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Fruit, vegetables, and antioxidants in childhood and risk of adult cancer: the Boyd Orr cohort.

ABSTRACT: STUDY OBJECTIVE:To examine associations between food and nutrient intake, measured in childhood, and adult cancer in a cohort with over 60 years follow up. DESIGN AND SETTING:The study is based on the Boyd Orr cohort. Intake of fruit and vegetables, energy, vitamins C and E, carotene, and retinol was assessed from seven day household food inventories carried out during a study of family diet and health in 16 rural and urban areas of England and Scotland in 1937-39. PARTICIPANTS:4999 men and women, from largely working class backgrounds, who had been children in the households participating in the pre-war survey. Analyses are based on 3878 traced subjects with full data on diet and social circumstances. MAIN RESULTS:Over the follow up period there were 483 incident malignant neoplasms. Increased childhood fruit intake was associated with reduced risk of incident cancer. In fully adjusted logistic regression models, odds ratios (95% confidence intervals) with increasing quartiles of fruit consumption were 1.0 (reference), 0.66 (0.48 to 0.90), 0.70 (0.51 to 0.97), 0.62 (0.43 to 0.90); p value for linear trend=0.02. The association was weaker for cancer mortality. There was no clear pattern of association between the other dietary factors and total cancer risk. CONCLUSIONS:Childhood fruit consumption may have a long term protective effect on cancer risk in adults. Further prospective studies, with individual measures of diet are required to further elucidate these relations.

SUBMITTER: Maynard M

PROVIDER: S-EPMC1732406 | biostudies-literature | 2003 Mar

REPOSITORIES: biostudies-literature

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Fruit, vegetables, and antioxidants in childhood and risk of adult cancer: the Boyd Orr cohort.

Maynard M M Gunnell D D Emmett P P Frankel S S Davey Smith G G

Journal of epidemiology and community health 20030301 3

<h4>Study objective</h4>To examine associations between food and nutrient intake, measured in childhood, and adult cancer in a cohort with over 60 years follow up.<h4>Design and setting</h4>The study is based on the Boyd Orr cohort. Intake of fruit and vegetables, energy, vitamins C and E, carotene, and retinol was assessed from seven day household food inventories carried out during a study of family diet and health in 16 rural and urban areas of England and Scotland in 1937-39.<h4>Participants ...[more]

PMID: 12594199

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Project description:ObjectivesTo assess the incidence of and risks for congestive heart failure, myocardial infarction, pericardial disease, and valvular abnormalities among adult survivors of childhood and adolescent cancers.DesignRetrospective cohort study.Setting26 institutions that participated in the Childhood Cancer Survivor Study.Participants14,358 five year survivors of cancer diagnosed under the age of 21 with leukaemia, brain cancer, Hodgkin's lymphoma, non-Hodgkin's lymphoma, kidney cancer, neuroblastoma, soft tissue sarcoma, or bone cancer between 1970 and 1986. Comparison group included 3899 siblings of cancer survivors.Main outcome measuresParticipants or their parents (in participants aged less than 18 years) completed a questionnaire collecting information on demographic characteristics, height, weight, health habits, medical conditions, and surgical procedures occurring since diagnosis. The main outcome measures were the incidence of and risk factors for congestive heart failure, myocardial infarction, pericardial disease, and valvular abnormalities in survivors of cancer compared with siblings.ResultsSurvivors of cancer were significantly more likely than siblings to report congestive heart failure (hazard ratio (HR) 5.9, 95% confidence interval 3.4 to 9.6; P<0.001), myocardial infarction (HR 5.0, 95% CI 2.3 to 10.4; P<0.001), pericardial disease (HR 6.3, 95% CI 3.3 to 11.9; P<0.001), or valvular abnormalities (HR 4.8, 95% CI 3.0 to 7.6; P<0.001). Exposure to 250 mg/m(2) or more of anthracyclines increased the relative hazard of congestive heart failure, pericardial disease, and valvular abnormalities by two to five times compared with survivors who had not been exposed to anthracyclines. Cardiac radiation exposure of 1500 centigray or more increased the relative hazard of congestive heart failure, myocardial infarction, pericardial disease, and valvular abnormalities by twofold to sixfold compared to non-irradiated survivors. The cumulative incidence of adverse cardiac outcomes in cancer survivors continued to increase up to 30 years after diagnosis.ConclusionSurvivors of childhood and adolescent cancer are at substantial risk for cardiovascular disease. Healthcare professionals must be aware of these risks when caring for this growing population.

