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Epidemiology

Fruit and vegetable consumption and incident breast cancer: a systematic review and meta-analysis of prospective studies

British Journal of Cancer volume 125, pages 284–298 (2021)Cite this article

Subjects

Abstract

Background

We conducted a systematic review and meta-analysis of prospective studies to clarify the relation of fruit and vegetable consumption with incident breast cancer.

Methods

We searched systematically PubMed and EMBASE databases up to November 2020 to include prospective studies that reported the association of fruit and vegetable consumption with incident breast cancer. The pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated for the highest versus the lowest category of total fruit and vegetable, total fruit and total vegetable consumption, as well as fruit juice and subgroups of vegetables in relation to breast cancer incidence, using a random-effect model.

Results

Total fruit and vegetable consumption was associated with lower overall (RR = 0.91, 95% CI = 0.87–0.95) and postmenopausal breast cancer risk (RR = 0.88, 95% CI = 0.79–0.99). Total fruit consumption was associated with lower overall (RR = 0.93, 95% CI = 0.88–0.99) and postmenopausal breast cancer risk (RR = 0.93, 95% CI = 0.87–0.99). Total fruit and vegetable intake were associated with 11% and 26% lower risk of oestrogen- and progesterone-receptor-positive (ER+/PR+) and -negative (ER−/PR−) breast cancer, respectively. Total vegetable consumption was associated with 27% lower risk of ER−/PR− breast cancer. Fruit juice consumption was associated with increased overall breast cancer risk (RR = 1.04, 95% CI = 1.01–1.07). We did not find significant associations for subgroups of vegetable intake and breast cancer risk.

Conclusions

These findings suggest that high total fruit and vegetable consumption are associated with reduced risk of overall, postmenopausal, ER+/PR+ and ER−/PR− breast cancer.

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Fig. 1: Flowchart of study selection.
Fig. 2: Associations of total fruit and vegetable intake and risk of breast cancer.
Fig. 3: Associations of total fruit intake and risk of breast cancer.
Fig. 4: Associations of fruit juice intake and risk of overall breast cancer.
Fig. 5: Associations of total vegetable intake and risk of breast cancer.
Fig. 6: Associations of total fruit and vegetable, total fruit and total vegetable intake and risk of overall breast cancer.
Fig. 7: Associations of total fruit and vegetable, total fruit and total vegetable intake and risk of breast cancer based on hormone-receptor status.

References

  1. Sung, H., Ferlay, J., Siegel, R.L., Laversanne, M., Soerjomataram, I., Jemal, A. & Bray, F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J. Clin. https://doi.org/10.3322/caac.21660 (2021).

  2. Rock, C. L., Thomson, C., Gansler, T., Gapstur, S. M., McCullough, M. L., Patel, A. V. et al. American cancer society guidelines on nutrition and physical activity for cancer prevention. CA Cancer J. Clin. 70, 245–271 (2020).

  3. Farvid, M. S., Spence, N. D., Holmes, M. D. & Barnett, J. B. Fiber consumption and breast cancer incidence: a systematic review and meta-analysis of prospective studies. Cancer 126, 3061–3075 (2020).

  4. Eliassen, A. H., Hendrickson, S. J., Brinton, L. A., Buring, J. E., Campos, H., Dai, Q. et al. Circulating carotenoids and risk of breast cancer: pooled analysis of eight prospective studies. J. Natl Cancer Inst. 104, 1905–1916 (2012).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Slavin, J. L. & Lloyd, B. Health benefits of fruits and vegetables. Adv. Nutr. 3, 506–516 (2012).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Shibata, A., Paganini-Hill, A., Ross, R. K. & Henderson, B. E. Intake of vegetables, fruits, beta-carotene, vitamin C and vitamin supplements and cancer incidence among the elderly: a prospective study. Br. J. Cancer 66, 673–679 (1992).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Rohan, T. E., Howe, G. R., Friedenreich, C. M., Jain, M. & Miller, A. B. Dietary fiber, vitamins A, C, and E, and risk of breast cancer: a cohort study. Cancer Causes Control. 4, 29–37 (1993).

