Cruciferous Vegetable Intake Research Articles

A nested case-control study of cruciferous vegetables intake, urinary isothiocyanates level and lung cancer risk among men in urban Shanghai

Objective: To investigate the association between consumption of cruciferous vegetables (CV), level of urinary isothiocyanates (ITC) and the risk of lung cancer among man in urban Shanghai. Methods: A nested case-control study was conducted within the Shanghai Men's Health Study. Using incidence density sampling with a 2∶1 control to case selection ratio, 885 controls were selected to match 443 lung cancer cases diagnosed prior December 31, 2010. A food-frequency questionnaire was administered to estimate CV consumption. The high performance liquid chromatography method was applied to measure urinary ITC level. The CV intake and urinary ITC level were divided into quartiles according to distribution of control group. The lowest quartile was as a reference group. Conditional logistic regression model was used to analyze the relationship between CV intake, urinary ITC level and the risk of lung cancer. Results: The cruciferous vegetables intake median (P(25), P(75)) in cases and controls were 80.05 (46.89, 129.04) and 97.68 (55.25, 151.72) g/d (Z=-3.93, P<0.001). The urinary ITC level were 1.256 (0.474, 3.836) and 1.244 (0.484, 3.004) μmol/g Cr (Z=-0.39, P=0.697). After adjusting for potential confounding factors such as age, education level, smoking and alcohol consumption, for urinary ITC level, the OR(95%CI) for the highest quartile(≥3.004 μmol/g Cr) was 1.25 (0.87-1.80) compared with the lowest quartile(<0.484 μmol/g). For CV intake, the OR(95%CI) for the highest quartile(≥151.71 g/d) was 0.66 (0.43-1.02) compared with the lowest quartile(<55.25 g/d). Conclusion: No association was found between the CV intake, urinary ITC level and lung cancer risk in men.

Abstract C46: Fruit and vegetable intake and lung cancer incidence among Black women according to cigarette smoking status

Abstract Objective: The objective of this project was to evaluate associations of fruit and vegetable intake, according to cigarette smoking history, with lung cancer incidence among U.S. Black women. Methods: The Black Women's Health Study is a prospective cohort study (analytic cohort=46,889) among Black women between the ages 21-69 at baseline (1995). Fruit and vegetable intake (collected in 1995 and 2001only) and smoking history were ascertained via questionnaires at baseline and during follow-up (every other year). Combined fruit and vegetable (&amp;lt;3, 3-5, ≥5 servings/day), total fruit (&amp;lt;1, 1-&amp;lt;2, ≥2 servings/day), citrus fruit (&amp;lt;1, 1-&amp;lt;2, ≥2 servings/day), total vegetable (&amp;lt;1, 1-&amp;lt;2, ≥2 servings/day), starchy vegetable (&amp;lt;1, 1-&amp;lt;2, ≥2 servings/day), non-starchy vegetable (&amp;lt;0.5, 0.5-&amp;lt;1, &amp;gt;1 servings/day), and cruciferous vegetable (&amp;lt;0.5, 0.5-&amp;lt;1, &amp;gt;1 servings/day) intakes were evaluated. Cigarette smoking measures that were evaluated include: 1) current smoking status (never, former, current &amp;lt;15 cigarettes/day, current ≥15 cigarettes/day); (2) age started smoking (never, &amp;lt;18, ≥18 years); (3) pack-years (never smoked, &amp;lt;10, 10-19, ≥20 pack-years); and (4) combined pack-years + age started smoking (never smoked, &amp;lt;18 years + &amp;lt;10 pack-years, &amp;lt;18 years + 10-19 pack-years, &amp;lt;18 years + ≥20 pack-years, ≥18 years + &amp;lt;10 pack-years, ≥18 years + 10-19 pack-years, ≥18 years + ≥20 pack-years). Cox proportional hazards regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for associations between fruit and vegetable intake and smoking and lung cancer incidence (N=306 cases through 2013) with exposures updated through follow-up. Associations between smoking history and lung cancer were additionally evaluated stratified by fruit and vegetable intake. Likelihood ratio X2 tests were utilized to assess interactions between smoking history and fruit and vegetable intake. Results: More than half the women reported no history of cigarette smoking (66.4%), while 18.4% were former smokers and 15.1% were current smokers (&amp;lt;15 cigarettes/day: 9.7%, ≥15 cigarettes/day: 5.4%). Reported fruit and vegetable intake was low, with 6.1% and 5.6% consuming at least 3 servings/day of fruit or vegetables, respectively. Smoking history was associated with increased lung cancer incidence. The adjusted HR of current cigarette smoking of ≥15 cigarettes/day compared to never smoking was 17.4 (95% CI: 11.5, 26.4). Combined fruit and vegetable intake was not significantly associated with lung cancer incidence in covariate-adjusted models (≥5 versus &amp;lt;3 servings/day HR:0.86, 95% CI: 0.54, 1.36). Similar, total intakes of fruit, citrus fruit, vegetable, starchy vegetable, non-starchy vegetable, and cruciferous vegetables were not associated with lung cancer incidence in adjusted models. Associations between smoking and lung cancer incidence did not differ by fruit and vegetable intake. Among women who reported “low” (&amp;lt;3 servings/day) fruits and vegetable intake the HR for women with ≥20 pack-years compared to never smokers was 12.3 (95% CI: 8.18, 18.5), while among women with “high” (≥3 servings/day) intake the HR was 15.2 (95% CI: 7.46, 30.8) (p-interaction=0.67). Conclusion: Low fruit and vegetable intake was widespread in this population of U.S. Black women, but results do not support an association between fruit and vegetable intake and lung cancer incidence, regardless of cigarette smoking history. Citation Format: Sarah JO Nomura, Chiranjeev Dash, Lynn Rosenberg, Julie Palmer, Lucile L. Adams-Campbell. Fruit and vegetable intake and lung cancer incidence among Black women according to cigarette smoking status [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C46.

