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Dietary intake of fruit and vegetables and risk of non-Hodgkin lymphoma

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Abstract

Objective

Few studies have evaluated the potential association between consumption of fruit and vegetables and non-Hodgkin lymphoma (NHL) by histologic subtype, and the results of these studies have been inconsistent.

Methods

A detailed history of dietary practices and food preferences was collected using a food frequency questionnaire from 348 cases and 470 controls in a population-based, case–control study conducted in Nebraska during 1999–2002. Risk for the highest versus lowest quartile or tertile of intake was estimated by odds ratios (ORs) and 95% confidence interval (CIs).

Results

A lower risk of overall NHL was associated with a high intake of green leafy vegetables (OR = 0.6; CI = 0.3–1.0) and cruciferous vegetables (OR = 0.7; CI = 0.4–1.0). Analysis by subtype showed that green leafy vegetable intake was associated with a lower risk of follicular lymphoma (OR = 0.5; CI = 0.3–0.8) and diffuse large B-cell lymphoma (DLBCL) (OR = 0.5; CI = 0.3–0.9), while consumption of cruciferous vegetables was associated with a lower risk of DLBCL (OR = 0.4; CI = 0.2–0.8). No association was found with intake of total vegetables, carotene-rich vegetables, or all fruit. For nutrients, the risk of NHL overall was inversely associated with a higher intake of β-cryptoxanthin (OR = 0.6; CI = 0.4–0.9), magnesium (OR = 0.4; CI = 0.2–0.6), potassium (OR = 0.5; CI = 0.3–1.0), and fiber (OR = 0.6; CI = 0.3–1.0), but positively associated with a higher intake of retinol (OR = 1.7; CI = 1.1–2.8). Intakes of vitamin E, magnesium, and potassium were inversely associated with the risk of DLBCL.

Conclusion

A higher intake of green leafy vegetables and cruciferous vegetables is associated with a lower risk of NHL overall, particularly follicular lymphoma and DLBCL.

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References

  1. Skibola CF (2007) Obesity, diet and risk of non-Hodgkin lymphoma. Cancer Epidemiol Biomark Prev 16:392–395

    Article  CAS  Google Scholar 

  2. Calder PC, Kew S (2002) The immune system: a target for functional foods? Br J Nutr 88:S165–S177

    Article  PubMed  CAS  Google Scholar 

  3. Chang ET, Smedby KE, Zhang SM et al (2005) Dietary factors and risk of non-hodgkin lymphoma in men and women. Cancer Epidemiol Biomarkers Prev 14:512–520

    Article  PubMed  Google Scholar 

  4. Chiu BC, Cerhan JR, Folsom AR et al (1996) Diet and risk of non-Hodgkin lymphoma in older women. JAMA 275:1315–1321

    Article  PubMed  CAS  Google Scholar 

  5. Kelemen LE, Cerhan JR, Lim U et al (2006) Vegetables, fruit, and antioxidant-related nutrients and risk of non-Hodgkin lymphoma: a national cancer institute-surveillance, epidemiology, and end results population-based case-control study. Am J Clin Nutr 83:1401–1410

    PubMed  CAS  Google Scholar 

  6. Purdue MP, Bassani DG, Klar NS et al (2004) Dietary factors and risk of non-Hodgkin lymphoma by histologic subtype: a case-control analysis. Cancer Epidemiol Biomark Prev 13:1665–1676

    CAS  Google Scholar 

  7. Rohrmann S, Becker N, Linseisen J et al (2007) Fruit and vegetable consumption and lymphoma risk in the European prospective investigation into cancer and nutrition (EPIC). Cancer Causes Control 18:537–549

    Article  PubMed  Google Scholar 

  8. Zhang SM, Hunter DJ, Rosner BA et al (2000) Intakes of fruits, vegetables, and related nutrients and the risk of non-Hodgkin’s lymphoma among women. Cancer Epidemiol Biomark Prev 9:477–485

    CAS  Google Scholar 

  9. Kelemen LE, Wang SS, Lim U et al (2008) Vegetables- and antioxidant-related nutrients, genetic susceptibility, and non-Hodgkin lymphoma risk. Cancer Causes Control 19:491–503

