Skip to main content

Advertisement

Log in

Dietary intakes of fruit, vegetables, and fiber, and risk of colorectal cancer in a prospective cohort of women (United States)

  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Objective: Although animal studies suggest an inverse association between consumption of plant foods and risk of colorectal cancer, many observational data have failed to support such an association. We prospectively examined the association between dietary intakes of fruit, vegetables, and fiber and colorectal cancer risk in a large female cohort from the Women’s Health Study.

Methods: Among 39,876 healthy women aged ≥45 years at baseline, 36,976 with baseline self-reported information on dietary intakes and other risk factors for colorectal cancer were included in the analyses. During an average follow-up of 10 years, 223 women were diagnosed with colorectal cancer. Intakes of fruit, vegetables, and fiber were assessed by a baseline food-frequency questionnaire. The analyses were carried out using the Cox proportional hazards regression and all tests were two-sided.

Results: Intakes of fruit, vegetables, and the specific subgroups were not found to be associated with colorectal cancer risk. Multivariate relative risks (RRs) comparing the highest with lowest quintile were 0.79 (95% CI = 0.49–1.27,pfor trend = 0.30) for fruit intake, and 0.88 (95% CI=0.56–1.38,pfor trend=0.30) for vegetables intake. Similarly, intake of total fiber was not associated with colorectal cancer risk; the RR for the highest relative to lowest quintile was 0.75 (95% CI=0.48–1.17,pfor trend=0.12). However, higher intake of legume fiber was associated with a lower risk of colorectal cancer; the RR for the highestversuslowest quintile was 0.60 (95% CI=0.40–0.91,pfor trend=0.02).

Conclusions: Our data offer little support for associations between intakes of fruit, vegetables, and fiber, and colorectal cancer risk. However, our data suggest that legume fiber and/or other related sources may reduce risk of colorectal cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. DJ Kim DH Shin B Ahn et al. (2003) ArticleTitleChemoprevention of colon cancer by Korean food plant components Mutat Res 523-524 99–107 Occurrence Handle1:CAS:528:DC%2BD3sXhs1Cntbk%3D Occurrence Handle12628507

    CAS  PubMed  Google Scholar 

  2. A Sengupta S Ghosh S Das (2003) ArticleTitleTomato and garlic can modulate azoxymethane-induced colon carcinogenesis in rats Eur J Cancer Prev 12 IssueID3 195–200 Occurrence Handle10.1097/00008469-200306000-00005 Occurrence Handle1:STN:280:DC%2BD3s3kslCrsQ%3D%3D Occurrence Handle12771557

    Article  CAS  PubMed  Google Scholar 

  3. MJ Wargovich (1997) ArticleTitleExperimental evidence for cancer preventive elements in foods Cancer Lett 114 IssueID1–2 11–17 Occurrence Handle10.1016/S0304-3835(97)04616-8 Occurrence Handle1:CAS:528:DyaK2sXit1ehs7o%3D Occurrence Handle9103245

    Article  CAS  PubMed  Google Scholar 

  4. MT Huang EE Deschner HL Newmark ZY Wang TA Ferraro AH Conney (1992) ArticleTitleEffect of dietary curcumin and ascorbyl palmitate on azoxymethanol-induced colonic epithelial cell proliferation and focal areas of dysplasia Cancer Lett 64 IssueID2 117–121 Occurrence Handle10.1016/0304-3835(92)90071-3 Occurrence Handle1:CAS:528:DyaK38XkvV2jsrs%3D Occurrence Handle1611594

    Article  CAS  PubMed  Google Scholar 

  5. PJ Rijken WG Timmer AJ Kooij Particlevan de et al. (1999) ArticleTitleEffect of vegetable and carotenoid consumption on aberrant crypt multiplicity, a surrogate end-point marker for colorectal cancer in azoxymethane-induced rats Carcinogenesis 20 IssueID12 2267–2272 Occurrence Handle10.1093/carcin/20.12.2267 Occurrence Handle1:CAS:528:DC%2BD3cXkt1Sntg%3D%3D Occurrence Handle10590218