Validity and reproducibility of isothiocyanate intake assesses by food frequency questionnaire in the JPHC-next validation study: Comparison with 12-day weighed food records

Introduction Isothiocyanate (ITC) found in cruciferous vegetables are known for its chemopreventive properties that inhibits phase-I enzyme and activates phase-II enzymes. In epidemiologic studies, dietary ITC has been indicated in prevention of various types of cancer, such as lungs and bladder. Food frequency questionnaire (FFQ) is commonly used to assess ITC intake, which combines with laboratory data on the ITC content of specific cruciferous vegetables. Although availability of ITC depends on the contribution of plant myrosinase in the hydrolysis of glucosinolates, ITC content is measured on the basis of raw cruciferous vegetables in general. To our knowledge, no prospective studies have considered the effect of cooking. Using such databases could limit the study outcome of dietary ITC and disease relationships due to overestimation of ITC intake. Here, we aim to evaluate the validity of FFQ in the estimation of isothiocyanate using 12-day weighed food record (WFR) as the reference method by taking cooking methods into account. Methods Two hundred and forty participants (98 men and 142 women) aged 40–74 years from five areas in the JPHC-NEXT validation study were asked to respond to the 172-item FFQ and provide 12-day WFR as reference. Dietary ITC was calculated by combining the newly developed ITC database after consideration of popular cooking methods used in Japan. As we calculated the percentage of both raw and cooked cruciferous vegetable intake from WFR, cooked ITC intake was estimated from FFQ by weighing the average percentage of raw and cooked cruciferous vegetable on the ITC value. Spearman's correlation coefficients between estimates from FFQ and WFR were calculated and corrected for intra-individual variation of the WFR. Reproducibility of ITC intake was also assessed between 2 FFQs administered at an interval of 1-year. Results The mean intake of isothiocyanate according to FFQ was slightly lower than intake by WFR in men and higher in women. Percentage of difference of ITC were −3% for men and +19% in women. Deattenuated Spearman's correlation coefficient for ITC was 0.36 for men and 0.60 for women. Results were virtually unchanged when we applied the sex-unique percentage of raw and cooked cruciferous vegetable intake from WFR to derive correlation coefficients. Conclusions In conclusion, the validity of FFQ in estimating ITC was moderate. The reason for slightly poor correlation of ITC in men, is probably due to larger variance as a results of smaller sample size than in women. Additional confirmation may be warranted by using urinary isothiocyanate, which reflects the true intake of ITC.

The Role of Cruciferous Vegetables and Isothiocyanates for Lung Cancer Prevention: Current Status, Challenges, and Future Research Directions.

Lung cancer remains a leading cause of cancer-related deaths in the United States. Although smoking and air pollution exposure are primary risk factors of lung cancer, diet has also been reported to contribute to lung cancer risk. Cruciferous vegetables contain many bioactive compounds that alter the detoxification process of air-borne carcinogenic compounds and, thereby, may decrease lung cancer risk. In the meta-analysis of 31 observational studies, cruciferous vegetable intake is inversely associated with lung cancer risk (summary odds ratio/relative risk=0.81 and 95% confidence interval=0.74-0.89 for comparing the highest with lowest intake categories). More observational studies need to measure urinary isothiocyanate (ITC) concentrations and investigate their association with lung cancer risk in populations with relatively high intake of cruciferous vegetables. Current evidence is limited to two phase 2 clinical trials with incomplete reporting. Hence, more short-term clinical phase 2 trials need to examine effects of various amounts and types of cruciferous vegetables on biomarkers of risk and efficacy before a large phase 3 trial can be conducted to assess effects upon lung cancer risk. This would help further elucidate whether the inverse association observed with self-reported cruciferous vegetable intake is indeed due to ITC content or other bioactive compounds.

