Associations between Christian Orthodox Church Fasting and Adherence to the World Cancer Research Fund’s Cancer Prevention Recommendations

Objective: Studies regarding the health effects of religious fasting have increased in the last decade. The aim of this research was to investigate the relationship between Christian Orthodox Church (COC) fasting recommendations and cancer risk, with a specific focus on fibre, fruit, vegetables, and red and processed meat consumption. Methods: In this cross-sectional study, participants included 361 individuals from Northern Greece. One hundred and seventy-six participants followed the COC fasting regime for more than 10 years, and 185 participants did not follow any restrictive dietary patterns. Diet was assessed using a 114-item food frequency questionnaire. Results: Fasters had a more favourable dietary intake compared to non-fasters, with fasters having a higher consumption of fruit and vegetables (p = 0.009) and a significantly lower consumption of total processed meat (p < 0.001) compared to non-fasters. No significant differences were observed in the consumption of fibre and red meat consumption between the two groups. Conclusions: Following the World Cancer Research Fund Cancer Recommendations, fasters are at a potentially lowering risk of developing colorectal cancer than non-fasters due to their more favourable dietary intake. Furthermore, higher consumption of fruit and vegetables with a lower consumption of total processed meat contributes to lower the risk of metabolic syndrome. Public health strategies based on following the structured COC fasting recommendations might hopefully contribute to the prevention of metabolic syndrome and colorectal cancer.     

Meat consumption and risk of lung cancer among never-smoking women

The relationship between diet and lung cancer, apart from the protective effect of fruit and vegetables, is poorly understood. Reports on the role of dietary components such as meat are inconsistent, and few studies include sufficient numbers of nonsmokers. We examined the relationship between meat consumption and never-smoking lung cancer in a hospital-based case-control study of Singapore Chinese women, a population with low smoking prevalence. Three hundred and ninety-nine cases and 815 controls were recruited, of whom 258 cases and 712 controls were never smokers. A standardized questionnaire (which included a food frequency questionnaire module) was administered by trained interviewers. Among these never smokers, fruit and vegetable intake were inversely associated with lung cancer risk. Seventy-two percent of meat consumed was white meat (chicken or fish). Meat consumption overall was inversely associated with lung cancer [adjusted odds ratio (OR), 0.88, 0.59 for second, third tertiles, P (trend) = .012]. An inverse relationship between fish consumption and lung cancer (adjusted OR, 0.81, 0.47 for 2nd, 3rd tertiles, P (trend) < .001) was observed. No association was seen between consumption of processed meats and lung cancer, nor between dietary heterocyclic amines and lung cancer. Our data suggest that fish consumption may be protective against lung cancer in never smokers.     

Consumption of red meat, white meat and processed meat in Irish adults in relation to dietary quality

The aim of the present study was to examine the association of red meat, white meat and processed meat consumption in Irish adults with dietary quality. A cross-sectional study of subjects, randomly selected using the electoral register, estimated habitual food intakes using a 7 d food diary in a nationally representative sample of 662 men and 717 women (not pregnant or lactating) aged 18-64 years. Consumers were classified into thirds, based on the distribution of mean daily intakes for red meat, white meat and processed meat. The mean intakes of red meat, white meat and processed meat were 51, 33 and 26 g/d respectively, and men consumed significantly more (P<0.001) than women for all meat types. In men, red meat consumption was associated with lower (P<0.001) prevalence of inadequacy for Zn, riboflavin and vitamin C intakes. Increasing processed meat intake was associated with a lower (P<0.01) level of compliance with dietary recommendations for fat, carbohydrate and fibre in men. Increasing processed meat consumption was associated with lower (P<0.01) wholemeal bread, vegetables, fruit and fish intakes in men and women. Managerial occupations were associated with lower processed meat intakes. It is important to distinguish between meat groups, as there was a large variation between the dietary quality in consumers of red meat, white meat and processed meat. Processed meat consumption is negatively associated with dietary quality and might therefore be a dietary indicator of poor dietary quality. This has important implications in nutritional epidemiological studies and for the development of food-based dietary guidelines.     