    Article  CAS  PubMed  Google Scholar 

  8. Byrne, C., Ursin, G. & Ziegler, R. G. A comparison of food habit and food frequency data as predictors of breast cancer in the NHANES I/NHEFS cohort. J. Nutr. 126, 2757–2764 (1996).

    CAS  PubMed  Google Scholar 

  9. Verhoeven, D. T., Assen, N., Goldbohm, R. A., Dorant, E., van ‘t Veer, P., Sturmans, F. et al. Vitamins C and E, retinol, beta-carotene and dietary fibre in relation to breast cancer risk: a prospective cohort study. Br. J. Cancer 75, 149–155 (1997).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Key, T. J., Sharp, G. B., Appleby, P. N., Beral, V., Goodman, M. T., Soda, M. et al. Soya foods and breast cancer risk: a prospective study in Hiroshima and Nagasaki, Japan. Br. J. Cancer 81, 1248–1256 (1999).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Sonestedt, E., Borgquist, S., Ericson, U., Gullberg, B., Landberg, G., Olsson, H. et al. Plant foods and oestrogen receptor alpha- and beta-defined breast cancer: observations from the Malmo Diet and Cancer cohort. Carcinogenesis 29, 2203–2209 (2008).

    Article  CAS  PubMed  Google Scholar 

  12. George, S. M., Park, Y., Leitzmann, M. F., Freedman, N. D., Dowling, E. C., Reedy, J. et al. Fruit and vegetable intake and risk of cancer: a prospective cohort study. Am. J. Clin. Nutr. 89, 347–353 (2009).

    Article  CAS  PubMed  Google Scholar 

  13. Jayalekshmi, P., Varughese, S. C., Kalavathi, Nair, M. K., Jayaprakash, V., Gangadharan, P. et al. A nested case-control study of female breast cancer in Karunagappally cohort in Kerala, India. Asian Pac. J. Cancer Prev. 10, 241–246 (2009).

    CAS  PubMed  Google Scholar 

  14. Boggs, D. A., Palmer, J. R., Wise, L. A., Spiegelman, D., Stampfer, M. J., Adams-Campbell, L. L. et al. Fruit and vegetable intake in relation to risk of breast cancer in the Black Women’s Health Study. Am. J. Epidemiol. 172, 1268–1279 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  15. Brasky, T. M., Lampe, J. W., Potter, J. D., Patterson, R. E. & White, E. Specialty supplements and breast cancer risk in the VITamins And Lifestyle (VITAL) Cohort. Cancer Epidemiol. Biomark. Prev. 19, 1696–1708 (2010).

    Article  CAS  Google Scholar 

  16. Butler, L. M., Wu, A. H., Wang, R., Koh, W. P., Yuan, J. M. & Yu, M. C. A vegetable-fruit-soy dietary pattern protects against breast cancer among postmenopausal Singapore Chinese women. Am. J. Clin. Nutr. 91, 1013–1019 (2010).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Löf, M., Sandin, S., Lagiou, P., Trichopoulos, D., Adami, H. O. & Weiderpass, E. Fruit and vegetable intake and risk of cancer in the Swedish women’s lifestyle and health cohort. Cancer Causes Control 22, 283–289 (2011).

    Article  PubMed  Google Scholar 

  18. Couto, E., Sandin, S., Löf, M., Ursin, G., Adami, H. O. & Weiderpass, E. Mediterranean dietary pattern and risk of breast cancer. PLoS ONE 8, e55374 (2013).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Suzuki, R., Iwasaki, M., Hara, A., Inoue, M., Sasazuki, S., Sawada, N. et al. Fruit and vegetable intake and breast cancer risk defined by estrogen and progesterone receptor status: the Japan Public Health Center-based Prospective Study. Cancer Causes Control 24, 2117–2128 (2013).