Intake of glucosinolates and risk of coronary heart disease in three large prospective cohorts of US men and women.

ImportanceGlucosinolates, a group of phytochemicals abundant in cruciferous vegetables, may have cardioprotective properties. However, no prospective study has evaluated the association of intake of glucosinolates with the risk of coronary heart disease (CHD).ObjectiveThe objective of the study was to evaluate the association between the intake of glucosinolates and incident CHD in US men and women.DesignProspective longitudinal cohort study.SettingHealth professionals in the USA.ParticipantsWe followed 74,241 women in the Nurses’ Health Study (NHS; 1984–2012), 94,163 women in the NHSII (1991–2013), and 42,170 men in the Health Professionals Follow-Up Study (1986–2012), who were free of cardiovascular disease and cancer at baseline.ExposureGlucosinolate intake was assessed using validated semi-quantitative food frequency questionnaires at baseline and updated every 2–4 years during follow-up.Main outcome measuresIncident cases of CHD were confirmed by medical record review.ResultsDuring 4,824,001 person-years of follow-up, 8,010 cases of CHD were identified in the three cohorts. After adjustment for major lifestyle and dietary risk factors of CHD, weak but significantly positive associations were observed for glucosinolates with CHD risk when comparing the top with bottom quintiles (hazard ratio [HR]:1.09; 95% CI: 1.01, 1.17; Ptrend<0.001). Higher intakes of three major subtypes of glucosinolates were consistently associated with a higher CHD risk, although the association for indolylglucosinolate did not achieve statistical significance. Regarding cruciferous vegetable intake, participants who consumed one or more servings per week of Brussels sprouts (HR: 1.16; 95% CI: 1.06, 1.26; P<0.001) and cabbage (HR: 1.09; 95% CI: 1.02, 1.17; P=0.009) had a significantly higher CHD risk than those who consumed these cruciferous vegetables less than once per month.Conclusion and relevanceIn these three prospective cohort studies, dietary glucosinolate intake was associated with a slightly higher risk of CHD in US adults. These results warrant replications in further studies including biomarker-based studies. Further studies are needed to confirm these findings and elucidate mechanistic pathways that may underlie these associations.

Usual Cruciferous Vegetable Consumption and Ovarian Cancer: A Case-Control Study

ABSTRACTOvarian cancer is the fifth leading cause of cancer-related deaths among women, primarily due to diagnosis at late stages. Therefore, identification of modifiable risk factors for this disease is warranted. Using the Patient Epidemiology Data System (PEDS), collected from 1981 to 1998 at Roswell Park Cancer Institute, Buffalo, NY, we conducted a hospital-based, case-control analysis of self-reported cruciferous vegetable intake and ovarian cancer among 675 women with primary, incident ovarian cancer, and 1275 without cancer. Cruciferous vegetable intake was queried using a 44-item food frequency questionnaire (FFQ). Odds ratios (OR) and 95% confidence intervals (CI) were estimated with logistic regression, adjusting for age, body mass index (BMI), education, smoking status, parity, family history of ovarian cancer, total fruit consumption, total meat consumption, and total noncruciferous vegetable consumption. We observed a significant inverse association for women with highest vs. lowest intakes of total vegetables (OR = 0.65, 95% CI = 0.46–0.92), cooked cauliflower (OR = 0.82, 95% CI = 0.67–0.99), and cooked greens (OR = 0.63, 95% CI = 0.46–0.86) and an inverse, dose-dependent association between cooked cruciferous vegetables intake and ovarian cancer (for each additional ten servings per month, OR = 0.85, 95% CI = 0.76–0.96). These findings suggest that a diet that includes cruciferous vegetables could be an important modifiable risk factor for ovarian cancer.