    Article  PubMed  Google Scholar 

  10. Koutros S, Zhang Y, Zhu Y et al (2008) Nutrients contributing to one-carbon metabolism and risk of non-Hodgkin lymphoma subtypes. Am J Epidemiol 167:287–294

    Article  PubMed  Google Scholar 

  11. Thompson CA, Habermann TM, Wang AH et al (2010) Antioxidant intake from fruits, vegetables and other sources and risk of non-Hodgkin’s lymphoma: the Iowa women’s health study. Int J Cancer 126:992–1003

    PubMed  CAS  Google Scholar 

  12. Talamini R, Polesel J, Montella M et al (2006) Food groups and risk of non-Hodgkin lymphoma: a multicenter, case-control study in Italy. Int J Cancer 118:2871–2876

    Article  PubMed  CAS  Google Scholar 

  13. Ward MH, Zahm SH, Weisenburger DD et al (1994) Dietary factors and non-Hodgkin’s lymphoma in Nebraska (United States). Cancer Causes Control 5:422–432

    Article  PubMed  CAS  Google Scholar 

  14. Evens AM, Chiu BC (2008) The challenges of epidemiologic research in non-Hodgkin lymphoma. JAMA 300:2059–2061

    Article  PubMed  Google Scholar 

  15. Morton LM, Wang SS, Cozen W et al (2008) Etiologic heterogeneity among non-Hodgkin lymphoma subtypes. Blood 112:5150–5160

    Article  PubMed  CAS  Google Scholar 

  16. Chang ET, Balter KM, Torrang A et al (2006) Nutrient intake and risk of non-Hodgkin’s lymphoma. Am J Epidemiol 164:1222–1232

    Article  PubMed  Google Scholar 

  17. Lim U, Schenk M, Kelemen LE et al (2005) Dietary determinants of one-carbon metabolism and the risk of non-Hodgkin’s lymphoma: NCI-SEER case-control study, 1998–2000. Am J Epidemiol 162:953–964

    Article  PubMed  CAS  Google Scholar 

  18. Zheng T, Holford TR, Leaderer B et al (2004) Diet and nutrient intakes and risk of non-Hodgkin’s lymphoma in Connecticut women. Am J Epidemiol 159:454–466

    Article  PubMed  Google Scholar 

  19. Chiu BC, Kolar C, Gapstur SM et al (2005) Association of NAT and GST polymorphisms with non-Hodgkin’s lymphoma: a population-based case-control study. Br J Haematol 128:610–615

    Article  PubMed  CAS  Google Scholar 

  20. Chiu BC, Soni L, Gapstur SM et al (2007) Obesity and risk of non-Hodgkin lymphoma (United States). Cancer Causes Control 18:677–685

    Article  PubMed  Google Scholar 

  21. Jaffe ES, Harris NL, Stein H et al (eds) (2001) World health organization classification of tumors. Pathology and genetics of tumors of haematopoietic and lymphoid tissues. IARC Press, Lyon

    Google Scholar 

  22. Block G, Coyle LM, Hartman AM et al (1994) Revision of dietary analysis software for the health habits and history questionnaire. Am J Epidemiol 139:1190–1196

    PubMed  CAS  Google Scholar 

  23. Block G, Woods M, Potosky A et al (1990) Validation of a self-administered diet history questionnaire using multiple diet records. J Clin Epidemiol 43:1327–1335

    Article  PubMed  CAS  Google Scholar 

  24. Chug-Ahuja JK, Holden JM, Forman MR et al (1993) The development and application of a carotenoid database for fruits, vegetables, and selected multicomponent foods. J Am Diet Assoc 93:318–323

    Article  PubMed  CAS  Google Scholar 

  25. Breslow NE, Day NE (1993) Statistical methods in cancer research. The analysis of case control studies, vol 1. IARC Scientific Publications, Lyon

    Google Scholar 

  26. Morton LM, Turner JJ, Cerhan JR et al (2007) Proposed classification of lymphoid neoplasms for epidemiologic research from the pathology working group of the international lymphoma epidemiology consortium (InterLymph). Blood 110:695–708

