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Fruit and vegetable consumption in relation to risk factors for cancer: a report from the Malmö Diet and Cancer Study

Published online by Cambridge University Press:  02 January 2007

Peter Wallström ,
Elisabet Wirfält ,
Lars Janzon ,
Irene Mattisson ,
Sölve Elmståhl ,
Ulla Johansson  and
Göran Berglund
Peter Wallström*
Affiliation:
Department of Medicine, Lund University, Malmö University Hospital, SE-205 02 Malmö, Sweden
Elisabet Wirfält
Affiliation:
Department of Medicine, Lund University, Malmö University Hospital, SE-205 02 Malmö, Sweden
Lars Janzon
Affiliation:
Department of Community Medicine, Lund University, Malmö University Hospital, SE-205 02 Malmö, Sweden
Irene Mattisson
Affiliation:
Department of Medicine, Lund University, Malmö University Hospital, SE-205 02 Malmö, Sweden
Sölve Elmståhl
Affiliation:
Department of Community Medicine, Lund University, Malmö University Hospital, SE-205 02 Malmö, Sweden
Ulla Johansson
Affiliation:
Department of Medicine, Lund University, Malmö University Hospital, SE-205 02 Malmö, Sweden
Göran Berglund
Affiliation:
Department of Medicine, Lund University, Malmö University Hospital, SE-205 02 Malmö, Sweden
*
*Corresponding author: Email [email protected]
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Abstract

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Objective

To examine the associations between the consumption of fruit and vegetables and other markers of cancer risk.

Design

A cross-sectional survey within the population-based prospective Malmö Diet and Cancer (MDC) Study. Information on food habits was collected through the modified diet history method designed and validated for the MDC Study. Data on smoking and alcohol habits, leisure time physical activity, birth country, education, socioeconomic status and cohabitation status were collected through a questionnaire.

Setting

Malmö, the third largest city in Sweden.

Subjects

All subjects who entered the MDC Study during winter 1991 to summer 1994 (men and women living in Malmö, aged between 46 and 68 years), with a total of 15 173.

Results

Women consumed more fruit and vegetables than men. Low consumption of both fruits and vegetables was associated with unfavourable nutrient profiles: higher percentage of energy from fat and lower intakes of antioxidant nutrients and dietary fibre. Low consumption was also associated with smoking, low leisure time physical activity, low education and being born in Sweden. High age was associated with low vegetable consumption in both genders. Alcohol intake was positively associated with vegetable consumption in both genders, while both zero and high alcohol consumers had low fruit consumption. Men residing without a partner consumed less fruits and vegetables than other men. There were very weak or no independent associations between socioeconomic status and fruit/vegetable consumption.

Conclusion

This study indicates that several established risk markers and risk factors of cancer may be independently associated with low fruit and vegetable consumption. The findings suggest that the adverse effects of factors such as smoking, low physical activity and a high-fat diet could partly be explained by low consumption of fruit or vegetables. The implied health benefits of a low or moderate alcohol consumption may be similarly confounded by high consumption of fruit or vegetables.

Keywords

FruitsVegetablesCross-sectional studySmokingAlcoholSociodemographic factorsSweden
Type
Research Article
Information
Public Health Nutrition , Volume 3 , Issue 3 , September 2000 , pp. 263 - 271
Copyright
Copyright © CABI Publishing 2000