Cruciferous vegetable intake and mortality in middle-aged adults: A prospective cohort study

Cruciferous vegetables contain isothiocyanates, which effectively reduce inflammation and oxidative stress related to chronic diseases, inhibit the bioactivation of procarcinogens, and enhance the excretion of carcinogens. However, at present, no large cohort studies have investigated the effect of cruciferous vegetable on mortality. We aimed to examine the association between cruciferous vegetable intake and all-cause mortality, namely cancer, heart disease, cerebrovascular disease, and injuries, in a large cohort study conducted between 1990 and 1993, in Japan. The analysis included 88,184 participants (age: 45-74 years) with no history of cancer, myocardial infarction, and stroke. Participants were tracked for a median of 16.9 years, during which 15,349 deaths were occurred. The association between cruciferous vegetable intake and risk of all-cause and cause-specific mortality was determined by Cox proportional hazard regression analysis to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs), after adjustment for potential confounding factors. An inverse association was found between cruciferous vegetable intake and total mortality in both gender. HRs (95% CI) for all-cause mortality in the highest compared to the lowest quintile were 0.86 (0.80, 0.93) for men (P=0.0002 for trend) and 0.89 (0.81, 0.98) for women (P=0.03 for trend). Cruciferous vegetable intake was associated with lower cancer mortality in men, as well as with heart disease-, cerebrovascular disease-, and injury-related mortality in women. This prospective study suggests that a higher cruciferous vegetables intake is associated with reduced risk of all-cause mortality.

Cruciferous and Total Vegetable Intakes Are Inversely Associated With Subclinical Atherosclerosis in Older Adult Women.

BackgroundDietary patterns rich in fruits and vegetables are considered to reduce atherosclerotic disease presentation and are reported to be inversely associated with subclinical measures of atherosclerosis, such as carotid artery intima‐media thickness (IMT) and plaque. However, the effect of vegetable intake alone, and relationships to specific types of vegetables containing different phytochemical profiles, is important. The aim of this study was to investigate the associations of total vegetable intake and specific vegetables grouped according to phytochemical constituents with common carotid artery IMT (CCA‐IMT) and carotid plaque severity in a cohort of older adult women (aged ≥70 years).Methods and ResultsTotal vegetable intake was calculated at baseline (1998) using a validated food frequency questionnaire. Vegetable types included cruciferous, allium, yellow/orange/red, leafy green, and legumes. In 2001, CCA‐IMT (n=954) and carotid focal plaque (n=968) were assessed using high‐resolution B‐mode carotid ultrasonography. Mean (SD) total vegetable intake was 199.9 (78.0) g/d. Women consuming ≥3 servings of vegetables each day had ≈4.6% to 5.0% lower mean CCA‐IMT (P=0.014) and maximum CCA‐IMT (P=0.004) compared with participants consuming <2 servings of vegetables. For each 10 g/d higher in cruciferous vegetable intake, there was an associated 0.006 mm (0.8%) lower mean CCA‐IMT (P<0.01) and 0.007 mm (0.8%) lower maximum CCA‐IMT (P<0.01). Other vegetable types were not associated with CCA‐IMT (P>0.05). No associations were observed between vegetables and plaque severity (P>0.05).ConclusionsIncreasing vegetables in the diet with a focus on consuming cruciferous vegetables may have benefits for the prevention of subclinical atherosclerosis in older adult women.Clinical Trial Registration URL: http://www.anzctr.org.au. Unique identifier: ACTRN12615000750583.

Correction to: Dietary intake of soy and cruciferous vegetables and treatment-related symptoms in Chinese-American and non-Hispanic White breast cancer survivors.

In the original publication, the values provided for the isoflavone and glucosinolate intake variables were incorrectly labeled in Table1. The correct values of 6.3mg/day for isoflavone intake, and 20.4 mg/day and 50.1mg/day for glucosinolate intake are provided in this erratum.

Sulforaphane Modulates AQP8-Linked Redox Signalling in Leukemia Cells.

Sulforaphane, a biologically active isothiocyanate compound extracted from cruciferous vegetables, has been shown to exert cytotoxic effects on many human cancer cells, including leukemia. However, the exact molecular mechanisms behind the action of sulforaphane in hematological malignancies are still unclear. Like other cancer cells, leukemia cells produce high level of reactive oxygen species; in particular, hydrogen peroxide derived from Nox family is involved in various redox signal transduction pathways, promoting cell proliferation and survival. Recent evidence show that many tumour cell types express elevated level of aquaporin isoforms, and we previously demonstrated that aquaporin-8 acts as H2O2 transport facilitator across the plasma membrane of B1647 cells, a model of acute myeloid human leukemia. Thus, the control of AQP8-mediated H2O2 transport could be a novel strategy to regulate cell signalling and survival. To this purpose, we evaluated whether sulforaphane could somehow affect aquaporin-8-mediated H2O2 transport and/or Nox-mediated H2O2 production in B1647 cell line. Results indicated that sulforaphane inhibited both aquaporin-8 and Nox2 expression, thus decreasing B1647 cells viability. Moreover, the data obtained by coimmunoprecipitation technique demonstrated that these two proteins are linked to each other; thus, sulforaphane has an important role in modulating the downstream events triggered by the axis Nox2-aquaporin-8. Cell treatment with sulforaphane also reduced the expression of peroxiredoxin-1, which is increased in almost all acute myeloid leukemia subtypes. Interestingly, sulforaphane concentrations able to trigger these effects are achievable by dietary intake of cruciferous vegetables, confirming the importance of the beneficial effect of a diet rich in bioactive compounds.

