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)