Meat Consumption and Risk of Lung Cancer Among Never-Smoking Women

The relationship between diet and lung cancer, apart from the protective effect of fruit and vegetables, is poorly understood. Reports on the role of dietary components such as meat are inconsistent, and few studies include sufficient numbers of nonsmokers. We examined the relationship between meat consumption and never-smoking lung cancer in a hospital-based case–control study of Singapore Chinese women, a population with low smoking prevalence. Three hundred and ninety-nine cases and 815 controls were recruited, of whom 258 cases and 712 controls were never smokers. A standardized questionnaire (which included a food frequency questionnaire module) was administered by trained interviewers. Among these never smokers, fruit and vegetable intake were inversely associated with lung cancer risk. Seventy-two percent of meat consumed was white meat (chicken or fish). Meat consumption overall was inversely associated with lung cancer [adjusted odds ratio (OR), 0.88, 0.59 for second, third tertiles, P _trend = .012]. An inverse relationship between fish consumption and lung cancer (adjusted OR, 0.81, 0.47 for 2nd, 3rd tertiles, P _trend < .001) was observed. No association was seen between consumption of processed meats and lung cancer, nor between dietary heterocyclic amines and lung cancer. Our data suggest that fish consumption may be protective against lung cancer in never smokers.     

Plasma Metabolite Profiles of Red Meat,Poultry, and Fish Consumption,and Their Associations with Colorectal Cancer Risk

Background: Red and processed meat consumption has been consistently associated with increased risk of colorectal cancer (CRC), but the association for fish intake is unclear. Evidence using objective dietary assessment approaches to evaluate these associations is sparse. Objectives: We aim to investigate the plasma metabolite profiles related to red meat, poultry, and fish consumption and examine their associations with CRC risk. Methods: We measured plasma metabolites among 5269 participants from the Nurses’ Health Study (NHS), NHSII, and Health Professionals Follow-Up study (HPFS). We calculated partial Spearman correlations between each metabolite and self-reported intake of seven red meat, poultry, and fish groups. Metabolite profile scores correlated to self-reported dietary intakes were developed using elastic net regression. Associations between self-reported intakes, metabolite profile scores, and subsequent CRC risk were further evaluated using conditional logistic regression among 559 matched (1:1) case-control pairs in NHS/HPFS and replicated among 266 pairs in Women’s Health Study. Results: Plasma metabolites, especially highly unsaturated lipids, were differentially associated with red meat and fish groups. Metabolite profile scores for each food group were significantly correlated with the corresponding self-reported dietary intake. A higher dietary intake of processed red meat was associated with a higher risk of CRC (pooled OR per 1 SD, 1.15; 95% CI: 1.03, 1.29). In contrast, higher metabolite profile scores for all fish groups, not dietary intakes, were consistently associated with a lower CRC risk: the pooled OR per 1 SD was 0.86 (95% CI: 0.78, 0.96) for total fish, 0.86 (95% CI: 0.77, 0.96) for dark meat fish, and 0.87 (95% CI: 0.78, 0.97) for canned tuna fish. No significant associations were found for other food groups. Conclusions: Red meat and fish intake exhibited systematically different plasma metabolite profiles. Plasma metabolite profile of fish intake was inversely associated with CRC risk.     

Colorectal cancer, diet and lifestyle factors: opportunities for prevention

A considerable amount of observational evidence from case-control and cohort studies demonstrates an association between various dietary and lifestyle factors and risk of colorectal cancer. This suggests the potential for colorectal cancer risk reduction by decreasing consumption of animal fats, red meat, alcohol and cigarettes, by increasing physical activity levels, and by increasing intake of fruits, vegetables and dietary fibre. Few intervention studies have been performed to corroborate this potential, although results of important trials will be available in the future. We argue, however, that the evidence is sufficient to support pilot implementation of lifestyle-modification programs in the context of targeted screening programs, and also the integration of prevention of colorectal cancer within a non-communicable disease strategy aimed at the general population. Evaluation of the costs and benefits of alternative strategies must be an integral part of program implementation, in order to advance the knowledge that we have of the impact of prevention strategies, so that resources are not wasted on ineffective interventions. Given the consistency of evidence relating lifestyle behaviours to colorectal cancer incidence and the negligible risk of undesirable consequences from promotion of a diet high in fruit, vegetables and fibre and low in red meat and animal fats, inaction can no longer be justified.Key words: colorectal cancer; diet; primary prevention      

Food groups and risk of type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies

The aim of this systematic review and meta-analysis was to synthesize the knowledge about the relation between intake of 12 major food groups and risk of type 2 diabetes (T2D). We conducted a systematic search in PubMed, Embase, Medline (Ovid), Cochrane Central, and Google Scholar for prospective studies investigating the association between whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages (SSB) on risk of T2D. Summary relative risks were estimated using a random effects model by contrasting categories, and for linear and non-linear dose–response relationships. Six out of the 12 food-groups showed a significant relation with risk of T2D, three of them a decrease of risk with increasing consumption (whole grains, fruits, and dairy), and three an increase of risk with increasing consumption (red meat, processed meat, and SSB) in the linear dose–response meta-analysis. There was evidence of a non-linear relationship between fruits, vegetables, processed meat, whole grains, and SSB and T2D risk. Optimal consumption of risk-decreasing foods resulted in a 42% reduction, and consumption of risk-increasing foods was associated with a threefold T2D risk, compared to non-consumption. The meta-evidence was graded “low” for legumes and nuts; “moderate” for refined grains, vegetables, fruit, eggs, dairy, and fish; and “high” for processed meat, red meat, whole grains, and SSB. Among the investigated food groups, selecting specific optimal intakes can lead to a considerable change in risk of T2D.     

萧山区大肠癌发病危险因素的病例对照研究

目的：探讨萧山区人群大肠癌发生的危险因素。方法：采用以医院和社区为基础的1∶2病例对照研究方法,对102例经过病理学确诊的大肠癌患者及204例对照的相关资料进行条件Logistic回归分析。结果：大肠癌的危险因素有红肉和腌制食物（腌肉、咸鱼）食用频率,情绪自我调节能力差,下消化道疾病史,肿瘤家族史。其OR值及95%CI分别为4.99（2.14-11.65）、3.71（1.27-10.88）、2.60（1.03-6.56）、4.66（1.65-13.16）、3.30（1.43-7.62）;保护因素有白肉、新鲜水产类、新鲜蔬菜类食用频率,体育锻炼,OR值分别为0.09（0.03-2.22）,0.30（0.14-0.66）,0.21（0.09-0.49）,0.16（0.03-0.80）。结论：大肠癌的发生与饮食因素、性格特征、下消化道疾病和肿瘤家族史密切相关。     

Dietary Patterns and Colorectal Adenoma and Cancer Risk: A Review of the Epidemiological Evidence

A number of studies exploring associations between individual dietary components and colorectal adenoma or cancer risk have yielded conflicting results. The study of food-based dietary patterns in relation to chronic disease risk represents an alternative approach to the evaluation of single dietary exposures in epidemiological investigations. Results from prospective cohort and population-based case-control studies examining associations between dietary patterns and colorectal cancer or adenoma risk were evaluated and described in this review. Despite notable differences in population characteristics, study design, and methods used for characterizing dietary patterns across the different studies, two general dietary patterns were found to modestly predict colorectal adenoma and cancer risk. A healthier pattern consisting of greater intakes of fruits and vegetables, and lower intakes of red and processed meat, appeared protective against colorectal adenoma and cancer incidence. Findings also suggest that a less healthy pattern characterized by higher intakes of red and processed meat, as well as potatoes and refined carbohydrates, may increase risk. Continued research efforts are needed to evaluate the cumulative and interactive effects of numerous dietary exposures on colorectal cancer risk.     

Dietary patterns as identified by factor analysis and colorectal cancer among middle-aged Americans

BACKGROUND: Although diet has long been suspected as an etiological factor for colorectal cancer, studies of single foods and nutrients have provided inconsistent results. OBJECTIVE: We used factor analysis methods to study associations between dietary patterns and colorectal cancer in middle-aged Americans. DESIGN: Diet was assessed among 293,615 men and 198,767 women in the National Institutes of Health-AARP Diet and Health Study. Principal components factor analysis identified 3 primary dietary patterns: a fruit and vegetables, a diet foods, and a red meat and potatoes pattern. State cancer registries identified 2151 incident cases of colorectal cancer in men and 959 in women between 1995 and 2000. RESULTS: Men with high scores on the fruit and vegetable pattern were at decreased risk [relative risk (RR) for quintile (Q) 5 versus Q1: 0.81; 95% CI: 0.70, 0.93; P for trend = 0.004]. Both men and women had a similar risk reduction with high scores on the diet food factor: men (RR: 0.82; 95% CI: 0.72, 0.94; P for trend = 0.001) and women (RR: 0.87; 95% CI: 0.71, 1.07; P for trend = 0.06). High scores on the red meat factor were associated with increased risk: men (RR: 1.17; 95% CI: 1.02, 1.35; P for trend = 0.14) and women (RR: 1.48; 95% CI: 1.20, 1.83; P for trend = 0.0002). CONCLUSIONS: These results suggest that dietary patterns characterized by a low frequency of meat and potato consumption and frequent consumption of fruit and vegetables and fat-reduced foods are consistent with a decreased risk of colorectal cancer.     

