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American Journal of Epidemiology Advance Access first published online on May 7, 2007
This version published online on June 21, 2007

American Journal of Epidemiology, doi:10.1093/aje/kwm067
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American Journal of Epidemiology Published by the Johns Hopkins Bloomberg School of Public Health 2007.

Original Contribution

Fruit and Vegetable Intakes and Risk of Colorectal Cancer in the NIH–AARP Diet and Health Study

Yikyung Park1, Amy F. Subar2, Victor Kipnis3, Frances E. Thompson2, Traci Mouw1, Albert Hollenbeck4, Michael F. Leitzmann1 and Arthur Schatzkin1

1 Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
2 Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
3 Division of Cancer Prevention, National Cancer Institute, Bethesda, MD
4 AARP, Washington, DC

Correspondence to Dr. Yikyung Park, Division of Cancer Epidemiology and Genetics, 6120 Executive Boulevard, Bethesda, MD 20852 (e-mail: parkyik{at}mail.nih.gov).

Received for publication September 15, 2006. Accepted for publication January 24, 2007.

The authors examined the associations between fruit and vegetable intakes and risk of colorectal cancer in the NIH–AARP Diet and Health Study. Diet was assessed with a food frequency questionnaire at baseline. Relative risks and 95% confidence intervals were estimated by using the Cox proportional hazards model. During 5-year follow-up of 488,043 men and women aged 50–71 years, 2,972 incident colorectal cancer cases were identified. The respective 10th and 90th percentiles of total fruit and vegetable intake (servings/1,000 kcal per day) were 1.4 and 5.2 for men and 1.8 and 6.5 for women. Compared with that for the lowest quintile of vegetable intake, the multivariate relative risk for the highest quintile was 0.82 (95% confidence interval: 0.71, 0.94) for men and 1.12 (95% confidence interval: 0.90, 1.38) for women. Increased risk of colorectal cancer was observed for very low intake of total fruits and vegetables by men (multivariate relative risk for <1 vs. ≥2.0 servings/1,000 kcal per day = 1.26, 95% confidence interval: 1.03, 1.54). Among subgroups of vegetables, green leafy vegetables were associated with a lower risk of colorectal cancer for men (multivariate relative risk for the highest quintile vs. the lowest = 0.86, 95% confidence interval: 0.74, 0.99). Intake of fruits was not related to risk of colorectal cancer in men or women.

cohort studies; colorectal neoplasms; fruit; vegetables

Abbreviations: CI, confidence interval; FFQ, food frequency questionnaire; RR, relative risk


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