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American Journal of Epidemiology Advance Access published online on October 10, 2007

American Journal of Epidemiology, doi:10.1093/aje/kwm263
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American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Original Contribution

Fruit and Vegetable Intake and Risk of Total Cancer and Cardiovascular Disease

Japan Public Health Center-based Prospective Study

Ribeka Takachi1,2, Manami Inoue2, Junko Ishihara2, Norie Kurahashi2, Motoki Iwasaki2, Shizuka Sasazuki2, Hiroyasu Iso3, Yoshitaka Tsubono1,4, Shoichiro Tsugane2 and for the JPHC Study Group

1 Department of Clinical Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan
2 Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
3 Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
4 Division of Health Policy, Tohoku University School of Public Policy, Sendai, Japan

Correspondence to Dr. Shoichiro Tsugane, Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan (e-mail: stsugane{at}ncc.go.jp).

Received for publication April 5, 2007. Accepted for publication August 17, 2007.

Few studies have investigated the effects of fruit and vegetables on the risk of both cancer and cardiovascular disease (CVD). The authors examined associations between fruit and vegetable consumption and risk of total cancer and CVD in the same Japanese population. During 1995–1998, a validated food frequency questionnaire was administered in nine areas to 77,891 men and women aged 45–74 years. During as many as 459,320 person-years of follow-up until the end of 2002, 3,230 cancer cases and 1,386 CVD cases were identified. Higher consumption of fruit, but not vegetables, was associated with significantly lower risk of CVD: multivariate hazard ratios for the highest versus lowest quartiles of intake were 0.81 (95% confidence interval (CI): 0.67, 0.97; trend p = 0.01) for fruit and 0.97 (95% CI: 0.82, 1.15; trend p = 0.66) for vegetables. Consumption of fruit or vegetables was not associated with decreased risk of total cancer: corresponding hazard ratios were 1.02 (95% CI: 0.90, 1.14; trend p = 0.95) for fruit and 0.94 (95% CI: 0.84, 1.05; trend p = 0.16) for vegetables. This prospective cohort study demonstrated that, in the Japanese population, consumption of fruit is associated with lower risk of CVD, whereas fruit or vegetables may not be associated with lower risk of total cancer.

cardiovascular diseases; fruit; Japan; neoplasms; prospective studies; vegetables

Abbreviations: CI, confidence interval; CVD, cardiovascular disease; FFQ, food frequency questionnaire; HR, hazard ratio


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