RESUMO
Many studies have reported inverse associations between vegetable and fruit consumption and lung cancer risk. The aim of the present study was to elucidate the role of several antioxidants and folate in this relationship. In the Netherlands Cohort Study on Diet and Cancer, 58,279 men of ages 55-69 years at baseline in 1986 returned a questionnaire including a 150-item food frequency questionnaire. After 6.3 years of follow-up, 939 male lung cancer cases were registered. A new Dutch carotenoid database was used to estimate intake of alpha-carotene, beta-carotene, lutein + zeaxanthin, beta-cryptoxanthin, and lycopene, completed with the antioxidant vitamins C and E and folate. Using case-cohort analysis, rate ratios were calculated, adjusted for age, smoking, educational level, and family history of lung cancer. Protective effects on lung cancer incidence were found for lutein + zeaxanthin, beta-cryptoxanthin, folate, and vitamin C. Other carotenoids (alpha-carotene, beta-carotene, and lycopene) and vitamin E did not show significant associations. After adjustment for vitamin C, only folate remained inversely associated, and after adjustment for folate, only beta-cryptoxanthin and vitamin C remained significantly associated. Inverse associations were strongest among current smokers and weaker for former smokers at baseline. Inverse associations with carotenes, lutein + zeaxanthin, and beta-cryptoxanthin seemed to be limited to small cell and squamous cell carcinomas. Only folate and vitamin C intake appeared to be inversely related to small cell and squamous cell carcinomas and adenocarcinomas. Folate, vitamin C, and beta-cryptoxanthin might be better protective agents against lung cancer in smokers than alpha-carotene, beta-carotene, lutein + zeaxanthin, and lycopene.
Assuntos
Antioxidantes/farmacologia , Ácido Fólico/farmacologia , Neoplasias Pulmonares/prevenção & controle , Idoso , Estudos de Casos e Controles , Estudos de Coortes , Dieta , Ácido Fólico/análogos & derivados , Humanos , Incidência , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Medição de Risco , Fumar/efeitos adversosRESUMO
OBJECTIVE: The purpose was to study the association between vegetable and fruit consumption and lung cancer incidence using 1074 cases after 6.3 years of follow-up in the Netherlands Cohort Study. METHODS: Dietary intake was assessed using a 150-item food-frequency questionnaire. Multivariate models were used including age, sex, family history of lung cancer, highest educational level attained, and smoking history. RESULTS: Statistically significant inverse associations were found with total vegetables and most vegetable groups. Rate ratios (RRs) based on consumption frequency showed the strongest effect of vegetables from the Brassica group (RR 0.5, 95% confidence interval (95% CI) 0.3-0.9, for consumption > or = 3 times per week versus < or = once a month). RR of highest versus lowest quintile of total vegetable consumption was 0.7 (95% CI 0.5-1.0, p-trend 0.001). Statistically significant inverse associations were found for all fruits listed in the questionnaire. RRs for quintiles of total fruit intake were 1.0, 0.7, 0.6, 0.6 and 0.8 respectively (p-trend < 0.0001). Protective effects of fruits and vegetables were stronger in current than in former smokers, and weaker for adenocarcinomas than for other types of tumors. CONCLUSIONS: Inverse associations with lung cancer are found for both vegetable and fruit intake, but no specific type of vegetable or fruit seems to be particularly responsible.
Assuntos
Frutas , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/prevenção & controle , Verduras , Distribuição por Idade , Idoso , Estudos de Coortes , Intervalos de Confiança , Fatores de Confusão Epidemiológicos , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Países Baixos/epidemiologia , Inquéritos Nutricionais , Estudos Prospectivos , Medição de Risco , Distribuição por SexoRESUMO
In 1983 the relative validity of a retrospective dietary history method was assessed against a current dietary history taken seven years previously in 1976 and a second current dietary history taken in 1983. In total, 44 men and 58 women, aged 38 to 62 years, participated in the study. For energy intake and for most nutrients, the relative difference between the results obtained with the retrospective dietary history and the current dietary history in 1976 was below 15% and for six of the 11 nutrients below 10%. When the three macronutrients (protein, fat, and carbohydrate) were expressed as a proportion of energy intake, the relative difference was also below 10%. Similar results were found for food groups. The data obtained retrospectively correlate rather well with the results of the current dietary history taken in 1983, suggesting an effect of contemporaneous food habits on retrospective reporting.