Skip to main content

Advertisement

SpringerLink
Log in

Fruit and vegetable consumption and lymphoma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

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

Abstract

Introduction

Lymphomas are a heterogeneous group of malignant diseases of cells of the immune system. The best-established risk factors are related to dys-regulation of immune function, and evidence suggests that factors such as dietary or lifestyle habits may be involved in the etiology.

Material and methods

In the European Prospective Investigation into Cancer and Nutrition (EPIC), 849 lymphoma cases were identified in a median follow-up period of 6.4 years. Fruit and vegetable consumption was estimated from validated dietary questionnaires. Cox proportional hazard models were used to examine the association between fruit and vegetable intake with the risk of lymphomas overall and subentities.

Results

There was no overall association between total fruit and vegetable consumption and risk of lymphoma [hazard ratio (HR) = 0.95, 95% confidence interval (CI) 0.78–1.15 comparing highest with lowest quartile]. However, the risk of diffuse large B-cell lymphomas (DLBCL) tended to be lower in participants with a high intake of total vegetables (HR = 0.49, 95% CI 0.23–1.02).

Conclusion

In this large prospective study, an inverse associations between fruit and vegetable consumption and risk of lymphomas overall could not be confirmed. Associations with lymphoma subentities such as DLBCL warrant further investigation.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Boyle P, Ferlay J (2005) Cancer incidence and mortality in Europe, 2004. Ann Oncol 16:481–488

    Article  PubMed  CAS  Google Scholar 

  2. Bray I, Brennan P, Boffetta P (2001) Recent trends and future projections of lymphoid neoplasms—a Bayesian age-period-cohort analysis. Cancer Causes Control 12:813–820

    Article  PubMed  CAS  Google Scholar 

  3. Fisher SG, Fisher RI (2004) The epidemiology of non-Hodgkin’s lymphoma. Oncogene 23:6524–6534

    Article  PubMed  CAS  Google Scholar 

  4. Morton LM, Zheng T, Holford TR et al (2005) Alcohol consumption and risk of non-Hodgkin lymphoma: a pooled analysis. The Lancet Oncol 6:469–476

    Article  CAS  Google Scholar 

  5. Nieters A, Deeg E, Becker N (2006) Tobacco and alcohol consumption and risk of lymphoma: Results of a population-based case–control study in Germany. Int J Cancer 118:422–430

    Article  PubMed  CAS  Google Scholar 

  6. Chang ET, Ekstrom Smedby K, 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 

  7. 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 

  8. Purdue MP, Bassani DG, Klar NS, Sloan M, Kreiger N, The Canadian Cancer Registries Epidemiology Research Group (2004) Dietary factors and risk of non-Hodgkin lymphoma by histologic subtype: a case–control analysis. Cancer Epidemiol Biomarkers Prev 13:1665–1676

    PubMed  CAS  Google Scholar 

  9. Brown L, Gridley G, Pottern L et al (2001) Diet and nutrition as risk factors for multiple myeloma among blacks and whites in the United States. Cancer Causes Control 12:117–125

    Article  PubMed  CAS  Google Scholar 

  10. 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 

  11. 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 

  12. Vlajinac H, Pekmezovic HD, Adanja B et al (2003) case–control study of multiple myeloma with special reference to diet as risk factor. Neoplasma 50:79–83

    PubMed  CAS  Google Scholar 

  13. De Stefani E, Fierro L, Barrios E, Ronco A (1998) Tobacco, alcohol, diet and risk of non-Hodgkin’s lymphoma: a case–control study in Uruguay. Leuk Res 22:445–452

    Article  PubMed  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  15. Negri E, La Vecchia C, Franceschi S, D’Avanzo B, Parazzini F (1991) Vegetable and fruit consumption and cancer risk. Int J Cancer 48:350–354

    Article  PubMed  CAS  Google Scholar 

  16. Franceschi S, Serraino D, Carbone A, Talamini R, La Vecchia C (1989) Dietary factors and non-Hodgkin’s lymphoma: a case–control study in the northeastern part of Italy. Nutr Cancer 12:333–341