    Article  CAS  PubMed  Google Scholar 

  6. B Frei JV Higdon (2003) ArticleTitleAntioxidant activity of tea polyphenols in vivo: evidence from animal studies J Nutr 133 IssueID10 3275S–3284S Occurrence Handle1:CAS:528:DC%2BD3sXotFKrtbo%3D Occurrence Handle14519826

    CAS  PubMed  Google Scholar 

  7. D Kritchevsky (1995) ArticleTitleEpidemiology of fibre, resistant starch and colorectal cancer Eur J Cancer Prev 4 IssueID5 345–352 Occurrence Handle1:STN:280:BymD1Mfkt1w%3D Occurrence Handle7496322

    CAS  PubMed  Google Scholar 

  8. E Giovannucci WC Willett (1994) ArticleTitleDietary factors and risk of colon cancer Ann Med 26 IssueID6 443–452 Occurrence Handle1:STN:280:ByqB3cbot10%3D Occurrence Handle7695871

    CAS  PubMed  Google Scholar 

  9. KA Steinmetz JD Potter (1996) ArticleTitleVegetables, fruit, and cancer prevention: a review J Am Diet Assoc 96 IssueID10 1027–1039 Occurrence Handle10.1016/S0002-8223(96)00273-8 Occurrence Handle1:STN:280:BymH3sfotlQ%3D Occurrence Handle8841165

    Article  CAS  PubMed  Google Scholar 

  10. KB Michels G Edward KJ Joshipura et al. (2000) ArticleTitleProspective study of fruit and vegetable consumption and incidence of colon and rectal cancers J Natl Cancer Inst 92 IssueID21 1740–1752 Occurrence Handle10.1093/jnci/92.21.1740 Occurrence Handle1:STN:280:DC%2BD3M%2Fkt1Gmtw%3D%3D Occurrence Handle11058617

    Article  CAS  PubMed  Google Scholar 

  11. RL Phillips DA Snowdon (1998) ArticleTitleDietary relationships with fatal colorectal cancer among Seventh-Day Adventists J Natl Cancer Inst 74 IssueID2 307–317

    Google Scholar 

  12. PN Singh GE Fraser (1998) ArticleTitleDietary risk factors for colon cancer in a low-risk population Am J Epidemiol 148 IssueID8 761–774 Occurrence Handle1:STN:280:DyaK1M%2FgtVWksg%3D%3D Occurrence Handle9786231

    CAS  PubMed  Google Scholar 

  13. KA Steinmetz LH Kushi RM Bostick AR Folsom JD Potter (1994) ArticleTitleVegetables, fruit, and colon cancer in the Iowa Women’s Health Study Am J Epidemiol 139 IssueID1 1–15 Occurrence Handle8296768

    PubMed  Google Scholar 

  14. MJ Thun EE Calle MM Namboodiri et al. (1992) ArticleTitleRisk factors for fatal colon cancer in a large prospective study J Natl Cancer Inst 84 IssueID19 1491–1500 Occurrence Handle1:STN:280:ByyD2Mbkt1U%3D Occurrence Handle1433333

    CAS  PubMed  Google Scholar 

  15. ML McCullough AS Robertson A Chao et al. (2003) ArticleTitleA prospective study of whole grains, fruits, vegetables and colon cancer risk Cancer Causes Control 14 IssueID10 959–970 Occurrence Handle10.1023/B:CACO.0000007983.16045.a1 Occurrence Handle14750535

    Article  PubMed  Google Scholar 

  16. A Shibata A Paganini-Hill RK Ross BE Henderson (1992) ArticleTitleIntake of vegetables, fruits, beta-carotene, vitamin C and vitamin supplements and cancer incidence among the elderly: a prospective study Br J Cancer 66 IssueID4 673–679 Occurrence Handle1:STN:280:ByyD2c%2FpvF0%3D Occurrence Handle1419605