Project description:BACKGROUND: In observational studies from western countries childhood emotional adversity is usually associated with adult cardiovascular disease. These findings are open to contextual biases making evidence from other settings valuable. We examined the association of a potential marker of childhood emotional adversity with cardiovascular disease risk factors in a developing country. METHODS: We used multivariable regression in cross-sectional analysis of older (≥50 years) men (n = 7,885) and women (n = 20,886) from the Guangzhou Biobank Cohort Study (2003-8) to examine the adjusted association of early life (<18 years) parental death (none, one or two deaths) with blood pressure, fasting glucose, LDL-cholesterol, HDL-cholesterol, triglycerides, body mass index (BMI), waist-hip ratio (WHR) and white blood cell count (WBC). We used seated height and delayed 10-word recall to assess content validity of parental death as a measure of childhood emotional adversity. We also examined whether associations varied by sex. RESULTS: Early life parental death was associated with shorter age- and sex-adjusted seated height. It was also associated with lower 10-word recall score adjusted for age, sex, socio-economic position, leg length and lifestyle. Similarly, adjusted early life parental death was not associated with blood pressure, fasting glucose, LDL-cholesterol or HDL-cholesterol but was associated with lower BMI (-0.40, 95% confidence interval (CI) -0.62 to -0.19 for 2 compared with no early life parental deaths) and triglycerides. Associations varied by sex for WHR and WBC. Among men only, early life parental death was associated with lower WHR (-0.008, 95% CI -0.015 to -0.001) and WBC (-0.35 10(9)/L, 95% CI -0.56 to -0.13). CONCLUSIONS: In a non-western population from a developing country, childhood emotional adversity was negatively associated with some cardiovascular risk factors, particularly among men. Our study suggests that some of the observed associations in western populations may be socially rather than biologically based or may be population specific.

Project description:OBJECTIVE:To investigate the impact of modifications to contemporary cancer protocols, which minimize exposures to cardiotoxic treatments and preserve long term health, on serious cardiac outcomes among adult survivors of childhood cancer. DESIGN:Retrospective cohort study. SETTING:27 institutions participating in the Childhood Cancer Survivor Study. PARTICIPANTS:23?462 five year survivors (6193 (26.4%) treated in the 1970s, 9363 (39.9%) treated in the 1980s, and 7906 (33.6%) treated in the 1990s) of leukemia, brain cancer, Hodgkin lymphoma, non-Hodgkin lymphoma, renal tumors, neuroblastoma, soft tissue sarcomas, and bone sarcomas diagnosed prior to age 21 years between 1 January 1970 and 31 December 1999. Median age at diagnosis was 6.1 years (range 0-20.9) and 27.7 years (8.2-58.3) at last follow-up. A comparison group of 5057 siblings of cancer survivors were also included. MAIN OUTCOME MEASURES:Cumulative incidence and 95% confidence intervals of reported heart failure, coronary artery disease, valvular heart disease, pericardial disease, and arrhythmias by treatment decade. Events were graded according to the National Cancer Institute's Common Terminology Criteria for Adverse Events. Multivariable subdistribution hazard models were used to estimate hazard ratios by decade, and mediation analysis examined risks with and without exposure to cardiotoxic treatments. RESULTS:The 20 year cumulative incidence of heart failure (0.69% for those treated in the 1970s, 0.74% for those treated in the 1980s, 0.54% for those treated in the 1990s) and coronary artery disease (0.38%, 0.24%, 0.19%, respectively), decreased in more recent eras (P<0.01), though not for valvular disease (0.06%, 0.06%, 0.05%), pericardial disease (0.04%, 0.02%, 0.03%), or arrhythmias (0.08%, 0.09%, 0.13%). Compared with survivors with a diagnosis in the 1970s, the risk of heart failure, coronary artery disease, and valvular heart disease decreased in the 1980s and 1990s but only significantly for coronary artery disease (hazard ratio 0.65, 95% confidence interval 0.45 to 0.92 and 0.53, 0.36 to 0.77, respectively). The overall risk of coronary artery disease was attenuated by adjustment for cardiac radiation (0.90, 0.78 to 1.05), particularly among survivors of Hodgkin lymphoma (unadjusted for radiation: 0.77, 0.66 to 0.89; adjusted for radiation: 0.87, 0.69 to 1.10). CONCLUSIONS:Historical reductions in exposure to cardiac radiation have been associated with a reduced risk of coronary artery disease among adult survivors of childhood cancer. Additional follow-up is needed to investigate risk reductions for other cardiac outcomes. TRIAL REGISTRATION:ClinicalTrials.gov NCT01120353.

Dataset Information

Fruit, vegetables, and antioxidants in childhood and risk of adult cancer: the Boyd Orr cohort.

Publications

Fruit, vegetables, and antioxidants in childhood and risk of adult cancer: the Boyd Orr cohort.

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