dossus and Boutron-Ruault, {Marie Christine} and Laura Baglietto and Fortner, {Ren{\'e}e T} and Rudolf Kaaks and Heiner Boeing and Antonia Trichopoulou and Pagona Lagiou and Dimitrios Trichopoulos and Giovanna Masala and Valeria Pala and Salvatore Panico and Rosario Tumino and Silvia Polidoro and Guri Skeie and Eiliv Lund and Elisabete Weiderpass and Quir{\'o}s, {J Ram{\'o}n} and No{\'e}mie Travier and Mar{\'i}a-Jos{\'e} S{\'a}nchez and Maria-Dolores Chirlaque and Eva Ardanaz and Miren Dorronsoro and Anna Winkvist and Maria Wennberg and Bueno-de-Mesquita, {H Bas} and Kay-Tee Khaw and Travis, {Ruth C} and Key, {Timothy J} and Dagfinn Aune and Marc Gunter and Elio Riboli and {van Gils}, {Carla H}",

note = "{\textcopyright} 2016 American Society for Nutrition.",

year = "2016",

month = jan,

doi = "10.3945/ajcn.114.101436",

language = "English",

volume = "103",

pages = "168--177",

journal = "American Journal of Clinical Nutrition",

issn = "0002-9165",

publisher = "Elsevier",

number = "1",

}

Emaus, MJ, Peeters, PH, Bakker, MF, Overvad, K, Tjønneland, A, Olsen, A, Romieu, I, Ferrari, P, Dossus, L, Boutron-Ruault, MC, Baglietto, L, Fortner, RT, Kaaks, R, Boeing, H, Trichopoulou, A, Lagiou, P, Trichopoulos, D, Masala, G, Pala, V, Panico, S, Tumino, R, Polidoro, S, Skeie, G, Lund, E, Weiderpass, E, Quirós, JR, Travier, N, Sánchez, M-J, Chirlaque, M-D, Ardanaz, E, Dorronsoro, M, Winkvist, A, Wennberg, M, Bueno-de-Mesquita, HB, Khaw, K-T, Travis, RC, Key, TJ, Aune, D, Gunter, M, Riboli, E & van Gils, CH 2016, 'Vegetable and fruit consumption and the risk of hormone receptor-defined breast cancer in the EPIC cohort', American Journal of Clinical Nutrition, vol. 103, no. 1, pp. 168-177. https://doi.org/10.3945/ajcn.114.101436

TY - JOUR

T1 - Vegetable and fruit consumption and the risk of hormone receptor-defined breast cancer in the EPIC cohort