Dietary intake of soy and cruciferous vegetables and treatment-related symptoms in Chinese-American and non-Hispanic White breast cancer survivors.

This project was undertaken to examine the association between dietary intake of soy or cruciferous vegetables and breast cancer treatment-related symptoms among Chinese-American(CA) and Non-Hispanic White (NHW) breast cancer survivors. This cross-sectional study included 192 CA and 173 NHW female breast cancer survivors (stages 0-III, diagnosed between 2006 and 2012) recruited from two California cancer registries, who had completed primary treatment. Patient-reported data on treatment-related symptoms and potential covariates were collected via telephone interviews. Dietary data were ascertained by mailed questionnaires. The outcomes evaluated were menopausal symptoms (hot flashes, night sweats, vaginal dryness, vaginal discharge), joint problems, fatigue, hair thinning/loss, and memory problems. Associations between soy and cruciferous vegetables and symptoms were assessed using logistic regression. Analyses were further stratified by race/ethnicity and endocrine therapy usage (non-user, tamoxifen, aromatase inhibitors). Soy food and cruciferous vegetable intake ranged from no intake to 431 and 865g/day, respectively, and was higher in CA survivors. Higher soy food intake was associated with lower odds of menopausal symptoms (≥24.0 vs. 0g/day, OR 0.51, 95% CI 0.25, 1.03), and fatigue (≥24.0 vs. 0g/day, OR 0.43, 95% CI 0.22, 0.84). However, when stratified by race/ethnicity, associations were statistically significant in NHW survivors only. Compared with low intake, higher cruciferous vegetable intake was associated with lower odds of experiencing menopausal symptoms (≥70.8 vs.<33.0g/day, OR 0.50, 95% CI 0.25, 0.97) in the overall population. In this population of breast cancer survivors, higher soy and cruciferous vegetable intake was associated with less treatment-related menopausal symptoms and fatigue.

Cruciferous and Allium Vegetable Intakes are Inversely Associated With 15-Year Atherosclerotic Vascular Disease Deaths in Older Adult Women.

BackgroundHigher vegetable intake is consistently associated with lower atherosclerotic vascular disease (ASVD) events. However, the components responsible and mechanisms involved are uncertain. Nonnutritive phytochemicals may be involved. The objective of this study was to investigate the associations of total vegetable intake and types of vegetables grouped according to phytochemical constituents with ASVD mortality.Methods and ResultsThe cohort consisted of 1226 Australian women aged 70 years and older without clinical ASVD or diabetes mellitus at baseline (1998). Vegetable intakes were calculated per serving (75 g/d) and were also classified into prespecified types relating to phytochemical constituents. ASVD‐related deaths were ascertained from linked mortality data. During 15 years (15 947 person‐years) of follow‐up, 238 ASVD‐related deaths occurred. A 1‐serving increment of vegetable intake was associated with a 20% lower hazard of ASVD‐related death (multivariable‐adjusted hazard ratio, 0.80; 95% confidence interval, 0.69–0.94 [P=0.005]). In multivariable‐adjusted models for vegetable types, cruciferous (per 10‐g/d increase: hazard ratio, 0.87; 95% confidence interval, 0.81–0.94 [P<0.001]) and allium (per 5‐g/d increase: hazard ratio, 0.82; 95% confidence interval, 0.73–0.94 [P=0.003]) vegetables were inversely associated with ASVD‐related deaths. The inclusion of other vegetable types, as well as lifestyle and cardiovascular risk factors, did not alter these associations. Yellow/orange/red (P=0.463), leafy green (P=0.063), and legume (P=0.379) vegetables were not significant.ConclusionsConsistent with current evidence, higher cruciferous and allium vegetable intakes were associated with a lower risk of ASVD mortality. In addition, cruciferous and allium vegetables are recognized to be a good source of several nonnutritive phytochemicals such as organosulfur compounds.Clinical Trial Registration URL: http://www.anzctr.org.au. Unique identifier: ACTRN12617000640303.

Associations of dietary patterns with bone mass, muscle strength and balance in a cohort of Australian middle-aged women.