    Article  PubMed  Google Scholar 

  20. Emaus, M. J., Peeters, P. H., Bakker, M. F., Overvad, K., Tjønneland, A., Olsen, A. et al. Vegetable and fruit consumption and the risk of hormone receptor-defined breast cancer in the EPIC cohort. Am. J. Clin. Nutr. 103, 168–177 (2016).

    Article  CAS  PubMed  Google Scholar 

  21. Kim, J. H., Lee, J., Jung, S. Y. & Kim, J. Dietary factors and female breast cancer risk: a prospective cohort study. Nutrients 9, 1331 (2017).

  22. Elwood, P. C., Whitmarsh, A., Gallacher, J., Bayer, A., Adams, R., Heslop, L. et al. Healthy living and cancer: evidence from UK Biobank. Ecancermedicalscience 12, 792 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  23. Farvid, M. S., Chen, W. Y., Rosner, B. A., Tamimi, R. M., Willett, W. C. & Eliassen, A. H. Fruit and vegetable consumption and breast cancer incidence: repeated measures over 30 years of follow-up. Int. J. Cancer 144, 1496–1510 (2019).

    Article  CAS  PubMed  Google Scholar 

  24. Key, T. J., Balkwill, A., Bradbury, K. E., Reeves, G. K., Kuan, A. S., Simpson, R. F. et al. Foods, macronutrients and breast cancer risk in postmenopausal women: a large UK cohort. Int. J. Epidemiol. 48, 489–500 (2019).

    Article  PubMed  Google Scholar 

  25. Dunneram, Y., Greenwood, D. C. & Cade, J. E. Diet and risk of breast, endometrial and ovarian cancer: UK Women’s Cohort Study. Br. J. Nutr. 122, 564–574 (2019).

    Article  CAS  PubMed  Google Scholar 

  26. Bravi, F., Decarli, A. & Russo, A. G. Risk factors for breast cancer in a cohort of mammographic screening program: a nested case–control study within the FRiCaM study. Cancer Med. 7, 2145–2152 (2018).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Althuis, M. D., Fergenbaum, J. H., Garcia-Closas, M., Brinton, L. A., Madigan, M. P. & Sherman, M. E. Etiology of hormone receptor-defined breast cancer: a systematic review of the literature. Cancer Epidemiol. Biomark. Prev. 13, 1558–1568 (2004).

    CAS  Google Scholar 

  28. Aune, D., Chan, D. S., Vieira, A. R., Rosenblatt, D. A., Vieira, R., Greenwood, D. C. et al. Fruits, vegetables and breast cancer risk: a systematic review and meta-analysis of prospective studies. Breast Cancer Res. Treat. 134, 479–493 (2012).

    Article  CAS  PubMed  Google Scholar 

  29. Jung, S., Spiegelman, D., Baglietto, L., Bernstein, L., Boggs, D. A., van den Brandt, P. A. et al. Fruit and vegetable intake and risk of breast cancer by hormone receptor status. J. Natl Cancer Inst. 105, 219–236 (2013).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. World Cancer Research Fund/American Institute for Cancer Research. Diet, nutrition, physcal activity, and breast cancer. Revised 2018. https://www.wcrf.org/sites/default/files/Breast-cancer-report.pdf.

  31. Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 6, e1000097 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  32. DerSimonian, R. & Laird, N. Meta-analysis in clinical trials. Control Clin. Trials 7, 177–188 (1986).

  33. Orsini, N. From floated to conventional confidence intervals for the relative risks based on published dose-response data. Comput Methods Prog. Biomed. 98, 90–93 (2010).

    Article  Google Scholar 

  34. Sterne, J. A. & Egger, M. Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J. Clin. Epidemiol. 54, 1046–1055 (2001).

    Article  CAS  PubMed  Google Scholar 

  35. Begg, C. B. & Mazumdar, M. Operating characteristics of a rank correlation test for publication bias. Biometrics 50, 1088–1101 (1994).

