This summary table contains detailed information about research studies. Summary tables offer an informative look at the science behind many breast cancer guidelines and recommendations. However, they should be viewed with some caution. In order to read and interpret research tables successfully, it is important to understand some key concepts. Learn how to read a research table.
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Introduction: Eating fruits and vegetables appears to have little, if any, impact on the risk of breast cancer.
Although some case-control studies have shown eating a lot of fruits and vegetables may lower the risk of breast cancer, most cohort studies show no link between the two. Case-control studies are more prone to problems when collecting information about diet and lifestyle than prospective cohort studies (learn more).
A pooled analysis of the data from eight large cohort studies found increasing the intake of fruits and vegetables by about one serving a day did not lower the risk of breast cancer [1]. And, findings showed women who ate the most fruits and vegetables did not have a lower risk of breast cancer compared to those who ate the least.
It may be that only certain fruits and vegetables have benefit, and this benefit may be limited to specific types of breast cancer. Findings from the Nurses’ Health Study and the Black Women’s Health Study showed women with the highest intake of vegetables compared to those with the lowest had a reduced risk of estrogen receptor-negative (ER-) breast cancer. These benefits were not seen in women with a high intake of fruit [2-4].
Learn about 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: Prospective cohort studies with at least 400 breast cancer cases.
Table note: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk.
Study
|
Study Population
(number of participants)
|
Follow-up
(years)
|
Levels of Fruit and Vegetable Intake Compared
|
Relative Risk of Breast Cancer of Women with the Highest Level of Fruit and/or Vegetable Intake versus Women with the Lowest Level of Intake
RR (95% CI)
|
Prospective cohort studies
|
EPIC [5]
|
285,526
(3,659 cases)
|
5.4
|
Highest vs. lowest level of fruit intake*
|
1.09 (0.94-1.25)
|
| |
|
|
Highest vs. lowest level of vegetable intake*
|
0.98 (0.84-1.14)
|
Nurses' Health Study [6]
|
83,234
(2,697 cases)
|
14
|
5 or more vs.
2 or fewer servings/day fruits and vegetables
|
1.03 (0.81-1.31)†
|
| |
|
|
5 or more vs.
2 or fewer servings/day fruits
|
0.84 (0.64-1.09)†
|
| |
|
|
5 or more vs.
2 or fewer servings/day vegetables
|
1.02 (0.85-1.24)†
|
Swedish Mammography Cohort [7]
|
61,463
(1,932 cases)
|
13
|
Highest vs. lowest level of vegetable intake
|
0.91 (0.79-1.05)
|
Black Women’s Health Study [4]
|
51,928
(1,268 cases)
|
12
|
4 or more vs.
less than 1 serving/day fruits and vegetables |
0.87 (0.71-1.07)
|
| |
|
|
2 or more servings/day vs.
fewer than 2 servings/week fruits
|
0.91 (0.74-1.11)
|
| |
|
|
2 or more servings/day vs.
fewer than 4 servings/week vegetables
|
0.87 (0.73-1.05)‡
|
Iowa Women's Health Study [1,8]
|
34,406
(1,130 cases)
|
9
|
Increase fruit and vegetable intake by 1 serving/day
|
1.00 (0.98-1.02)
|
Netherlands Cohort Study [1,9]
|
62,412
(937 cases)
|
6
|
Increase fruit/ vegetable intake by 1 serving/day
|
0.96 (0.91-1.01)
|
| Melbourne Collaborative Cohort Study [10] |
20,967
(815 cases)
|
14.1
|
Highest vs. lowest level of fruit and salad intake
|
0.81 (0.63-1.03)¶
|
| |
|
|
Highest vs. lowest level of vegetable intake
|
0.98 (0.76-1.28)¶
|
Singapore Chinese Health Study [11]
|
34,028
(629 cases)
|
10.7
|
Highest vs. lowest level of fruit intake§
|
1.03 (0.77-1.38)
|
| |
|
|
Highest vs. lowest level of vegetable intake§
|
0.86 (0.63-1.16)
|
Diet, Cancer and Health Cohort-Denmark [12]
|
23,798
(425 cases)
|
4.7
|
Increase fruit and vegetable intake by 1 serving/day
|
1.02 (0.98-1.06)¶
|
Canadian National Breast Screening Study [1,13]
|
56,837
(419 cases)
|
5
|
Increase fruit and vegetable intake by 1 serving/day
|
0.98 (0.94-1.03)
|
Pooled analysis
|
Smith-Warner, et al. [1]
|
351,825
(7,377 cases)
|
|
Increase fruit and vegetable intake by 1 serving/day
|
0.99 (0.98-1.00)**
|
* Highest vs. lowest intake levels were: more than 367 vs. 114 or fewer grams of fruit per day and more than 309 vs. 109 or fewer grams of vegetables per day.
† Relative risks for postmenopausal breast cancer. For premenopausal women, fruit and vegetable intake and fruit intake alone did not affect breast cancer risk. However, women who ate 5 or more vs. fewer than 2 servings of vegetables per day had a decreased risk of premenopausal breast cancer, with a relative risk of 0.64 (0.43-0.95).
‡ Fruit and vegetable intake and fruit intake alone did not affect breast cancer by hormone status. However, women who at 2 or more servings of vegetables per day vs. fewer than 4 servings per week had a decreased risk of hormone receptor-negative breast cancer, with a relative risk of 0.57 (0.38-0.85).
§ Highest vs. lowest intake levels were: average of 357 vs. 39 grams of fruit per day and an average of 174 vs. 51 grams of vegetables per day.
¶ Vegetable intake alone did not affect breast cancer by hormone status. However, women who ate the most fruit and salad vs. those who ate the least had a decreased risk of hormone receptor-negative breast cancers, with a relative risk of 0.55 (0.32-0.93).
** Results for total fruit and vegetable intake from references 8, 9 and 12 were calculated by Smith Warner, et al. and do not appear in the original papers.
References
- 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.
- 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.
- 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.
- Boggs DA, Palmer JR, Wise LA, et al. Fruit and vegetable intake in relation to risk of breast cancer in the Black Women's Health Study. Am J Epidemiol. 172(11):1268-79, 2010.
- 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.
- 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.
- 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.
- 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.
- 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.
- Baglietto L, Krishnan K, Severi G, et al. Dietary patterns and risk of breast cancer. Br J Cancer. 104(3):524-31, 2011.
- Butler LM, Wu AH, Wang R, Koh WP, Yuan JM, Yu MC. A vegetable-fruit-soy dietary pattern protects against breast cancer among postmenopausal Singapore Chinese women. Am J Clin Nutr. 91(4):1013-9, 2010.
- 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.
- 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.
Updated 07/07/11