Influences of dietary patterns on musculoskeletal health are poorly understood in middle-aged women. This cross-sectional analysis from a cohort of 347 women (aged 36-57 years) aimed to examine associations between dietary patterns and musculoskeletal health outcomes in middle-aged women. Diet was measured by the Cancer Council of Victoria FFQ. Total body bone mineral content (TB BMC), femoral neck and lumbar spine bone density (dual-energy X-ray absorptiometry), lower limbs muscle strength (LMS) and balance tests (timed up and go test, step test, functional reach test (FRT) and lateral reach test) were also measured. Exploratory factor analysis was used to identify dietary patterns and scores for each pattern generated using factor loadings with absolute values ≥0·20. Associations between food pattern scores and musculoskeletal outcomes were assessed using multivariable linear regression. Three dietary patterns were identified: 'Healthy' (high consumption of a plant-based diet - vegetables, legumes, fruit, tomatoes, nuts, snacks, garlic, whole grains and low intake of high-fat dairy products), 'high protein, high fat' (red meats, poultry, processed meats, potatoes, cruciferous and dark-yellow vegetables, fish, chips, spirits and high-fat dairy products) and 'Processed foods' (high intakes of meat pies, hamburgers, beer, sweets, fruit juice, processed meats, snacks, spirits, pizza and low intake of cruciferous vegetables). After adjustment for confounders, Healthy pattern was positively associated with LMS, whereas Processed foods pattern was inversely associated with TB BMC and FRT. The associations were not significant after accounting for multiple comparisons. There were no associations with any other outcomes. These results suggest that maintaining a healthy diet could contribute to bone acquisition, muscle strength and balance in adult life. However, while they provide some support for further investigating dietary strategies for prevention of age-related loss of muscle and deterioration in balance, the exploratory nature of the analyses means that confirmation in longitudinal studies and/or trials with pre-specified hypotheses is needed.

Trends in Cruciferous Vegetable Consumption and Associations with Breast Cancer Risk: A Case-Control Study

BackgroundThe chemopreventive activities of cruciferous vegetables were recognized in the early 1990s, followed by a growth of evidence in various cancer models, including breast cancer. To our knowledge, no studies have examined whether consumption of cruciferous vegetables has changed accordingly, and what impact, if any, on breast cancer risk may have resulted. ObjectiveThe time trend in cruciferous vegetable intake was investigated between 1982 and 1998, and its associations with breast cancer risk were examined. MethodsIn a hospital-based case-control study in 1491 patients with breast cancer and 1482 controls, loess curves were constructed to describe the relation between median consumption of cruciferous vegetables and year of admission. ORs and 95% CIs were calculated with unconditional logistic regression, adjusting for age, year of admission, family income, body mass index, cigarette smoking, age at menarche, parity, age at first birth, family history of breast cancer, hormone replacement therapy, and total meat intake. ResultsConsumption patterns differed between cases and controls. A slow but steady increase in cruciferous vegetable intake was observed in the cases, although among controls, cruciferous vegetable consumption increased from 1982 to 1987, reached a plateau during 1988–1992, and then declined from 1993 to 1998. Accordingly, although an overall inverse association with breast cancer risk was observed for cruciferous vegetable intake (highest compared with lowest quartile—OR: 0.68; 95% CI: 0.55, 0.86; P-trend = 0.0006), the inverse association tended to be more pronounced within more recent-year strata, with an OR of 0.52 (95% CI: 0.33, 0.83) for 1993–1998 compared with an OR of 0.89 (95% CI: 0.64, 1.23) for 1982–1987. ConclusionsThe consumption of cruciferous vegetables increased during the past 2 decades, showing different trends in cases and controls. The subtle but sustained increase in cruciferous vegetable intake reported by the cases could influence association studies with breast cancer risk.

Cruciferous Vegetable Intake Is Inversely Associated with Lung Cancer Risk among Current Nonsmoking Men in the Japan Public Health Center (JPHC) Study

BackgroundCruciferous vegetables, a rich source of isothiocyanates, have been reported to lower the risk of several types of cancer, including lung cancer. However, evidence from prospective observations of populations with a relatively high intake of cruciferous vegetables is sparse. ObjectiveWe investigated the association between cruciferous vegetable intake and lung cancer risk in a large-scale population-based prospective study in Japan. MethodsWe studied 82,330 participants (38,663 men; 43,667 women) aged 45–74 y without a past history of cancer. Participants were asked to respond to a validated questionnaire that included 138 food items. The association between cruciferous vegetable intake and lung cancer incidence was assessed with the use of Cox proportional hazard regression analysis to estimate HRs analysisd 95% CIs (with adjustments for potential confounding factors). ResultsAfter 14.9 y of follow-up, a total of 1499 participants (1087 men; 412 women) were diagnosed with lung cancer. After deleting early-diagnosed cancer and adjusting for confounding factors, we observed a nonsignificant inverse trend between cruciferous vegetable intake and lung cancer risk in men in the highest compared with the lowest quartiles (multivariate HR: 0.85; 95% CI: 0.69, 1.06; P-trend = 0.13). Stratified analysis by smoking status revealed a significant inverse association between cruciferous vegetable intake and lung cancer risk among those who were never smokers and those who were past smokers after deleting lung cancer cases in the first 3 y of follow-up [multivariate HR for never smokers: 0.49 (95% CI: 0.27, 0.87; P-trend = 0.04); multivariate HR for past smokers: 0.59 (95% CI: 0.35, 0.99; P-trend = 0.10)]. No association was noted in men who were current smokers and women who were never smokers. ConclusionThis study suggests that cruciferous vegetable intake may be associated with a reduction in lung cancer risk among men who are currently nonsmokers.