    Article  PubMed  CAS  Google Scholar 

  17. 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 

  18. 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 

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

    PubMed  CAS  Google Scholar 

  20. Riboli E, Hunt KJ, Slimani N et al (2002) European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collection. Public Health Nutr 5:1113–1124

    Article  PubMed  CAS  Google Scholar 

  21. Margetts BM, Pietinen P (1997) European Prospective Investigation into Cancer and Nutrition: validity studies on dietary assessment methods. Int J Epidemiol 26 Suppl 1:S1–S5

    Article  PubMed  Google Scholar 

  22. Agudo A, Slimani N, Ocke MC et al (2002) Consumption of vegetables, fruit and other plant foods in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts from 10 European countries. Public Health Nutr 5:1179–1196

    Article  PubMed  CAS  Google Scholar 

  23. Jaffe ES, Harris NL, Stein H, Vardiman JW (eds) (2001) Pathology and Genetics of Tumours of Haematopoietic and Lymphoid Tissues Lyon

  24. Slimani N, Kaaks R, Ferrari P et al (2002) European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study: rationale, design and population characteristics. Public Health Nutr 5:1125–1145

    Article  PubMed  CAS  Google Scholar 

  25. Slimani N, Ferrari P, Ocke M et al (2000) Standardization of the 24-hour diet recall calibration method used in the European Prospective Investigation into Cancer and Nutrition (EPIC): general concepts and preliminary results. Eur J Clin Nutr 54:900–917

    Article  PubMed  CAS  Google Scholar 

  26. Ferrari P, Kaaks R, Fahey MT et al (2004) Within- and between-cohort variation in measured macronutrient intakes, taking account of measurement errors, in the European Prospective Investigation into Cancer and Nutrition Study. Am J Epidemiol 160:814–822

    Article  PubMed  Google Scholar 

  27. Ferrari P, Slimani N, Ciampi A et al (2002) Evaluation of under- and overreporting of energy intake in the 24-hour diet recalls in the European Prospective Investigation into Cancer and Nutrition (EPIC). Public Health Nutr 5:1329–1345

    PubMed  CAS  Google Scholar 

  28. Ward MH, deKok TM, Levallois P et al (2005) Workgroup report: Drinking-water nitrate and health–recent findings and research needs. Environ Health Perspect 113:1607–1614

    Article  PubMed  CAS  Google Scholar 

  29. Knekt P, Jarvinen R, Dich J, Hakulinen T (1999) Risk of colorectal and other gastro-intestinal cancers after exposure to nitrate, nitrite and N-nitroso compounds: a follow-up study. Int J Cancer 80:852–856

    Article  PubMed  CAS  Google Scholar 

  30. Jakszyn P, Bingham S, Pera G et al (2006) Endogenous versus exogenous exposure to N-nitroso compounds and gastric cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST) study. Carcinogenesis 27:1497–1501

    Article  PubMed  CAS  Google Scholar 

  31. Mirvish SS (1975) Blocking the formation of N-nitroso compounds with ascorbic acid in vitro and in vivo. Ann N Y Acad Sci 258:175–180

    Article  PubMed  CAS  Google Scholar 

  32. Ward MH, Mark SD, Cantor KP, Weisenburger DD, Correa-Villasenor A, Zahm SH (1996) Drinking water nitrate and the risk of non-Hodgkin’s lymphoma. Epidemiology 7:465–471

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  34. Hung H-C, Joshipura KJ, Jiang R et al (2004) Fruit and vegetable intake and risk of major chronic disease. J Natl Cancer Inst 96:1577–1584

    Article  PubMed  Google Scholar 

  35. van Gils CH, Peeters PHM, Bueno-de-Mesquita HB et al (2005) Consumption of vegetables and fruits and risk of breast cancer. JAMA 293:183–193

    Article  PubMed  Google Scholar 

  36. Schulz M, Lahmann PH, Boeing H et al (2005) Fruit and vegetable consumption and risk of epithelial ovarian cancer: The European Prospective Investigation into Cancer and Nutrition. Cancer Epidemiol Biomarkers Prev 14:2531–2535

