Table 15: Fruits and vegetables and breast cancer risk

Introduction: Eating fruits and vegetables appears to have little, if any, impact on the risk of breast cancer. Some studies have found that eating a lot of fruits and vegetables may lower the risk of breast cancer, but most of these studies have been case-control studies (not shown). Case-control studies are more prone to problems when collecting information about diet and lifestyle than prospective cohort studies (learn more). A study that pooled the results of eight large cohort studies found that increasing the intake of fruits and vegetables by about one serving a day did not lower the risk of breast cancer [1]. Even women with a high intake of fruits and vegetables only had a four percent lower risk of breast cancer compared to those with a low intake, and this was not statistically significant.

It may be that only certain fruits and vegetables have benefit, and this benefit may be limited to specific types of breast cancer. A recent study from the Nurses’ Health Study found that women with the highest intake of vegetables compared to those with the lowest intake of vegetables had a reduced risk of estrogen receptor-negative (ER-) breast cancer [2]. Further, women who ate one or more servings of yellow/orange vegetables per day, compared to those who ate fewer than two servings per week had a reduced risk of ER- breast cancer [2]. These benefits were not seen with fruit consumption [2].

Find more information on the strengths and weaknesses of different types of studies.

See how this risk factor compares with other risk factors for breast cancer.

Study selection criteria: Available prospective cohort studies with at least 200 breast cancer cases.

Table note: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk.

NS = No statistically significant increase or decrease in risk.

* Highest vs. lowest intake levels were >367 vs. <=114 grams of fruit/day and >309 vs. <=109 grams of vegetables/day.
† Relative risks for postmenopausal estrogen receptor-negative breast cancer.
‡ Relative risks for postmenopausal breast cancer. For premenopausal women, neither increased servings of fruits and vegetables or fruits alone were associated with breast cancer. However, >=5 vs. <2 servings of vegetables per day decreased risk of premenopausal breast cancer with a relative risk of 0.64 (0.43-0.95).
§ Relative risks for postmenopausal breast cancer.
Follow-up time estimated from person-years.
** Highest vs. lowest vegetable intake levels were: Average of 293 g/day vs. 121 g/day (Netherlands); average of 151 g/day vs. 41 g/day (Sweden); and average 396 g/day vs. 240 g/day (Italy).
†† Results for total fruit and vegetable intake from references 3, 4, 5, 8, 9, 10 were calculated by Smith Warner, et al. and do not appear in the original papers.


References

1. Smith-Warner SA, Spiegelman D, Yaun SS, et al. Intake of fruits and vegetables and risk of breast cancer: a pooled analysis of cohort studies. JAMA. 285(6): 769-76, 2001.

2. Fung TT, Hu FB, McCullough ML, et al. Diet quality is associated with the risk of estrogen receptor-negative breast cancer in postmenopausal women. J Nutr. 136(2):466-72, 2006.

3. van Gils CH, Peeters PHM, Bueno-de-Mesquita HB, et al. Consumption of vegetables and fruits and risk of breast cancer. JAMA. 293(2):183-93, 2005.

4. Fung TT, Hu FB, Holmes MD, et al. Dietary patterns and the risk of postmenopausal breast cancer. Int J Cancer. 116(1):116-21, 2005.

5. Zhang S, Hunter DJ, Forman MR, et al. Dietary carotenoids, and vitamins A, C, and E and risk of breast cancer. J Natl Cancer Inst. 91:547-556, 1999.

6. Männistö S, Dixon LB, Balder HF, et al. Dietary patterns and breast cancer risk: results from three cohort studies in the DIETSCAN project. Cancer Causes Control. 16(6):725-33, 2005.

7. Kushi LH, Fee RM, Sellers TA, et al. Intake of vitamin A, C, and E and postmenopausal breast cancer. Am J Epidemiol. 144:165-174, 1996.

8. Verhoeven DT, Assen N, Goldbohm RA, et al. Vitamins C and E, retinol, beta-carotene and dietary fibre in relation to breast cancer risk: a prospective cohort study. Br J Cancer. 75:149-155, 1997.

9. Olsen A, Tjonneland A, Thomsen BL, Loft S, Stripp C, Overvad K, Moller S, Olsen JH. Fruits and vegetables intake differentially affects estrogen receptor negative and positive breast cancer incidence rates. J Nutr. 133(7);2342-7, 2003.

10. Rohan TE, Howe GR, Friedenreich CM, et al. Dietary fiber, vitamins A, C, and E, and risk of breast cancer: a cohort study. Cancer Causes Control. 4:29-37, 1993.

11. Toniolo P, Riboli E, Shore RE, and Pasternack BS. Consumption of meat, animal products, protein, and fat, and risk of breast cancer: a prospective cohort study in New York. Epidemiology. 5:391-397, 1994.

12. Graham S, Zielezny M, Marshall J, et al. Diet in the epidemiology of postmenopausal breast cancer in the New York State Cohort. Am J Epidemiol. 136:1327-1337, 1992.

13. Mattisson I, Wirfalt E, Johansson U, Gullberg B, Olsson H, Berglund G. Intakes of plant foods, fibre and fat and risk of breast cancer--a prospective study in the Malmo Diet and Cancer cohort. Br J Cancer. 90(1):122-7, 2004.

14. Sieri S, Krogh V, Pala V, et al. Dietary patterns and risk of breast cancer in the ORDET cohort. Cancer Epidemiol Biomarkers Prev. 13(4):567-72, 2004.

Updated 09/12/09