    Article  CAS  PubMed  Google Scholar 

  36. Makarem, N., Bandera, E. V., Lin, Y., Jacques, P. F., Hayes, R. B. & Parekh, N. Consumption of sugars, sugary foods, and sugary beverages in relation to adiposity-related cancer risk in the Framingham Offspring Cohort (1991-2013). Cancer Prev. Res (Philos.). 11, 347–358 (2018).

    Article  CAS  Google Scholar 

  37. van Gils, C. H., Peeters, P. H., Bueno-de-Mesquita, H. B., Boshuizen, H. C., Lahmann, P. H., Clavel-Chapelon, F. et al. Consumption of vegetables and fruits and risk of breast cancer. J. Am. Med. Assoc. 293, 183–193 (2005).

    Article  Google Scholar 

  38. Chazelas, E., Srour, B., Desmetz, E., Kesse-Guyot, E., Julia, C., Deschamps, V. et al. Sugary drink consumption and risk of cancer: results from NutriNet-Santé prospective cohort. BMJ 366, l2408 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  39. Li, Y., Roswall, N., Sandin, S., Strom, P., Adami, H. O. & Weiderpass, E. Adherence to a healthy Nordic food index and breast cancer risk: results from a Swedish cohort study. Cancer Causes Control 26, 893–902 (2015).

    Article  CAS  PubMed  Google Scholar 

  40. Hirvonen, T., Mennen, L. I., de Bree, A., Castetbon, K., Galan, P., Bertrais, S. et al. Consumption of antioxidant-rich beverages and risk for breast cancer in French women. Ann. Epidemiol. 16, 503–508 (2006).

    Article  PubMed  Google Scholar 

  41. van den Brandt, P. A. & Schulpen, M. Mediterranean diet adherence and risk of postmenopausal breast cancer: results of a cohort study and meta-analysis. Int. J. Cancer 140, 2220–2231 (2017).

  42. Slavin, J. L. Position of the American Dietetic Association: health implications of dietary fiber. J. Am. Diet. Assoc. 108, 1716–1731 (2008).

    Article  PubMed  Google Scholar 

  43. Chu, Y. F., Sun, J., Wu, X. & Liu, R. H. Antioxidant and antiproliferative activities of common vegetables. J. Agric Food Chem. 50, 6910–6916 (2002).

    Article  CAS  PubMed  Google Scholar 

  44. Reuben, S. C., Gopalan, A., Petit, D. M. & Bishayee, A. Modulation of angiogenesis by dietary phytoconstituents in the prevention and intervention of breast cancer. Mol. Nutr. Food Res. 56, 14–29 (2012).

    Article  CAS  PubMed  Google Scholar 

  45. Pan, M. H., Lai, C. S., Dushenkov, S. & Ho, C. T. Modulation of inflammatory genes by natural dietary bioactive compounds. J. Agric Food Chem. 57, 4467–4477 (2009).

    Article  CAS  PubMed  Google Scholar 

  46. Collins, A. R., Harrington, V., Drew, J. & Melvin, R. Nutritional modulation of DNA repair in a human intervention study. Carcinogenesis 24, 511–515 (2003).

    Article  CAS  PubMed  Google Scholar 

  47. Riso, P., Martini, D., Moller, P., Loft, S., Bonacina, G., Moro, M. et al. DNA damage and repair activity after broccoli intake in young healthy smokers. Mutagenesis 25, 595–602 (2010).

    Article  CAS  PubMed  Google Scholar 

  48. Liu, R. H. Potential synergy of phytochemicals in cancer prevention: mechanism of action. J. Nutr. 134(12 Suppl), 3479S–3485SS (2004).

    Article  CAS  PubMed  Google Scholar 

  49. Canene-Adams, K., Lindshield, B. L., Wang, S., Jeffery, E. H., Clinton, S. K. & Erdman, J. W. Jr. Combinations of tomato and broccoli enhance antitumor activity in dunning r3327-h prostate adenocarcinomas. Cancer Res. 67, 836–843 (2007).