Nutrition and cancer: the current epidemiological evidence

We have examined the current scientific evidence on the relationship between nutrition and the most frequent tumours in the Spanish population: lung, colorectal, prostate, breast and stomach. Consumption of fruit is negatively associated with cancer of the lung and stomach, possibly with colorectal cancer, but probably not with prostate cancer and breast cancer. Consumption of vegetables probably reduces the risk of colorectal and stomach cancer, but probably is not associated with cancer of the lung, prostate and breast. Consumption of red and processed meat is positively associated with colorectal cancer and probably with stomach cancer. Animal fat is possibly associated with colorectal cancer and probably with prostate and breast cancer. High alcohol intake increases the risk of colorectal and breast cancer, while dairy products and calcium seem to decrease the risk of colorectal cancer. Obesity is a recognised risk factor of colorectal cancer and breast cancer in postmenopausal women, while foods with a high glycaemic index and glycaemic load possibly increase the risk of colorectal and prostate cancer. The relevance of nutrition on the cancer process is evident. Nevertheless important issues remain to be solved and further studies are needed. This accumulative knowledge should be used by public health authorities to develop recommendations and activities to reduce overweight and obesity and to promote healthy dietary habits.     

Red meat intake may increase the risk of colon cancer in Japanese, a population with relatively low red meat consumption

Asian populations have changed from traditional to Westernized diets, with increased red meat intake. They are suggested to be particularly susceptible to the adverse effects of red meat on the development of colorectal cancers, however, few prospective studies of this putative link have been conducted. We examined associations between the consumption of red and processed meat and the risk of subsite-specific colorectal cancer by gender in a large Japanese cohort. During 1995-1998, a validated food frequency questionnaire was administered to 80,658 men and women aged 45-74 years. During 758,116 person-years of follow-up until the end of 2006, 1,145 cases of colorectal cancer were identified. Higher consumption of red meat was significantly associated with a higher risk of colon cancer among women [multivariate hazard ratios (95%CIs) for the highest versus lowest quintiles (HR): 1.48 (1.01, 2.17; trend p=0.03)], as was higher consumption of total meat among men [HR=1.44 (1.06, 1.98; trend p=0.07)]. By site, these positive associations were found for the risk of proximal colon cancer among women and for distal colon cancer among men. No association was found between the consumption of processed meat and risk of either colon or rectal cancer. In conclusion, red meat intake may modestly increase the risk of colon cancer in middle-aged Japanese, although the highest quintile of red meat consumption could be considered moderate by Western standards.     

Dietary patterns and adenocarcinoma of the esophagus and distal stomach.

BACKGROUND: Dietary pattern analysis is a unique approach to studying relations between diet and disease. OBJECTIVE: Our objective was to describe the dietary patterns of an eastern Nebraska population and investigate the associations between those dietary patterns and risks of adenocarcinoma of the esophagus and distal stomach. DESIGN: We recruited 124 subjects with esophageal adenocarcinoma, 124 subjects with distal stomach adenocarcinoma, and 449 control subjects in a population-based, case-control study. RESULTS: Six dietary patterns were identified with the use of cluster analysis. The first dietary pattern represented healthy food choices and had higher energy contributions from fruit and vegetables and grain products and lower energy contributions from red meats, processed meats, and gravy than did the other dietary patterns. In contrast, a second dietary pattern was high in meats and low in fruit and cereals. The other 4 dietary patterns were each characterized by a concentrated energy source: salty snacks, desserts, milk, and white bread, respectively. The test of overall difference in cancer risk across dietary patterns was significant for distal stomach adenocarcinoma (P = 0.04) but not for esophageal adenocarcinoma. Risk of esophageal adenocarcinoma was inversely associated with intakes of dairy products, fish, all vegetables, citrus fruit and juices, and dark bread and was positively associated with gravy intake. Risk of distal stomach adenocarcinoma was positively associated with red meat intake. CONCLUSIONS: Our study suggests that a diet high in fruit and vegetables may decrease the risk of esophageal adenocarcinoma and that a diet high in meats may increase the risk of distal stomach adenocarcinoma.     