AU - Emaus, Marleen J

AU - Peeters, Petra Hm

AU - Bakker, Marije F

AU - Overvad, Kim

AU - Tjønneland, Anne

AU - Olsen, Anja

AU - Romieu, Isabelle

AU - Ferrari, Pietro

AU - Dossus, Laure

AU - Boutron-Ruault, Marie Christine

AU - Baglietto, Laura

AU - Fortner, Renée T

AU - Kaaks, Rudolf

AU - Boeing, Heiner

AU - Trichopoulou, Antonia

AU - Lagiou, Pagona

AU - Trichopoulos, Dimitrios

AU - Masala, Giovanna

AU - Pala, Valeria

AU - Panico, Salvatore

AU - Tumino, Rosario

AU - Polidoro, Silvia

AU - Skeie, Guri

AU - Lund, Eiliv

AU - Weiderpass, Elisabete

AU - Quirós, J Ramón

AU - Travier, Noémie

AU - Sánchez, María-José

AU - Chirlaque, Maria-Dolores

AU - Ardanaz, Eva

AU - Dorronsoro, Miren

AU - Winkvist, Anna

AU - Wennberg, Maria

AU - Bueno-de-Mesquita, H Bas

AU - Khaw, Kay-Tee

AU - Travis, Ruth C

AU - Key, Timothy J

AU - Aune, Dagfinn

AU - Gunter, Marc

AU - Riboli, Elio

AU - van Gils, Carla H

PY - 2016/1

Y1 - 2016/1

N2 - BACKGROUND: The recent literature indicates that a high vegetable intake and not a high fruit intake could be associated with decreased steroid hormone receptor-negative breast cancer risk.OBJECTIVE: This study aimed to investigate the association between vegetable and fruit intake and steroid hormone receptor-defined breast cancer risk.DESIGN: A total of 335,054 female participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort were included in this study (mean ± SD age: 50.8 ± 9.8 y). Vegetable and fruit intake was measured by country-specific questionnaires filled out at recruitment between 1992 and 2000 with the use of standardized procedures. Cox proportional hazards models were stratified by age at recruitment and study center and were adjusted for breast cancer risk factors.RESULTS: After a median follow-up of 11.5 y (IQR: 10.1-12.3 y), 10,197 incident invasive breast cancers were diagnosed [3479 estrogen and progesterone receptor positive (ER+PR+); 1021 ER and PR negative (ER-PR-)]. Compared with the lowest quintile, the highest quintile of vegetable intake was associated with a lower risk of overall breast cancer (HRquintile 5-quintile 1: 0.87; 95% CI: 0.80, 0.94). Although the inverse association was most apparent for ER-PR- breast cancer (ER-PR-: HRquintile 5-quintile 1: 0.74; 95% CI: 0.57, 0.96; P-trend = 0.03; ER+PR+: HRquintile 5-quintile 1: 0.91; 95% CI: 0.79, 1.05; P-trend = 0.14), the test for heterogeneity by hormone receptor status was not significant (P-heterogeneity = 0.09). Fruit intake was not significantly associated with total and hormone receptor-defined breast cancer risk.CONCLUSION: This study supports evidence that a high vegetable intake is associated with lower (mainly hormone receptor-negative) breast cancer risk.

AB - BACKGROUND: The recent literature indicates that a high vegetable intake and not a high fruit intake could be associated with decreased steroid hormone receptor-negative breast cancer risk.OBJECTIVE: This study aimed to investigate the association between vegetable and fruit intake and steroid hormone receptor-defined breast cancer risk.DESIGN: A total of 335,054 female participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort were included in this study (mean ± SD age: 50.8 ± 9.8 y). Vegetable and fruit intake was measured by country-specific questionnaires filled out at recruitment between 1992 and 2000 with the use of standardized procedures. Cox proportional hazards models were stratified by age at recruitment and study center and were adjusted for breast cancer risk factors.RESULTS: After a median follow-up of 11.5 y (IQR: 10.1-12.3 y), 10,197 incident invasive breast cancers were diagnosed [3479 estrogen and progesterone receptor positive (ER+PR+); 1021 ER and PR negative (ER-PR-)]. Compared with the lowest quintile, the highest quintile of vegetable intake was associated with a lower risk of overall breast cancer (HRquintile 5-quintile 1: 0.87; 95% CI: 0.80, 0.94). Although the inverse association was most apparent for ER-PR- breast cancer (ER-PR-: HRquintile 5-quintile 1: 0.74; 95% CI: 0.57, 0.96; P-trend = 0.03; ER+PR+: HRquintile 5-quintile 1: 0.91; 95% CI: 0.79, 1.05; P-trend = 0.14), the test for heterogeneity by hormone receptor status was not significant (P-heterogeneity = 0.09). Fruit intake was not significantly associated with total and hormone receptor-defined breast cancer risk.CONCLUSION: This study supports evidence that a high vegetable intake is associated with lower (mainly hormone receptor-negative) breast cancer risk.

KW - Breast cancer

KW - Estrogen receptor

KW - Fruit

KW - Progesterone receptor

KW - Vegetables

U2 - 10.3945/ajcn.114.101436

DO - 10.3945/ajcn.114.101436

M3 - Article

C2 - 26607934

SN - 0002-9165

VL - 103

SP - 168

EP - 177

JO - American Journal of Clinical Nutrition

JF - American Journal of Clinical Nutrition

IS - 1

ER -

Vegetable and fruit consumption and the risk of hormone receptor-defined breast cancer in the EPIC cohort

Abstract

Keywords

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