Fruit and vegetable consumption in relation to risk factors for cancer: a report from the Malmo Diet and Cancer Study

Objective: To examine the associations between the consumption of fruit and vegetables and other markers of cancer risk. Design: A cross-sectional survey within the population-based prospective Malmo Diet and Cancer (MDC) Study. Information on food habits was collected through the modified diet history method designed and validated for the MDC Study. Data on smoking and alcohol habits, leisure time physical activity, birth country, education, socioeconomic status and cohabitation status were collected through a questionnaire. Setting: Malmo E, the third largest city in Sweden. Subjects: All subjects who entered the MDC Study during winter 1991 to summer 1994 (men and women living in Malmo E, aged between 46 and 68 years), with a total of 15 173. Results: Women consumed more fruit and vegetables than men. Low consumption of both fruits and vegetables was associated with unfavourable nutrient profiles: higher percentage of energy from fat and lower intakes of antioxidant nutrients and dietary fibre. Low consumption was also associated with smoking, low leisure time physical activity, low education and being born in Sweden. High age was associated with low vegetable consumption in both genders. Alcohol intake was positively associated with vegetable consumption in both genders, while both zero and high alcohol consumers had low fruit consumption. Men residing without a partner consumed less fruits and vegetables than other men. There were very weak or no independent associations between socioeconomic status and fruit/vegetable consumption. Conclusion: This study indicates that several established risk markers and risk factors of cancer may be independently associated with low fruit and vegetable consumption. The findings suggest that the adverse effects of factors such as smoking, low physical activity and a high-fat diet could partly be explained by low consumption of fruit or vegetables. The implied health benefits of a low or moderate alcohol consumption may be similarly confounded by high consumption of fruit or vegetables.