References

1Sies, H, Stahl, W.Vitamins E and C, β-carotene, and other carotenoids as antioxidants. Am. J. Clin. Nutr. 1995; 62 (Suppl.): S1315–21.CrossRefGoogle Scholar
2Steinmetz, KA, Potter, JD. Vegetables, fruit, and cancer prevention: a review. J. Am. Diet. Assoc. 1996; 96: 1027–39.CrossRefGoogle ScholarPubMed
3Steinmetz, KA, Potter, JD. Vegetables, fruit, and cancer. II. Mechanisms. Cancer Causes Control 1991; 2: 427–42.CrossRefGoogle ScholarPubMed
4Johnson, IT, Williamson, G, Musk, SRR. Anticarcinogenic factors in plant foods: a new class of nutrients? Nutr. Res. Rev. 1994; 7: 175–204.CrossRefGoogle Scholar
5Berglund, G, Elmståhl, S, Janzon, L, Larsson, SA. The Malmö Diet and Cancer Study. Design and feasibility. J. Intern. Med. 1993; 232: 45–51.CrossRefGoogle Scholar
6Riboli, E, Elmståhl, S, Saracci, R, Gullberg, B, Lindgärde, F.The Malmö Food Study: validity of two dietary assessment methods for measuring nutrient intake. Int. J. Epidemiol 1997; 26 (Suppl. 1): S161–73.CrossRefGoogle ScholarPubMed
7Elmståhl, S, Gullberg, B, Riboli, E, Saracci, R, Lindgärde, F.The reproducibility of a novel diet history method and an extensive food frequency questionnaire. The Malmö Food Study. Eur. J. Clin. Nutr. 1996; 50: 134–42.Google Scholar
8Elmståhl, S, Riboli, E, Lindgärde, F, Gullberg, B, Saracci, R.The Malmö Food Study. The relative validity of a modified diet history method and an extensive food frequency questionnaire for measuring food intake. Eur. J. Clin. Nutr. 1996; 50: 143–51.Google Scholar
9Willett, WC, Sampson, L, Stampfer, MJ, et al. Reproducibility and validity of a semiquantitative food frequency questionnaire. Am. J. Epidemiol. 1985; 122: 51–65.CrossRefGoogle ScholarPubMed
10Block, G, Woods, M, Potosky, A, Clifford, C.Validation of a self-administered diet history questionnaire using multiple diet records. J. Clin. Epidemiol. 1990; 43: 1327–35.CrossRefGoogle ScholarPubMed
11Pietinen, P, Hartman, AM, Haapa, E, et al. Reproducibility and validity of dietary assessment instruments. I. A self-administered food use questionnaire with a portion size picture booklet. Am. J. Epidemiol. 1988; 128: 655–66.CrossRefGoogle Scholar
12Statistics Sweden. Occupations in Population and Housing Census 1985 (FoB 85) according to Nordic Standard Occupational Classification (Nordisk yrkesklassificering, NYK) and Swedish Socio-economic Classification (Socioekonomisk indelning, SEI) [in Swedish]. Reports on Statistical Co-ordination 1989:5. Stockholm: Statistics Sweden, 1989.Google Scholar
13Royal College of Psychiatrists. Alcohol: Our Favourite Drug. London: Tavistock, 1986.Google Scholar
14Taylor, HL, Jacobs, DR Jr, Schucker, B, Knudsen, J, Leon, AS, Debacker, G.A questionnaire for the assessment of leisure time physical activity. J. Chron. Dis. 1978; 31: 741–55.CrossRefGoogle Scholar
15Johansson, L, Solvoll, K, Aa Bjørneboe, G-E, Drevon, CA. Dietary habits among Norwegian men and women. Scand. J. Nutr. 1997; 41: 63–70.Google Scholar
16Margetts, BM, Nelson, M, eds. Design Concepts in Nutritional Epidemiology, 2nd edn. Oxford: Oxford University Press, 1997.CrossRefGoogle Scholar
17McTiernan, A, Ulrich, C, Slate, S, Potter, J.Physical activity and cancer etiology: associations and mechanisms. Cancer Causes Control 1998; 9: 487–509.CrossRefGoogle ScholarPubMed
18Serdula, MK, Byers, T, Mokdad, AH, Simoes, E, Mendlein, JM, Coates, RJ. The association between fruit and vegetable intake and chronic disease risk factors. Epidemiology 1996; 7: 161–65.CrossRefGoogle ScholarPubMed
19Johansson, L, Frost Andersen, L.Who eats 5 A Day?: intake of fruits and vegetables among Norwegians in relation to gender and lifestyle. J. Am. Diet. Assoc. 1998; 98: 689–91.CrossRefGoogle Scholar
20Midgette, AS, Baron, JA, Rohan, TE. Do cigarette smokers have diets that increase their risks of coronary heart disease and cancer? Am. J. Epidemiol. 1993; 137: 521–9.CrossRefGoogle ScholarPubMed