    Article  PubMed  CAS  Google Scholar 

  27. Maldonado G, Greenland S (1993) Simulation study of confounder-selection strategies. Am J Epidemiol 138:923–936

    PubMed  CAS  Google Scholar 

  28. Kipnis V, Freedman LS, Brown CC et al (1993) Interpretation of energy adjustment models for nutritional epidemiology. Am J Epidemiol 137:1376–1380

    PubMed  CAS  Google Scholar 

  29. Thompson CA, Cerhan JR (2010) Fruit and vegetable intake and survival from non-Hodgkin lymphoma: does an apple a day keep the doctor away? Leuk Lymphoma 51:963–964

    Google Scholar 

  30. Wintergerst ES, Maggini S, Hornig DH (2007) Contribution of selected vitamins and trace elements to immune function. Ann Nutr Metab 51:301–323

    Article  PubMed  CAS  Google Scholar 

  31. Choi S-W, Mason JB (2000) Folate and carcinogenesis: an integrated scheme. J Nutr 130:129–132

    PubMed  CAS  Google Scholar 

  32. McCoy H, Kenney MA (1992) Magnesium and immune function: recent findings. Magnes Res 5:281–293

    PubMed  CAS  Google Scholar 

  33. Nishino H, Murakoshi M, Tokuda H, et al. (2008) Cancer prevention by carotenoids. Arch biochem biophys

  34. Tavani A, Pregnolato A, Negri E et al (1997) Diet and risk of lymphoid neoplasms and soft tissue sarcomas. Nutr Cancer 27:256–260

    Article  PubMed  CAS  Google Scholar 

  35. Dal-Pizzol F, Klamt F, Dalmolin RJ et al (2001) Mitogenic signaling mediated by oxidants in retinol treated sertoli cells. Free Rad Res 35:749–755

    Article  CAS  Google Scholar 

  36. Mayne ST, Graham S, Zheng TZ (1991) Dietary retinol: prevention or promotion of carcinogenesis in humans? Cancer Causes Control 2:443–450

    Article  PubMed  CAS  Google Scholar 

  37. Pan SY, Mao Y, Ugnat AM (2005) Physical activity, obesity, energy intake, and the risk of non-Hodgkin’s lymphoma: a population-based case-control study. Am J Epidemiol 162:1162–1173

    Article  PubMed  Google Scholar 

  38. Cerhan JR, Bernstein L, Severson RK et al (2005) Anthropometrics, physical activity, related medical conditions, and the risk of non-hodgkin lymphoma. Cancer Causes Control 16:1203–1214

    Article  PubMed  Google Scholar 

  39. Chang ET, Hjalgrim H, Smedby KE et al (2005) Body mass index and risk of malignant lymphoma in scandinavian men and women. J Nat Cancer Inst 97:210–218

    Article  PubMed  Google Scholar 

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Acknowledgments

This research was supported by research grant 99B083 from the American Institute for Cancer Research and, in part, by grants CA94770 and CA100555 from the National Cancer Institute. The authors thank Mr. Martin Bast of the Nebraska Lymphoma Registry and Tissue Bank for coordinating the patient identification and physician consent. We also thank Ms. Marina Antillon for editing the manuscript and Ms. Angela J Fought, MS, from the Department of Preventive Medicine at Northwestern University for statistical analysis.

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Authors and Affiliations

  1. Department of Health Studies, University of Chicago, 5841 South Maryland Avenue, MC 2007, Chicago, IL, 60637, USA

    Brian C.-H. Chiu & Soyang Kwon

  2. University of Chicago Comprehensive Cancer Center, Chicago, IL, USA

    Brian C.-H. Chiu & Sonali M. Smith

  3. Division of Hematology/Oncology Lymphoma Program, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Andrew M. Evens

  4. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Tanya Surawicz

  5. Division of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, IL, USA

    Sonali M. Smith

  6. Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA

    Dennis D. Weisenburger

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  1. Brian C.-H. Chiu
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Correspondence to Brian C.-H. Chiu.

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Chiu, B.CH., Kwon, S., Evens, A.M. et al. Dietary intake of fruit and vegetables and risk of non-Hodgkin lymphoma. Cancer Causes Control 22, 1183–1195 (2011). https://doi.org/10.1007/s10552-011-9797-5

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  • DOI: https://doi.org/10.1007/s10552-011-9797-5

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