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Clinical Epidemiology (C020), German Cancer Research Centre, Im Neuenheimer Feld 280, Heidelberg, 69120, Germany

    Sabine Rohrmann, Nikolaus Becker, Jakob Linseisen, Alexandra Nieters & Rudolf Kaaks

  2. Institute of Pathology, University of Wurzburg, Würzburg, Germany

    Thomas Rüdiger

  3. Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark

    Ole Raaschou-Nielsen & Anne Tjønneland

  4. Department of Haematology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark

    Hans E. Johnsen

  5. Department of Clinical Epidemiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark

    Kim Overvad

  6. Department of Epidemiology, German Institute of Human Nutrition, Potsdam, Germany

    Manuela M. Bergmann & Heiner Boeing

  7. Department of Hygiene and Epidemiology, School of Medicine, University of Athens, Athens, Greece

    Vasiliki Benetou, Theodora Psaltopoulou & Antonia Trichopoulou

  8. Molecular and Nutritional Epidemiology Unit, CSPO—Scientific Institute of Tuscany, Florence, Italy

    Giovanna Masala

  9. Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy

    Amalia Mattiello

  10. Nutritional Epidemiology Unit, National Cancer Institute, Milan, Italy

    Vittorio Krogh

  11. Cancer Registry, Azienda Ospedaliera “Civile MP Arezzo”, Ragusa, Italy

    Rosario Tumino

  12. Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, Netherlands

    Carla H. van Gils & Petra H. M. Peeters

  13. National Institute for Public Health and the Environment, Centre for Nutrition and Health, Bilthoven, The Netherlands

    H. Bas Bueno-de-Mesquita & Martine M. Ros

  14. Institute of Community Medicine, University of Tromsø, Tromso, Norway

    Eiliv Lund

  15. Public Health Institute of Navarra, Pamplona, Spain

    Eva Ardanaz

  16. Epidemiology Department, Murcia Health Council, Murcia, Spain

    María-Dolores Chirlaque

  17. Epidemiology Unit, Catalan Institue of Oncology (ICO-IDIBELL), Barcelona, Spain

    Paula Jakszyn

  18. Department of Public Health of Gipuzkoa, San Sebastian, Spain

    Nerea Larrañaga

  19. Public Health Directorate and Health Planning, Asturias, Spain

    A. Losada

  20. The Andalusian School of Public Health, Granada, Spain

    Carmen Martínez-García

  21. Department of Public Health and Clinical Medicine, Nutrition, Umeå University, Umea, Sweden

    Åsa Ågren & Göran Hallmans

  22. Department of Clinical Sciences, Malmö University Hospital, Malmo, Sweden

    Göran Berglund

  23. Department of Surgery, Malmö University Hospital, Malmo, Sweden

    Jonas Manjer

  24. Cancer Research UK, Epidemiology Unit, University of Oxford, Oxford, UK

    Naomi E. Allen & Timothy J. Key

  25. Department of Public Health and Primary Care, MRC Centre for Nutritional Epidemiology in Cancer Prevention and Survival, University of Cambridge, Cambridge, UK

    Sheila Bingham

  26. Clinical Gerontology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK

    Kay Tee Khaw

  27. Nutrition and Hormones Group, International Agency for Research on Cancer, Lyon, France

    Nadia Slimani & Pietro Ferrari

  28. Gene-Environment Epidemiology Group, International Agency for Research on Cancer, Lyon, France

    Paolo Boffetta

  29. Department of Epidemiology and Public Health, Imperial College London, London, UK

    Teresa Norat & Elio Riboli

  30. Environmental Epidemiology, Imperial College London, London, UK

    Paolo Vineis

Authors
  1. Sabine Rohrmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nikolaus Becker
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jakob Linseisen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alexandra Nieters
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Thomas Rüdiger
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ole Raaschou-Nielsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Anne Tjønneland
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hans E. Johnsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kim Overvad
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Rudolf Kaaks
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Manuela M. Bergmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Heiner Boeing
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Vasiliki Benetou
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Theodora Psaltopoulou
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Antonia Trichopoulou
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Giovanna Masala
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Amalia Mattiello
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Vittorio Krogh
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Rosario Tumino
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. Carla H. van Gils
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. Petra H. M. Peeters
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. H. Bas Bueno-de-Mesquita
    View author publications