    CAS  PubMed  Google Scholar 

  17. P Terry E Giovannucci KB Michels et al. (2001) ArticleTitleFruit, vegetables, dietary fiber, and risk of colorectal cancer J Natl Cancer Inst 93 IssueID7 525–533

    Google Scholar 

  18. LE Voorrips RA Goldbohm G Poppel Particlevan F Sturmans RJ Hermus PA Brandt Particlevan den (2000) ArticleTitleVegetable and fruit consumption and risks of colon and rectal cancer in a prospective cohort study: The Netherlands Cohort Study on Diet and Cancer Am J Epidemiol 152 IssueID11 1081–1092 Occurrence Handle10.1093/aje/152.11.1081 Occurrence Handle1:STN:280:DC%2BD3M%2FntVGjtQ%3D%3D Occurrence Handle11117618

    Article  CAS  PubMed  Google Scholar 

  19. SA Bingham NE Day R Luben et al. (2003) ArticleTitleDietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study Lancet 361 IssueID9368 1496–1501 Occurrence Handle10.1016/S0140-6736(03)13174-1 Occurrence Handle12737858

    Article  PubMed  Google Scholar 

  20. U Peters R Sinha N Chatterjee et al. (2003) ArticleTitleDietary fibre and colorectal adenoma in a colorectal cancer early detection programme Lancet 361 IssueID9368 1491–1495 Occurrence Handle10.1016/S0140-6736(03)13173-X Occurrence Handle12737857

    Article  PubMed  Google Scholar 

  21. CS Fuchs EL Giovannucci GA Colditz et al. (1999) ArticleTitleDietary fiber and the risk of colorectal cancer and adenoma in women N Engl J Med 340 IssueID3 169–176 Occurrence Handle10.1056/NEJM199901213400301 Occurrence Handle1:STN:280:DyaK1M7gtFylsA%3D%3D Occurrence Handle9895396

    Article  CAS  PubMed  Google Scholar 

  22. KA Steinmetz JD Potter (1993) ArticleTitleFood-group consumption and colon cancer in the Adelaide Case–control Study. II. Meat, poultry, seafood, dairy foods and eggs Int J Cancer 53 IssueID5 720–727 Occurrence Handle1:STN:280:ByyC1MvjvVY%3D Occurrence Handle8449595

    CAS  PubMed  Google Scholar 

  23. E Giovannucci EB Rimm MJ Stampfer GA Colditz A Ascherio WC Willett (1994) ArticleTitleIntake of fat, meat, and fiber in relation to risk of colon cancer in men Cancer Res 54 IssueID9 2390–2397 Occurrence Handle1:STN:280:ByuB3MrhslI%3D Occurrence Handle8162586

    CAS  PubMed  Google Scholar 

  24. V Mai A Flood U Peters JV Lacey SuffixJr. C Schairer A Schatzkin (2003) ArticleTitleDietary fibre and risk of colorectal cancer in the Breast Cancer Detection Demonstration Project (BCDDP) follow-up cohort Int J Epidemiol 32 IssueID2 234–239 Occurrence Handle10.1093/ije/dyg052 Occurrence Handle12714542

    Article  PubMed  Google Scholar 

  25. A Schatzkin E Lanza D Corle et al. (2000) ArticleTitleLack of effect of a low-fat, high-fiber diet on the recurrence of colorectal adenomas.Polyp Prevention Trial Study Group N Engl J Med 342 IssueID16 1149–1155 Occurrence Handle10.1056/NEJM200004203421601 Occurrence Handle1:STN:280:DC%2BD3c3hvVKjsg%3D%3D Occurrence Handle10770979

    Article  CAS  PubMed  Google Scholar 

  26. C Bonithon-Kopp O Kronborg A Giacosa U Rath J Faivre (2000) ArticleTitleCalcium and fibre supplementation in prevention of colorectal adenoma recurrence: a randomised intervention trial. European Cancer Prevention Organisation Study Group Lancet 356 IssueID9238 1300–1306 Occurrence Handle10.1016/S0140-6736(00)02813-0 Occurrence Handle1:CAS:528:DC%2BD3cXotVOgt70%3D Occurrence Handle11073017