Consumption of vegetables and fruits and breast cancer survival: a systematic review and meta-analysis

We aimed to conduct a meta-analysis investigating the association between consumption of vegetables and fruits and breast cancer survival. A comprehensive search of the PubMed and EMBASE was performed from the inception to September 30, 2016. The summary hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a random effects model. Ten studies, with a total of 31,210 breast cancer cases, were included in the meta-analysis. The summary HRs (95% CIs) of overall survival (highest vs. lowest) were 1.08 (0.88–1.33; I2 = 41.1%) for pre-diagnostic intake of vegetables and fruits combined, 0.96 (0.71–1.30; I2 = 48.4%) for vegetables alone, and 0.83 (0.67–1.02; I2 = 0) for fruit alone. No significant risk associations of overall survival were found for post-diagnostic intake of vegetables and fruits. Line dose-response analyses indicated the likely results for both pre- and post- diagnostic dietary intake. No significant association was found between intake of vegetables and fruits and breast cancer-specific mortality. In addition, intake of cruciferous vegetables was not associated with death from breast cancer. Our findings indicated a borderline inverse association between pre-diagnostic intake of fruit and overall survival of breast cancer, whereas intake of vegetables was not associated with survival.

Small servings of vegetables or a cruciferous supplement do not affect urinary estrogen metabolites in premenopausal women

BackgroundThe ratio of urinary 2‐hydroxyestrone to 16‐α‐hydroxyestrone (2:16) is hypothesized as a potential biomarker of breast cancer risk in premenopausal women, with higher ratios theoretically protective. Cruciferous vegetable intake has been inconsistently associated with higher urinary 2:16.ObjectiveWe investigated whether or not a cruciferous vegetable supplement made from dried Brussels sprouts and kale, would increase the urinary 2:16 estrogen metabolite ratio in comparison to placebo or cruciferous vegetables in healthy premenopausal women.DesignThis registered (NCT01726127) parallel arm, placebo‐controlled, partly blinded study included 78 healthy premenopausal women (38–50 years) with screening urinary 2:16 ≤ 3.0 who were not using exogenous hormone treatment. Subjects were randomly assigned to receive 1) Crucifer supplement 2) 40 g daily alternating broccoli or Brussels sprouts or 3) placebo daily for eight weeks. Urinary 2:16 was measured at baseline, four, and 8 weeks. Serum chemistries of progesterone, estradiol, estrone, luteinizing hormone, and follicle‐stimulating hormone were analyzed.ResultsIntent‐to‐treat repeated measures‐ANOVA identified no treatment effect on urinary 2:16 (P = 0.83) or treatment by time interaction (P = 0.79). Per‐protocol analyses including only complete cases found no significant treatment by time interaction (P = 0.63) and restricting the analysis to subjects with minimum 80% verifiable compliance to treatment found similar results (Ptreatment = 0.90 Pinteraction = 0.86).ConclusionsNeither the crucifer supplement nor a small serving of cruciferous vegetables significantly altered the urinary 2:16 estrogen metabolite ratio in healthy premenopausal women.Support or Funding InformationThis project was funded by Standard Process, Inc. (Palmyra, WI).

Feasibility Outcomes of a Pilot Randomized Controlled Trial to Increase Cruciferous and Green Leafy Vegetable Intake in Post‐Treatment Head and Neck Cancer Survivors