    You can also search for this author in PubMed Google Scholar

  23. Martine M. Ros
    View author publications

    You can also search for this author in PubMed Google Scholar

  24. Eiliv Lund
    View author publications

    You can also search for this author in PubMed Google Scholar

  25. Eva Ardanaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  26. María-Dolores Chirlaque
    View author publications

    You can also search for this author in PubMed Google Scholar

  27. Paula Jakszyn
    View author publications

    You can also search for this author in PubMed Google Scholar

  28. Nerea Larrañaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  29. A. Losada
    View author publications

    You can also search for this author in PubMed Google Scholar

  30. Carmen Martínez-García
    View author publications

    You can also search for this author in PubMed Google Scholar

  31. Åsa Ågren
    View author publications

    You can also search for this author in PubMed Google Scholar

  32. Göran Hallmans
    View author publications

    You can also search for this author in PubMed Google Scholar

  33. Göran Berglund
    View author publications

    You can also search for this author in PubMed Google Scholar

  34. Jonas Manjer
    View author publications

    You can also search for this author in PubMed Google Scholar

  35. Naomi E. Allen
    View author publications

    You can also search for this author in PubMed Google Scholar

  36. Timothy J. Key
    View author publications

    You can also search for this author in PubMed Google Scholar

  37. Sheila Bingham
    View author publications

    You can also search for this author in PubMed Google Scholar

  38. Kay Tee Khaw
    View author publications

    You can also search for this author in PubMed Google Scholar

  39. Nadia Slimani
    View author publications

    You can also search for this author in PubMed Google Scholar

  40. Pietro Ferrari
    View author publications

    You can also search for this author in PubMed Google Scholar

  41. Paolo Boffetta
    View author publications

    You can also search for this author in PubMed Google Scholar

  42. Teresa Norat
    View author publications

    You can also search for this author in PubMed Google Scholar

  43. Paolo Vineis
    View author publications

    You can also search for this author in PubMed Google Scholar

  44. Elio Riboli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sabine Rohrmann.

Additional information

The work described in this article was carried out with the financial support of: Europe Against Cancer Program of the European Commission (SANCO); Deutsche Krebshilfe, Deutsches Krebsforschungszentrum, German Federal Ministry of Education and Research; Danish Cancer Society; Health Research Fund (FIS) of the Spanish Ministry of Health, Spanish Regional Governments of Andalucia, Asturia, Basque Country, Murcia and Navarra; the ISCIII Network RCESP (C03/09), Spain; Cancer Research UK; Medical Research Council, United Kingdom; Stroke Association, United Kingdom; British Heart Foundation; Department of Health, United Kingdom; Food Standards Agency, United Kingdom; Wellcome Trust, United Kingdom; Greek Ministry of Health; Greek Ministry of Education; Italian Association for Research on Cancer (AIRC); Italian National Research Council, Fondazione-Istituto Banco Napoli, Italy; Compagnia di San Paolo; Dutch Ministry of Public Health, Welfare and Sports; World Cancer Research Fund; Swedish Cancer Society; Swedish Scientific Council; Regional Government of Skåne, Sweden; Norwegian Cancer Society; Research Council of Norway; French League against Cancer (LNCC); National Institute for Health and Medical Research (INSERM), France; Mutuelle Générale de l’Education Nationale (MGEN), France; 3M Co, France; Gustave Roussy Institute (IGR), France; and General Councils of France.

Appendix

Appendix

Table 6
Full size table

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rohrmann, S., Becker, N., Linseisen, J. et al. Fruit and vegetable consumption and lymphoma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). Cancer Causes Control 18, 537–549 (2007). https://doi.org/10.1007/s10552-007-0125-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-007-0125-z

Keywords

Search

Navigation