Fruits, vegetables, and bladder cancer risk: a systematic review and meta‐analysis

Vieira, Ana; Vingeliene, Snieguole; Chan, Doris S. M.; Aune, Dagfinn; Abar, Leila; Rosenblatt, Deborah Navarro; Greenwood, Darren C.; Norat, Teresa

doi:10.1002/cam4.327

Cited by 69 publications

(52 citation statements)

References 34 publications

(102 reference statements)

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“…If we had been as inclusive as Krueger et al ., our estimate for the economic burden of inadequate consumption of vegetables and fruit would have been $CAN 3·8 billion per year. The estimate of the economic burden of inadequate vegetables and fruit consumption should be considered an economic burden in addition to the estimates for smoking tobacco, excess body weight and physical activity by Krueger et al ., because the relative risks used in our estimation originated from meta-analyses of mostly clinical trials and observational studies that were adjusted for tobacco use, excess body weight, and physical activity among other confounders ( 4 , 20 – 24 , 28 ) . By expanding the estimates by Krueger et al .…”

Section: Discussionmentioning

confidence: 99%

“…Based on these sources, we considered risk estimates for type 2 diabetes ( 21 ) , CVD (IHD, ischaemic stroke) ( 4 ) and cancers (lung ( 22 ) , colorectal ( 25 ) , oesophagus ( 20 ) , stomach/gastric ( 4 ) , bladder ( 24 ) , oral ( 20 ) , larynx ( 20 ) and breast ( 23 ) ). Because we were interested in the effect of the combination of vegetables and fruit, in cases where a meta-analysis reported separate effects of vegetables only and of fruit only, we considered the lower risk estimate.…”

Section: Methodsmentioning

confidence: 99%

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The economic burden of inadequate consumption of vegetables and fruit in Canada

Ekwaru

Öhinmaa

Loehr

et al. 2016

Public Health Nutr.

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ObjectivePublic health decision makers not only consider health benefits but also economic implications when articulating and issuing lifestyle recommendations. Whereas various estimates exist for the economic burden of physical inactivity, excess body weight and smoking, estimates of the economic burden associated with our diet are rare. In the present study, we estimated the economic burden attributable to the inadequate consumption of vegetables and fruit in Canada.DesignWe accessed the Canadian Community Health Survey to assess the inadequacy in the consumption of vegetables and fruit and published meta-analyses to assemble risk estimates for chronic diseases. Based on these inadequacy and risk estimates, we calculated the population-attributable fraction and avoidable direct and indirect costs to society. Direct costs include those for hospital care, physician services and drugs in 2015.ResultsAbout 80 % of women and 89 % of men consume inadequate amounts of vegetables and fruit. We estimated this to result in an economic burden of $CAN 3·3 billion per year, of which 30·5 % is direct health-care costs and 69·5 % is indirect costs due to productivity losses. A modest 1 percentage point annual reduction in the prevalence of inadequate vegetables and fruit consumption over the next 20 years would avoid approximately $CAN 10·8 billion, and an increase of one serving of vegetables and fruit per day would avoid approximately $CAN 9·2 billion.ConclusionsFurther investments in the promotion of vegetables and fruit will prevent chronic disease and substantially reduce direct and indirect health-care costs.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The economic burden of inadequate consumption of vegetables and fruit in Canada

Ekwaru

Öhinmaa

Loehr

et al. 2016

Public Health Nutr.

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“…Conversely, some epidemiologic studies examining cruciferous vegetables intake and bladder cancer risk, have shown no association of decreased risk . For example, a prospective study from Alpha‐Tocopherol Beta‐Carotene Cancer Prevention Study did not find an association between total fruits and vegetables intake or cruciferous vegetables intake and bladder cancer risk in smokers .…”

Section: Epidemiology Of Cruciferous Vegetables Isothiocyanates Andmentioning

confidence: 98%

Cruciferous Vegetables, Isothiocyanates, and Bladder Cancer Prevention

Abbaoui

Lucas

Riedl

et al. 2018

Molecular Nutrition Food Res

126

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Bladder cancer is a significant health burden due to its high prevalence, risk of mortality, morbidity, and high cost of medical care. Epidemiologic evidence suggests that diets rich in cruciferous vegetables, particularly broccoli, are associated with lower bladder cancer risk. Phytochemicals in cruciferous vegetables, such as glucosinolates, which are enzymatically hydrolyzed to bioactive isothiocyanates, are possible mediators of an anticancer effect. In vitro studies have shown inhibition of bladder cancer cell lines, cell cycle arrest, and induction of apoptosis by these isothiocyanates, in particular sulforaphane and erucin. Although not yet completely understood, many mechanisms of anticancer activity at the steps of cancer initiation, promotion, and progression have been attributed to these isothiocyanates. They target multiple pathways including the adaptive stress response, phase I/II enzyme modulation, pro-growth, pro-survival, pro-inflammatory signaling, angiogenesis, and even epigenetic modulation. Multiple in vivo studies have shown the bioavailability of isothiocyanates and their antitumoral effects. Although human studies are limited, they support oral bioavailability with reasonable plasma and urine concentrations achieved. Overall, both cell and animal studies support a potential role for isothiocyanates in bladder cancer prevention and treatment. Future studies are necessary to examine clinically relevant outcomes and define guidelines on ameliorating the bladder cancer burden.

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“…Keeping in mind a report that 71% of the articles selected for meta-analysis do not lend themselves to DRMA [3], findings from nutritional epidemiological studies should be presented in a manner that would facilitate future meta-analyses. Under the current circumstances, DRMA should be considered as a method to be applied concurrently with the HLM or ICM, instead of replacing them [27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Comparison of methods of extracting information for meta-analysis of observational studies in nutritional epidemiology

Bae¹

2016

Epidemiol Health

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OBJECTIVES:A common method for conducting a quantitative systematic review (QSR) for observational studies related to nutritional epidemiology is the "highest versus lowest intake" method (HLM), in which only the information concerning the effect size (ES) of the highest category of a food item is collected on the basis of its lowest category. However, in the interval collapsing method (ICM), a method suggested to enable a maximum utilization of all available information, the ES information is collected by collapsing all categories into a single category. This study aimed to compare the ES and summary effect size (SES) between the HLM and ICM. METHODS:A QSR for evaluating the citrus fruit intake and risk of pancreatic cancer and calculating the SES by using the HLM was selected. The ES and SES were estimated by performing a meta-analysis using the fixedeffect model. The directionality and statistical significance of the ES and SES were used as criteria for determining the concordance between the HLM and ICM outcomes. RESULTS:No significant differences were observed in the directionality of SES extracted by using the HLM or ICM. The application of the ICM, which uses a broader information base, yielded more-consistent ES and SES, and narrower confidence intervals than the HLM. CONCLUSIONS:The ICM is advantageous over the HLM owing to its higher statistical accuracy in extracting information for QSR on nutritional epidemiology. The application of the ICM should hence be recommended for future studies.

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Fruits, vegetables, and bladder cancer risk: a systematic review and meta‐analysis

Cited by 69 publications

References 34 publications

The economic burden of inadequate consumption of vegetables and fruit in Canada

The economic burden of inadequate consumption of vegetables and fruit in Canada

Cruciferous Vegetables, Isothiocyanates, and Bladder Cancer Prevention

Comparison of methods of extracting information for meta-analysis of observational studies in nutritional epidemiology

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