21Kushi, LH, Folsom, AR, Jacobs, DR Jr, Luepker, RV, Elmer, PJ, Blackburn, H.Educational attainment and nutrient consumption patterns: the Minnesota Heart Study. J. Am. Diet. Assoc. 1988; 88: 1230–6.CrossRefGoogle Scholar
22Braddon, FEM, Wadsworth, MEJ, Davies, JMC, Cripps, HA. Social and regional differences in food and alcohol consumption and their measurement in a national birth cohort. J. Epidemiol. Community Health 1988; 42: 341–9.CrossRefGoogle Scholar
23Aro, S, Räsänen, L, Telama, R.Social class and changes in health-related habits in Finland in 1973–1983. Scand. J. Soc. Med. 1986; 14: 39–47.CrossRefGoogle ScholarPubMed
24Bolton-Smith, C, Smith, WCS, Woodward, M, Tunstall-Pedoe, H.Nutrient intakes of different social-class groups: results from the Scottish Heart Health Study (SHHS). Br. J. Nutr. 1991; 65: 321–35.CrossRefGoogle ScholarPubMed
25La Vecchia, C, Negri, E, Franceschi, S, Parazzini, F, Decarli, A.Differences in dietary intake with smoking, alcohol, and education. Nutr. Cancer 1992; 17: 297–304.CrossRefGoogle ScholarPubMed
26Becker, W. Food Habits and Nutrient Intake in Sweden 1989. (Befolkningens kostvanor och näringsintag i Sverige 1989. Metod- och resultatanalys) [in Swedish, with a summary in English]. Uppsala: Statens Livsmedelsverk, 1994.Google Scholar
27Wirfält, E, Mattisson, I, Gullberg, B, Berglund, G.Food patterns defined by cluster analysis and their utility as dietary exposure variables. Public Health Nutr. 2000 (in press).CrossRefGoogle ScholarPubMed
28Klatsky, AL, Armstrong, MA. Alcoholic beverage choice and risk of coronary artery disease mortality: do red wine drinkers fare best? Am. J. Cardiol. 1993; 71: 467–9.CrossRefGoogle ScholarPubMed
29Grønbæk, M, Deis, A, Sørensen, TIA, Becker, U, Schnohr, P, Jensen, G.Mortality associated with moderate intakes of wine, beer, or spirits. BMJ 1995; 310: 1165–9.CrossRefGoogle ScholarPubMed
30Tjønneland, A, Grønbæk, M, Stripp, C, Overvad, K.Wine intake and diet in a random sample of 48 763 Danish men and women. Am. J. Clin. Nutr. 1999; 69: 49–54.CrossRefGoogle Scholar
31Harnack, L, Block, G, Subar, AF, Lane, S, Brand, R.Association of cancer prevention-related nutrition knowledge, beliefs, and attitudes to cancer prevention dietary behavior. J. Am. Diet. Assoc. 1997; 97: 957–65.CrossRefGoogle ScholarPubMed
32Krebs-Smith, SM, Heimendinger, J, Patterson, BH, et al. Psychosocial factors associated with fruit and vegetable consumption. Am. J. Health Prom. 1995; 10: 98–104.CrossRefGoogle ScholarPubMed
33Havas, S, Treiman, K, Langenberg, P, et al. Factors associated with fruit and vegetable consumption among women participating in WIC. J. Am. Diet. Assoc. 1998; 98: 1141–8.CrossRefGoogle ScholarPubMed
34Turrell, G.Determinants of healthy food choice in a population-based sample. Am. J. Health Behav. 1998; 22: 342–57.Google Scholar
35Caltabiano, ML, Shellshear, J.Palatability versus healthiness as determinants of food preferences in young adults: a comparison of nomothetic and idiographic analytic approaches. Aust. NZ J. Public Health. 1998; 22: 547–551.CrossRefGoogle ScholarPubMed
36Glanz, K, Basil, M, Maibach, E, Goldberg, J, Snyder, D.Why Americans eat what they do: taste, nutrition, cost, convenience, and weight control concerns as influences on food consumption. J. Am. Diet. Assoc. 1998; 98: 1118–26.CrossRefGoogle ScholarPubMed
37Steptoe, A, Lipsey, Z, Wardle, J.Stress, hassles and variations in alcohol consumption, food choice and physical exercise: a diary study. Br. J. Health Psychol. 1998; 3 (Part 1): 51–63.CrossRefGoogle Scholar
38Hellerstedt, WL, Jeffery, RW. The association of job strain and health behaviours in men and women. Int. J. Epidemiol. 1997; 26: 575–83.CrossRefGoogle ScholarPubMed
39Povey, R, Conner, M, Sparks, P, James, R, Shepherd, R.Interpretations of healthy and unhealthy eating, and implications for dietary change. Health Educ. Res. 1998; 13: 171–83.CrossRefGoogle ScholarPubMed