    Article  CAS  PubMed  Google Scholar 

  27. DS Alberts ME Martinez DJ Roe et al. (2000) ArticleTitleLack of effect of a high-fiber cereal supplement on the recurrence of colorectal adenomas.Phoenix Colon Cancer Prevention Physicians’ Network N Engl J Med 342 IssueID16 1156–1162 Occurrence Handle10.1056/NEJM200004203421602 Occurrence Handle1:STN:280:DC%2BD3c3hvVKjsw%3D%3D Occurrence Handle10770980

    Article  CAS  PubMed  Google Scholar 

  28. KM Rexrode IM Lee NR Cook CH Hennekens JE Buring (2000) ArticleTitleBaseline characteristics of participants in the Women’s Health Study J Womens Health Gend Based Med 9 IssueID1 19–27 Occurrence Handle10.1089/152460900318911 Occurrence Handle1:STN:280:DC%2BD3c7otFChuw%3D%3D Occurrence Handle10718501

    Article  CAS  PubMed  Google Scholar 

  29. U.S. Department of Agriculture ARS. USDA Nutrient DataBase for Standard Reference, Release 10: Nutrient Data Laboratory Home Page, http://www.nal.usda.gov/fnic/foodcomp, (1993).

  30. L Prosky NG Asp I Furda JW DeVries TF Schweizer BF Harland (1985) ArticleTitleDetermination of total dietary fiber in foods and food products: collaborative study J Assoc Off Anal Chem 68 IssueID4 677–679 Occurrence Handle1:STN:280:BiqB1cfptVI%3D Occurrence Handle2993226

    CAS  PubMed  Google Scholar 

  31. L Prosky NG Asp TF Schweizer JW DeVries I Furda (1988) ArticleTitleDetermination of insoluble, soluble, and total dietary fiber in foods and food products: interlaboratory study J Assoc Off Anal Chem 71 IssueID5 1017–1023 Occurrence Handle1:CAS:528:DyaL1cXlvVyqs7s%3D Occurrence Handle2853153

    CAS  PubMed  Google Scholar 

  32. W Willett (1998) Nutritional Epidemiology EditionNumber2 Oxford University Press New York

    Google Scholar 

  33. S Salvini DJ Hunter L Sampson et al. (1989) ArticleTitleFood-based validation of a dietary questionnaire: the effects of week-to-week variation in food consumption Int J Epidemiol 18 IssueID4 858–867 Occurrence Handle1:STN:280:By%2BC2Mzgt1I%3D Occurrence Handle2621022

    CAS  PubMed  Google Scholar 

  34. W Willett M Stampfer NF Chu D Spiegelman M Holmes E Rimm (2001) ArticleTitleAssessment of questionnaire validity for measuring total fat intake using plasma lipid levels as criteria Am J Epidemiol 154 IssueID12 1107–1112 Occurrence Handle1:STN:280:DC%2BD38%2FivFSrtw%3D%3D Occurrence Handle11744515

    CAS  PubMed  Google Scholar 

  35. RJ Landis ER Heyman G.G Koch (1978) ArticleTitleAverage partial association in three-way contingency tables: a review and discussion of alternative tests In Stat Rev 46 237–254

    Google Scholar 

  36. RD. Bock (1975) Multivariate Statistical Methods in Behavioral Research McGraw-Hill New York

    Google Scholar 

  37. S Higginbotham ZF Zhang IM Lee et al. (2004) ArticleTitleDietary glycemic load and risk of colorectal cancer in the Women’s Health Study J Natl Cancer Inst 96 IssueID3 229–233 Occurrence Handle1:CAS:528:DC%2BD2cXhtVKkurk%3D Occurrence Handle14759990

    CAS  PubMed  Google Scholar 

  38. M Sato DJ Ahnen (1992) ArticleTitleRegional variability of colonocyte growth and differentiation in the rat Anat Rec 233 IssueID3 409–414 Occurrence Handle1:STN:280:By2A3cznvVw%3D Occurrence Handle1376970