    Article  CAS  PubMed  Google Scholar 

  50. Biswas, D. K., Cruz, A. P., Gansberger, E. & Pardee, A. B. Epidermal growth factor-induced nuclear factor kappa B activation: a major pathway of cell-cycle progression in estrogen-receptor negative breast cancer cells. Proc. Natl Acad. Sci. USA 97, 8542–8547 (2000).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Landberg, G. Multiparameter analyses of cell cycle regulatory proteins in human breast cancer: a key to definition of separate pathways in tumorigenesis. Adv. Cancer Res. 84, 35–56 (2002).

    Article  CAS  PubMed  Google Scholar 

  52. Moiseeva, E. P., Heukers, R. & Manson, M. M. EGFR and Src are involved in indole-3-carbinol-induced death and cell cycle arrest of human breast cancer cells. Carcinogenesis 28, 435–445 (2007).

    Article  CAS  PubMed  Google Scholar 

  53. Nguyen, H. H., Aronchik, I., Brar, G. A., Nguyen, D. H., Bjeldanes, L. F. & Firestone, G. L. The dietary phytochemical indole-3-carbinol is a natural elastase enzymatic inhibitor that disrupts cyclin E protein processing. Proc. Natl Acad. Sci. USA 105, 19750–19755 (2008).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Singh, V., Singh, R., Kujur, P. K. & Singh, R. P. Combination of resveratrol and quercetin causes cell growth inhibition, DNA damage, cell cycle arrest, and apoptosis in oral cancer cells. Assay. Drug Dev. Technol. 18, 226–238 (2020).

    Article  CAS  PubMed  Google Scholar 

  55. Schulze, M. B., Manson, J. E., Ludwig, D. S., Colditz, G. A., Stampfer, M. J., Willett, W. C. et al. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. J. Am. Med. Assoc. 292, 927–934 (2004).

    Article  CAS  Google Scholar 

  56. Muraki, I., Imamura, F., Manson, J. E., Hu, F. B., Willett, W. C., van Dam, R. M. et al. Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. BMJ 347, f5001 (2013).

    Article  PubMed  PubMed Central  Google Scholar 

  57. Engin, A. Obesity-associated breast cancer: analysis of risk factors. Adv. Exp. Med. Biol. 960, 571–606 (2017).

    Article  CAS  PubMed  Google Scholar 

  58. Vrachnis, N., Iavazzo, C., Iliodromiti, Z., Sifakis, S., Alexandrou, A., Siristatidis, C. et al. Diabetes mellitus and gynecologic cancer: molecular mechanisms, epidemiological, clinical and prognostic perspectives. Arch. Gynecol. Obstet. 293, 239–246 (2016).

    Article  CAS  PubMed  Google Scholar 

  59. Taskinen, M. R., Packard, C. J. & Boren, J. Dietary fructose and the metabolic syndrome. Nutrients 11, 1987 (2019).

  60. Gambaro, S. E., Zubiria, M. G., Portales, A. E., Rey, M. A., Rumbo, M. & Giovambattista, A. M1 macrophage subtypes activation and adipocyte dysfunction worsen during prolonged consumption of a fructose-rich diet. J. Nutr. Biochem. 61, 173–182 (2018).

    Article  CAS  PubMed  Google Scholar 

  61. Pektas, M. B., Koca, H. B., Sadi, G. & Akar, F. Dietary fructose activates insulin signaling and inflammation in adipose tissue: modulatory role of resveratrol. Biomed. Res. Int. 2016, 8014252 (2016).

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  62. Pan, K., Chlebowski, R. T., Mortimer, J. E., Gunter, M. J., Rohan, T., Vitolins, M. Z. et al. Insulin resistance and breast cancer incidence and mortality in postmenopausal women in the Women’s Health Initiative. Cancer 126, 3638–3647 (2020).

    Article  CAS  PubMed  Google Scholar 

  63. Michels, N., van Aart, C., Morisse, J., Mullee, A. & Huybrechts, I. Chronic inflammation towards cancer incidence: a systematic review and meta-analysis of epidemiological studies. Crit. Rev. Oncol. Hematol. 157, 103177 (2021).

