Cohort analysis of fruit and vegetable consumption and lung cancer mortality in European men

Our aim was to examine the relationship between fruit and vegetable consump tion acid lung cancer mortality in a cohort of European males. Around 1970, dietary intake of Finnish, Italian and Dutch middle-aged men was assessed using a cross-check dietary history, Complete baseline information was avai lable for 3,108 men, of whom 1,578 were baseline smokers, We used Cox propo rtional hazard analyses to calculate risk estimates for the consumption in country-specific tertiles on lung cancer in smokers. During 25 years of fol lowup, 149 lung cancer deaths occurred in the smokers. Fruit consumption wa s inversely associated with lung cancer mortality among smokers; compared w ith the lowest, adjusted RRs for the intermediate and highest tertiles were 0.56 (0.37-0.84) and 0.69 (0.46-1.02), p-trend 0.05, Only in the Dutch coh ort was this association statistically significant [adjusted relative risks (RRs) 1.00, 0.33 (0.16-0.70) and 0.35 (0.16-0.74), p-trend 0.004], In Finl and lung cancer risk was lower with higher fruit intake but not significant ly, whereas in Italy no association was observed. Stratifying on cigarette smoking intensity (non, light and heavy) revealed an inverse association in the heavy smokers only [adjusted RRs (95% confidence intervals [CI]) 1; 0. 47 (0.26-0.84); 0.40 (0.20-0.78)), Vegetable consumption was not related to lung cancer risk in smokers. However, analyses stratified on cigarette smo king intensity gave some indication for a lower lung cancer risk with highe r intake. In conclusion, in this prospective analysis among European smokin g men, fruit intake was inversely related to lung cancer mortality. This as sociation was confined to heavy cigarette smokers. (C) 2001 Wiley-Liss, Inc .