| A
new study suggests eating fruits and vegetables does more to prevent heart
disease than cancer. Researchers at the Harvard School of Public Health
found that people who ate at least 5 servings a day of fruits and
vegetables had a 28% lower risk of heart disease than people who ate less
than 1.5 servings per day. Cancer risk, however, was not affected by the
amount of fruits and vegetables eaten.
But that
doesn't necessarily mean a healthy diet has no impact on your cancer risk.
The American Cancer Society and other health organizations -- including
the National Cancer Institute and the American Heart Association --
recommend eating at
least 5 servings of fruits and vegetables a day.
"When you
eat fruits and vegetables, you're meeting your calorie needs with healthy
food, as opposed to meeting them with sugar, fat, or low-nutrient
foods," said Jeanne Calle, director of analytic epidemiology for ACS.
"Making good food choices is going to directly protect you from heart
disease, but it's also going to protect you from weight gain, and that's
going to protect you from cancer."
Calle
published a study last year that showed being overweight
or obese can substantially raise a person's risk of dying from cancer.
Food Only One
Part of the Equation
The Harvard
study, published in the Journal of the National Cancer Institute (Vol. 96,
No. 21:1577-1584), followed more than 100,000 participants for more than
10 years, periodically asking them what they ate and whether they had
developed cancer, or had a stroke or heart attack.
Its findings
support the 5-a-day recommendation, said senior author Walter Willett, MD.
"Our
study means that everyone should still try to eat 5 or more servings of
fruit and vegetables per day, but that the benefit will be mainly for
cardiovascular disease," he said.
It's possible
that fruits and vegetables do protect against cancer, he said, but the
benefit is not as great as the public may believe. "Not smoking,
avoiding [becoming] overweight, and staying physically active will be more
effective in preventing cancer."
Study Methods
May Affect Results
Why didn't
Willett's study show a bigger impact on cancer from these healthy foods?
There could be a number of reasons.
One
possibility raised in an editorial accompanying the study is that the food
questionnaires used to gauge people's diets may not be entirely accurate.
In this study, as in many others, participants were asked how often they
had eaten particular foods over the past year; if their recollections were
flawed, the study results may be, too.
If that's the
case, then it's possible that the protective effect on cardiovascular
disease is even greater than the study showed, and that there actually is
an effect on cancer that the study couldn't find.
The time frame
of the study may also have disguised an effect of fruits and veggies on
cancer risk. Because cancer can take decades to develop, it may simply
take longer follow-up to find a benefit.
Or, Calle
said, it may be that what people ate more recently has more of an impact
on heart disease, while diet at a younger age has more of an impact on
cancer. The Harvard researchers only tracked what participants ate during
the course of the study, not during earlier periods of life.
Benefit for
Specific Cancers Possible
Another
possibility, Calle said, is that the study masked any protective effect on
cancer by looking at all cancers combined, rather than specific cancers.
"Cancers
are very different from one another, and risk factors for cancer are very
different," she said. "If you looked at individual cancers you
might see things that you don't see with all cancers combined."
Willett also
noted that some fruits and vegetables may have an effect on some types of
cancer.
"I think
it is plausible that there are some components of fruits and vegetables
that may modestly reduce the risk of some cancers, but lumping all fruits
and vegetables together obscures the benefit," he said. "For
example, we have seen evidence that a higher intake of tomato-based
products may reduce the risk of prostate cancer."
In addition,
the researchers found a protective association for cruciferous vegetables
(such as cauliflower, cabbage, broccoli, and even mustard and collard
greens, for instance) and cancer, but only in men. Whether the types of
cancers occurring in men are more responsive to these types of vegetables
compared to cancers in women remains to be determined.
The bottom
line, Calle said, is that studying the effects of foods on disease is a
very complex process.
"While
the data don't really indicate a reduction in risk for all cancers
combined, we're not really ready to believe there's no reduction for
individual cancer sites," she said. "Fruits and vegetables are
healthy choices whether we can directly show this impact on all cancers
combined or not.
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