Research Article

Intake of fruits, vegetables, folic acid and related nutrients and risk of breast cancer in postmenopausal women

Barbara Thoranda1, Lenore Kohlmeiera1a2 c1, Naal Simonsena1, Carry Croghana1 and Michael Thamma3

a1 Department of Epidemiology, School of Public Health, McGavran-Greenberg Hall, CB#7400, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7400, USA

a2 Department of Nutrition, Schools of Public Health and Medicine, McGavran-Greenberg Hall,CB#7400, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7400, USA

a3 Robert Koch Institute, General-Pape-Strasse 62–66, D-12101 Berlin, Germany


Objective: To determine the role of fruit and vegetable consumption and dietary intake of folic acid and related nutrients such as methionine, cysteine and alcohol in the aetiology of breast cancer.

Design: Population based case-control study.

Setting: Part of the European Community Multicentre Study on Antioxidants, Myocardial Infarction, and Cancer of the Breast (EURAMIC) in Berlin, Germany.

subjects: As part of the EURAMIC study, dietary intake data were collected in 43 postmenopausal women diagnosed with breast cancer between 191 and 1992 in Berlin, Germany, and compared to 106 population-based controls.

Results: Odds ratios (ORs) adjusted for major risk factors of breast cancer but not for total energy intake showed a non-significant inverse association between a high intake of vegetables (OR=0.76, 95% CI=0.48–1.20) and fruits (OR=0.74, 95% CI=0.48–1.15) and breast cancer. Once results were adjusted for total energy intake the associations became much weaker (vegetables: OR=0.86, 95% CI=0.51–1.46; fruits: OR=0.82, 95% CI=0.51–1.32). For all nutrients, the effect of energy adjustment was more profound and the inverse associations disappeared when results were adjusted for energy intake (total folate—not energy adjusted: OR=0.79, 95% CI=O.51–1.21; energy adjusted: OR=1.14, 95% CI=0.73–1.79; folate equivalents-not energy adjusted: OR=0.81, 95% CI= 0.53–1.23; energy adjusted: OR=1.16, 95% CI=0.78–1.74; methionine—not energy adjusted: OR=0.60, 95% CI=0.35–1.03; energy adjusted: OR=1.29, 95% CI=0.76–2.19; cysteine—not energy adjusted: OR=0.52, 95% CI=0.29–0.94; energy adjusted: OR=1.22, 95% CI=0.75–1.97). Alcohol intake was inversely associated with breast cancer in a non-significant way, possibly due to the relatively low alcohol intake of the study population.

Conclusions: The results of this study do not provide firm evidence that a high intake of fruits and vegetables, folic acid, methionine or cysteine reduces the risk of getting breast cancer.

(Received May 21 1998)

(Accepted July 12 1998)