    Article  PubMed  Google Scholar 

  64. Arts, C. J., Govers, C. A., van den Berg, H., Wolters, M. G., van Leeuwen, P. & Thijssen, J. H. In vitro binding of estrogens by dietary fiber and the in vivo apparent digestibility tested in pigs. J. Steroid Biochem. Mol. Biol. 38, 621–628 (1991).

    Article  CAS  PubMed  Google Scholar 

  65. Shultz, T. D. & Howie, B. J. In vitro binding of steroid hormones by natural and purified fibers. Nutr. Cancer 8, 141–147 (1986).

    Article  CAS  PubMed  Google Scholar 

  66. Schaefer, E. J., Lamon-Fava, S., Spiegelman, D., Dwyer, J. T., Lichtenstein, A. H., McNamara, J. R. et al. Changes in plasma lipoprotein concentrations and composition in response to a low-fat, high-fiber diet are associated with changes in serum estrogen concentrations in premenopausal women. Metabolism 44, 749–756 (1995).

    Article  CAS  PubMed  Google Scholar 

  67. Tonin, F. S., Steimbach, L. M., Wiens, A., Perlin, C. M. & Pontarolo, R. Impact of natural juice consumption on plasma antioxidant status: a systematic review and meta-analysis. Molecules 20, 22146–22156 (2015).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Hyson, D. A. A review and critical analysis of the scientific literature related to 100% fruit juice and human health. Adv. Nutr. 6, 37–51 (2015).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Bertram, J. S. Dietary carotenoids, connexins and cancer: what is the connection? Biochem Soc. Trans. 32, 985–989 (2004).

    Article  CAS  PubMed  Google Scholar 

  70. Hu, F., Wang, Yi. B., Zhang, W., Liang, J., Lin, C., Li, D. et al. Carotenoids and breast cancer risk: a meta-analysis and meta-regression. Breast Cancer Res. Treat. 131, 239–253 (2012).

    Article  CAS  PubMed  Google Scholar 

  71. Fuentes, F., Paredes-Gonzalez, X. & Kong, A. N. Dietary glucosinolates sulforaphane, phenethyl isothiocyanate, indole-3-carbinol/3,3’-diindolylmethane: anti-oxidative stress/inflammation, Nrf2, epigenetics/epigenomics and in vivo cancer chemopreventive efficacy. Curr. Pharm. Rep. 1, 179–196 (2015).

    Article  CAS  Google Scholar 

  72. Smith-Warner, S. A., Spiegelman, D., Yaun, S. S., Adami, H. O., Beeson, W. L., van den Brandt, P. A. et al. Intake of fruits and vegetables and risk of breast cancer: a pooled analysis of cohort studies. J. Am. Med. Assoc. 285, 769–776 (2001).

    Article  CAS  Google Scholar 

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Acknowledgements

We would like to thank Jacqueline Cellini MLIS, MPH—Research & Instruction Librarian, Harvard T.H. Chan School of Public Health for her valuable contributions in developing the search string.

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Authors and Affiliations

  1. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Maryam S. Farvid

  2. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Junaidah B. Barnett

  3. Department of Sociology and Department of Health and Society, University of Toronto, Toronto, ON, Canada

    Nicholas D. Spence

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Contributions

Study concept and design: M.F.S., data collection and collation: M.S.F., statistical analysis: M.S.F., writing—original draft: M.S.F., writing—review and editing: M.S.F., J.B.B. and N.D.S, study supervision: M.S.F. Interpretation of the data, critical revision of the paper for important intellectual content and approval of the final paper for submission: M.S.F., J.B.B. and N.D.S. The corresponding authors prove that all listed authors meet the authorship criteria, and that no other eligible authors have been omitted.

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Correspondence to Maryam S. Farvid.

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Farvid, M.S., Barnett, J.B. & Spence, N.D. Fruit and vegetable consumption and incident breast cancer: a systematic review and meta-analysis of prospective studies. Br J Cancer 125, 284–298 (2021). https://doi.org/10.1038/s41416-021-01373-2

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