ObjectivePrevious research has shown higher intake of green leafy (GLV) and cruciferous vegetables (CV) are associated with improved biomarkers of prognosis and disease‐free survival in patients diagnosed with head and neck cancer (HNC). These observational study results have not yet been corroborated in a randomized controlled trial (RCT). The purpose of this study was to determine the feasibility of implementing a RCT to increase CV and GLV intake in post‐treatment HNC survivors.MethodsBetween January 2015 – April 2015, 17 post‐treatment HNC survivors were recruited via an institutional cancer registry and randomized to one of two groups: 1) an intervention group (n=9) that received weekly telephone dietary counseling aimed at reaching specific goals for weekly intake of CV (2.5 cups/week) and GLV (3.5 cups/week) or 2) a usual care attention control group (n=8). Participants completed a baseline survey, three 24‐hour dietary recalls, a blood draw, and anthropometric measures prior to randomization and at the end of the 12‐week study period. Feasibility outcomes included recruitment, retention, adherence, and safety. Retention was measured as the number completing the 12‐week study. Adherence was measured as completion of the weekly telephone sessions (for both groups) and self‐reported weekly CV and GLV intake for the intervention group.ResultsDuring the enrollment period, 350 incident HNC cases were screened for eligibility. Of these, n=98 were eligible for study participation and n=252 were ineligible. Reasons for ineligibility were “deceased” (n=93), “wrong/inactive numbers/unable to reach” (n=60) and “medical exclusions” (n=27). Of the n=98 eligible HNC cases, n=17 agreed to participate for an enrollment rate of 17.3%. The most common reason for non‐participation was “distance” (n=48). Other reasons for non‐participation included “not interested” (n=19) and “too busy” (n=5). Throughout the study period the retention rate was 100%. Mean intervention adherence rates for weekly goals were 68.7% for GLV, 66.6% for CV, and 66.9% overall. The mean adherence rate for completion of weekly telephone counseling was 92.5%. No serious adverse events were reported. Participants in the intervention group reported an overall mean increase of 4.4 and 2.9 cups of GLV and CV per week from baseline (pre‐intervention) intake, respectively.ConclusionThese results support the feasibility and acceptability of a post‐treatment intervention aimed at increasing CV and GLV intake in HNC survivors and suggest it may offer a promising strategy to improve vegetable consumption in this population. A larger RCT is warranted to assess the efficacy of this intervention on disease outcomes.Support or Funding InformationThis study was supported by a NIH/NCI Cancer Prevention and Control Training Grant: R25 CA047888 and a Research Enhancement Project Grant from the University of Alabama at Birmingham Center for Palliative and Supportive Care.

Effect of Cruciferous Vegetable Intake on Oxidative Stress Biomarkers: Differences by Breast Cancer Status

ABSTRACTThis post hoc analysis examined cruciferous vegetable intake on urinary oxidative metabolites in postmenopausal women. Intervention participants (n = 69) received cruciferous vegetables (≥14 cups/week) during a 3-week period. First morning urine measured 8-isoprostane and 8-hydroxy-2′-deoxyguanosine. Dietary intake was estimated using 24-h recalls. When stratified by history of breast cancer, those with breast cancer had significantly lower post-intervention urinary 8-hydroxy-2′-deoxyguanosine values in the intervention arm versus. the control arm (1.1 ng/mL vs. 3.2 ng/mL, p = .01) after adjustment for baseline 8-hydroxy-2′-deoxyguanosine. This was not observed in those without breast cancer. Further work is needed to understand the role of breast cancer in these relationships.

An Adolescent and Early Adulthood Dietary Pattern Associated with Inflammation and the Incidence of Breast Cancer.

Adolescence is a highly susceptible period for mammary carcinogenesis, but few prospective studies have examined the role of adolescent diet in breast cancer risk. Reduced rank regression has previously been used to identify a dietary pattern associated with markers of inflammation (C-reactive protein, IL6, and TNFα receptor 2). We investigated whether an adolescent and early adulthood inflammatory dietary pattern was associated with breast cancer among 45,204 women in the Nurses' Health Study II using reduced rank regression. Participants completed a food frequency questionnaire in 1998 about their high school diet (HS-FFQ) and a FFQ in 1991 when they were ages 27-44 years. Among women who completed the HS-FFQ, 1,477 cases of breast cancer were diagnosed during 22 years of follow-up. An adolescent and early adulthood dietary pattern characterized by inflammation was associated with an increased incidence of premenopausal but not postmenopausal breast cancer. Women in the fifth quintile of the inflammatory pattern score had multivariable adjusted HRs for premenopausal breast cancer of 1.35 for adolescent diet [95% confidence interval (95% CI), 1.06-1.73; Ptrend = 0.002] and 1.41 for early adulthood diet (95% CI, 1.11-1.78; Ptrend = 0.006) compared with women in the first quintile. The corresponding RRs for postmenopausal breast cancer were 0.84 (95% CI, 0.60-1.17) for adolescent and 0.76 (95% CI, 0.54-1.06) for adult intake. Overall, our findings support the notion that an adolescent and early adulthood diet characterized by high intake of sugar-sweetened and diet soft drinks, refined grains, red and processed meat, and margarine, and low intake of green leafy vegetables, cruciferous vegetables, and coffee may increase the incidence of premenopausal breast cancer. Cancer Res; 77(5); 1179-87. ©2017 AACR.