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Nutrition in acute and chronic diseases

Vegetable and fruit intake and colorectal cancer risk by smoking status in adults: The Japan Public Health Center-based Prospective Study

Abstract

Background

Cigarette smoke contains many oxidants and free radicals which may affect the association between vegetable and fruit intake and colorectal cancer (CRC) risk. However, this relationship remains unclear.

Objective

This study aimed to investigate the associations between vegetable and fruit intake and CRC risk by smoking status.

Methods

The Japan Public Health Center-based Prospective Study is a population-based prospective cohort study. Participants completed a self-administered questionnaire in 1995–1999 (baseline survey) and were followed through to 2013. At the baseline survey, 89,283 residents (41,797 men and 47,486 women) aged 45–74 years were included. Participants were asked about their lifestyle and dietary habits. To investigate the association of vegetable and fruit intake with risk of CRC, Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). We analyzed the relationship between vegetable and fruit intake and CRC risk stratified by sex and smoking status.

Results

During follow-up, 2261 participants were diagnosed with CRC. Overall, vegetable and fruit intake were not associated with CRC risk in either sex. When stratified by sex and smoking status, CRC risk among male never smokers was inversely associated with intake of vegetables and fruit combined (HR: 0.72; 95% CI: 0.53, 0.98; highest vs lowest quartile p trend = 0.01) and fruit alone (HR: 0.62; 95% CI: 0.45, 0.86; p trend < 0.01).

Conclusions

Cigarette smoking may affect the association between vegetable and fruit intake and CRC risk among men.

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Data availability

For information on how to submit an application to gain access to JPHC data and/or biospecimens, please follow the instructions at https://epi.ncc.go.jp/en/jphc/805/8155.html.

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Acknowledgements

We thank the members in each of the study areas for their corporation and technical advice. JPHC Study members are listed at the following website (accessed November 2020): [https://epi.ncc.go.jp/en/jphc/781/8510.html].

Funding

This study was supported by the National Cancer Center Research and Development Fund (since 2010), a Grant-in-Aid for Cancer Research from the Ministry of Health, Labor and Welfare of Japan (from 1989 to 2010), and a MAFF Commissioned project study (JPJ009842). These supporting sources were not involved in the research work.

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The authors’ responsibilities were as follows: ST, MI, MI, TY, and NS designed the research; ST, MI, MI, TY, and NS conducted the research; MH and KK analyzed the data; and MH and NS wrote the paper. MH had primary responsibility for the final content. All authors read and approved the final manuscript.

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Correspondence to Norie Sawada.

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Hori, M., Sawada, N., Kito, K. et al. Vegetable and fruit intake and colorectal cancer risk by smoking status in adults: The Japan Public Health Center-based Prospective Study. Eur J Clin Nutr (2022). https://doi.org/10.1038/s41430-022-01214-2

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