Cancers in Australia in 2010 attributable to the consumption of red and processed meat

Objectives: To estimate the proportion and numbers of cancers in Australia in 2010 attributable to consuming red/processed meat. Methods: We estimated the population attributable fraction (PAF) for cancers causally associated with red/processed meat consumption (colon, rectum) using standard formulae incorporating prevalence of consumption (1995 National Nutrition Survey), relative risks associated with consumption and cancer incidence. We also estimated the proportion change in cancer incidence (potential impact fraction [PIF]) that might have occurred under two hypothetical interventions whereby Australian adults reduced their consumption of red/processed meat from prevailing levels to ≤100 g or ≤65 g per day, respectively. Results: An estimated 2,614 cases (18%) of colorectal cancer occurring in Australians in 2010 were attributable to red/processed meat consumption (16% of colon cancers; 23% of rectal cancers). We estimated that if all Australian adults had consumed ≤65 g/day or ≤100 g/day of red/processed meat, then the incidence of colorectal cancer would have been 5.4% (798 cancers) or 1.4% (204 cancers) lower, respectively. Conclusions: About one in six colorectal cancers in Australians in 2010 were attributable to red/processed meat consumption. Implications: Reducing red/processed meat intake may reduce colorectal cancer incidence, but must be balanced against nutritional benefits of modest lean meat consumption.     

Associations between microalbuminuria and animal foods, plant foods, and dietary patterns in the Multiethnic Study of Atherosclerosis

BACKGROUND: The balance between the intake of animal and the intake of plant foods may influence renal vascular integrity as reflected by urinary albumin excretion. OBJECTIVE: We assessed cross-sectional associations between urinary albumin excretion and dietary patterns and intake of plant and animal foods. DESIGN: At baseline, diet (food-frequency questionnaire) and the urinary albumin-to-creatinine ratio (ACR; spot urine collection) were measured in 5042 participants in the Multi-Ethnic Study of Atherosclerosis who were aged 45-84 y and were without clinical cardiovascular disease, diabetes, or macroalbuminuria (sex-adjusted ACR >or= 250). We derived dietary patterns by principal components analysis. We also summed food groups to characterize plant food intake (fruit, fruit juice, vegetables, nuts, legumes, whole grains, and refined grains), animal food intake (red meat, processed meat, poultry, fish, high-fat dairy, and low-fat dairy), and nondairy animal food intake. RESULTS: After adjustment for multiple demographic and lifestyle confounders, a dietary pattern characterized by high consumption of whole grains, fruit, vegetables, and low-fat dairy foods was associated with 20% lower ACR across quintiles (P for trend = 0.004). Neither total animal nor total plant food intake was associated with ACR. However, greater low-fat dairy consumption was associated with 13% lower ACR across quartiles (P for trend = 0.03). Total nondairy animal food consumption was associated with 11% higher ACR across quintiles (P for trend = 0.03). CONCLUSIONS: A high intake of low-fat dairy foods and a dietary pattern rich in whole grains, fruit, and low-fat dairy foods were both associated with lower ACR. In contrast, collectively, nondairy animal food intake was positively associated with ACR.     

蔬菜水果摄入与前列腺癌风险的Meta分析

目的 系统评价蔬菜水果摄入与前列腺癌(prostate cancer,PCa)风险之间的关系,为前列腺癌的预防策略提供相关依据.方法 计算机检索Pubmed、Embase、Web of science数据库,查找评价蔬菜和/或水果摄入与前列腺癌风险之间关系的队列研究以及相关文献,对纳入的文献进行质量评级,采用R软件(4...     

Dietary habits and prostate cancer prevention: a review of observational studies by focusing on South America

There exist several works considering the association between diet and prostate cancer (PC) risk, but the issue is largely unsettled. This article systematically reviews the epidemiological studies on diet and risk of PC focusing on those carried out in countries of South America. There is some suggestion that dairy products, red meat, processed meat, α-linolenic fatty acids, as well as dietary patterns characterized by higher intakes of red and processed meat, eggs, and grains may play some role in the development of PC. There is no clear association with the intake of vegetables and fruits, lycopene, fats, and different types of fatty acids. The evidence on diet and PC is therefore inconclusive in general and specifically in South America. Particular attention must be paid to the study of cancer risk in some countries of South America because of the singularly risky dietary pattern consumed by its population.     

