Vegetable intake, but not fruit intake, is associated with a reduction in the risk of cancer incidence and mortality in middle-aged Korean men.

ABSTRACT

BACKGROUND: Few prospective studies have examined the preventive role of fruit and vegetable intakes against cancer in Asian populations. OBJECTIVE: This prospective study evaluated the associations between total fruit intake, total vegetable intake, and total fruit and vegetable intake and total cancer incidence and mortality. METHODS: This prospective cohort study included 14,198 men 40-59 y of age enrolled in the Seoul Male Cohort Study from 1991 to 1993. Fruit and vegetable intakes were assessed by a validated food-frequency questionnaire. We used Cox proportional hazard regression models to compute RR ratios and 95% CIs. RESULTS: During the follow-up period from 1993 to 2008, 1343 men were diagnosed with cancer, and 507 died of cancer. Total vegetable intake was linearly associated with cancer incidence but was nonlinearly associated with cancer mortality; by comparing ≥ 500 g/d with <100 g/d of total vegetable intake, the multivariable-adjusted RR for total cancer incidence was 0.72 (95% CI 0.58, 0.90; P-trend 0.02; P-nonlinearity 0.06). For total cancer mortality, the multivariable-adjusted RRs comparing 100 to <200 g/d, 200 to <300 g/d, 300 to <500 g/d, and ≥ 500 g/d with <100 g/d of total vegetable intake were 0.68 (95% CI 0.53, 0.88), 0.75 (95% CI 0.57, 0.98), 0.72 (95% CI 0.54, 0.95), and 0.67 (95% CI 0.47, 0.95), respectively (P-trend 0.09; P-nonlinearity 0.01). No associations were found between total fruit intake and total cancer incidence and mortality; ≥ 300 g/d vs. <50 g/d, RR 1.04 (95% CI 0.87, 1.25; P-trend = 0.56) for incidence and RR 0.89 (95% CI 0.66, 1.21; P-trend = 0.71) for mortality. CONCLUSIONS: Our findings suggest that total vegetable intake is linearly associated with cancer incidence but nonlinearly associated with total cancer mortality in middle-aged Korean men. However, total fruit intake is not associated with total cancer incidence or mortality.