    CAS  PubMed  Google Scholar 

  39. KA Brackett SF Townsend (1980) ArticleTitleOrganogenesis of the colon in rats J Morphol 163 IssueID2 191–201 Occurrence Handle1:STN:280:Bi%2BC283osFw%3D Occurrence Handle7365799

    CAS  PubMed  Google Scholar 

  40. B Iacopetta (2002) ArticleTitleAre there two sides to colorectal cancer? Int J Cancer 101 IssueID5 403–408 Occurrence Handle1:CAS:528:DC%2BD38Xnt1ehsrw%3D Occurrence Handle12216066

    CAS  PubMed  Google Scholar 

  41. B Trock E Lanza P Greenwald (1990) ArticleTitleDietary fiber, vegetables, and colon cancer: critical review and meta-analyses of the epidemiologic evidence J Natl Cancer Inst 82 IssueID8 650–661 Occurrence Handle1:STN:280:By%2BB3cvlslU%3D Occurrence Handle2157027

    CAS  PubMed  Google Scholar 

  42. E Giovannucci (2002) ArticleTitleModifiable risk factors for colon cancer Gastroenterol Clin North Am 31 IssueID4 925–943 Occurrence Handle10.1016/S0889-8553(02)00057-2 Occurrence Handle12489270

    Article  PubMed  Google Scholar 

  43. P Pietinen N Malila M Virtanen et al. (1999) ArticleTitleDiet and risk of colorectal cancer in a cohort of Finnish men Cancer Causes Control 10 IssueID5 387–396 Occurrence Handle10.1023/A:1008962219408 Occurrence Handle1:STN:280:DyaK1MvlvVWqsw%3D%3D Occurrence Handle10530608

    Article  CAS  PubMed  Google Scholar 

  44. GR Howe E Benito R Castelleto et al. (1992) ArticleTitleDietary intake of fiber and decreased risk of cancers of the colon and rectum: evidence from the combined analysis of 13 case–control studies J Natl Cancer Inst 84 IssueID24 1887–1896 Occurrence Handle1:STN:280:ByyD1Mrht1M%3D Occurrence Handle1334153

    CAS  PubMed  Google Scholar 

  45. DA Lieberman S Prindiville DG Weiss W Willett (2003) ArticleTitleRisk factors for advanced colonic neoplasia and hyperplastic polyps in asymptomatic individuals Jama 290 IssueID22 2959–2967 Occurrence Handle10.1001/jama.290.22.2959 Occurrence Handle14665657

    Article  PubMed  Google Scholar 

  46. SE Fleming AU O’Donnell JA Perman (1985) ArticleTitleInfluence of frequent and long-term bean consumption on colonic function and fermentation Am J Clin Nutr 41 IssueID5 909–918 Occurrence Handle1:CAS:528:DyaL2MXitF2qtrc%3D Occurrence Handle2986447

    CAS  PubMed  Google Scholar 

  47. SA Bingham (1990) ArticleTitleMechanisms and experimental and epidemiological evidence relating dietary fibre (non-starch polysaccharides) and starch to protection against large bowel cancer Proc Nutr Soc 49 IssueID2 153–171 Occurrence Handle1:STN:280:By6D2cngs1A%3D Occurrence Handle2172992

    CAS  PubMed  Google Scholar 

  48. LH Augenlicht JM Mariadason A Wilson et al. (2002) ArticleTitleShort chain fatty acids and colon cancer J Nutr 132 IssueID12 3804S–3808S Occurrence Handle12468628

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jennifer Lin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lin, J., Zhang, S.M., Cook, N.R. et al. Dietary intakes of fruit, vegetables, and fiber, and risk of colorectal cancer in a prospective cohort of women (United States). Cancer Causes Control 16, 225–233 (2005). https://doi.org/10.1007/s10552-004-4025-1

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-004-4025-1

Keywords

Navigation