Usual Dietary Intake among Female Breast Cancer Survivors Is Not Significantly Different from Women with No Cancer History: Results of the National Health and Nutrition Examination Survey, 2003-2006

Dietary intake is a modifiable behavior that may reduce the risk of recurrence and death among breast cancer survivors. Cancer survivors are encouraged to consume a diet rich in fruit, vegetables, and whole grains and limit red meat, processed meat, and alcohol intake. Using data from the National Health and Nutrition Examination Survey (2003-2006), this study examined whether breast cancer survivors and women with no history of cancer differed in the distribution of usual intake of foods included in the dietary recommendations for preventing cancer and recurrences. Participants completed one or two 24-hour dietary recalls. The food groups included in this analysis were whole fruit; total vegetables; dark green and orange vegetables; whole grains; red meat; processed meat; alcohol; and calories from solid fat, alcohol, and added sugar. The National Cancer Institute Method was used to estimate the distribution of usual intake and to compare breast cancer survivors (n=102) to noncancer respondents (n=2,684). Using age and cancer survivor as covariates, subgroup estimates of usual intake were constructed. No significant group differences were found, except that survivors reported a greater intake of whole grains. More than 90% of both groups did not meet recommendations for fruits, vegetables, and whole grains; 75.4% and 70.2%, respectively, consumed less than the red meat recommendation; and <10% of either group met the recommendation for percent energy from solid fat, alcohol, and added sugar. The diet of breast cancer survivors was not significantly different from women with no history of cancer.     

Associations of Red Meat,Fat, and Protein Intake With Distal Colorectal Cancer Risk

Studies have suggested that red and processed meat consumption elevate the risk of colon cancer; however, the relationship between red meat, as well as fat and protein, and distal colorectal cancer (CRC) specifically is not clear. We determined the risk of distal CRC associated with red and processed meat, fat, and protein intakes in Whites and African Americans. There were 945 cases (720 White, 225 African American) of distal CRC and 959 controls (800 White, 159 African American). We assessed dietary intake in the previous 12 mo. Multivariate logistic regression analyses were used to obtain odds ratios (OR) and 95% confidence intervals (95% CI). There was no association between total, saturated, or monounsaturated fat and distal CRC risk. In African Americans, the OR of distal CRC for the highest category of polyunsaturated fat intake was 0.28 (95% CI = 0.08–0.96). The percent of energy from protein was associated with a 47% risk reduction in Whites (Q4 OR = 0.53, 95% CI = 0.37–0.77). Red meat consumption in Whites was associated with a marginally significant risk reduction (Q4 OR = 0.66, 95% CI = 0.43–1.00). Our results do not support the hypotheses that fat, protein, and red meat increase the risk of distal CRC.     

Vegetable and fruit consumption and risks of colon and rectal cancer in a prospective cohort study: The Netherlands Cohort Study on Diet and Cancer

The relation between vegetable and fruit consumption and colorectal cancer risk was comprehensively assessed in the Netherlands Cohort Study on Diet and Cancer using a validated 150-item food frequency questionnaire. After 6.3 years of follow-up (1986-1992), over 1,000 incident cases of colorectal cancer were registered. Using case-cohort analysis, the authors calculated rate ratios and 95% confidence intervals adjusted for age, alcohol intake, and family history of colorectal cancer. For colon cancer, no statistically significant associations with total vegetable intake or total fruit intake were found. However, among women, an inverse association was observed with vegetables and fruits combined (for the highest quintile vs. the lowest, the rate ratio was 0.66 (95% confidence interval: 0.44, 1.01)). Brassica vegetables and cooked leafy vegetables showed inverse associations for both men and women. Among women and, to a lesser extent, among men, inverse associations were stronger for distal colonic tumors than for proximal colonic tumors. For rectal cancer, no statistically significant associations were found for vegetable consumption or fruit consumption or for specific groups of vegetables and fruits; only Brassica vegetables showed a positive association in women. As in other cohort studies, the observed inverse relation between vegetable and fruit consumption and occurrence of colorectal cancer was less strong than relations reported in case-control studies.