Intake of fruit, vegetables, and carotenoids in relation to risk of uterine leiomyomata

Wise LA; Radin RG; Palmer JR; Kumanyika SK; Boggs DA; Rosenberg L

doi:10.3945/ajcn.111.016600

Lifestyle and Environment · Nutrition and Metabolic Health

Intake of fruit, vegetables, and carotenoids in relation to risk of uterine leiomyomata

Wise LA, Radin RG, Palmer JR, Kumanyika SK, Boggs DA, Rosenberg L

Published December 2011 The American journal of clinical nutrition, 94(6), 1620-31

DOI 10.3945/ajcn.111.016600 PMID 22071705 PMC PMC3252555

RRM Academy Synopsis

Higher fruit intake is linked to lower fibroid risk in Black women

A cohort study of 22,583 premenopausal Black women followed from 1997 to 2009 found that women who ate more fruit had a lower rate of uterine fibroid diagnoses. Dietary vitamin A showed a similar link, which appeared to come from animal foods. Vegetables, vitamins C and E, folate, fiber and carotenoids showed no clear link with fibroids.

Key Findings

Fibroids were diagnosed in 6627 of 22,583 women. Four or more daily fruit and vegetable servings, versus fewer than one, gave an incidence rate ratio (IRR) of 0.90 (95% CI: 0.82, 0.98).
Fruit (2 or more servings a day versus fewer than 2 a week) gave an IRR of 0.89 (95% CI: 0.81, 0.98; P-trend = 0.07).
Vegetables (2 or more servings a day versus fewer than 4 a week) gave an IRR of 0.97 (95% CI: 0.89, 1.05).
Citrus fruit, 3 or more servings a week versus fewer than 1 a month, gave an IRR of 0.92 (95% CI: 0.86, 1.00).
Dietary vitamin A, highest versus lowest fifth of intake, gave an IRR of 0.89 (95% CI: 0.83, 0.97). The link appeared to come mainly from preformed vitamin A in animal foods.

Interpretation

The Black Women's Health Study is a prospective cohort. Women reported their diet on food questionnaires in 1995 and 2001. Researchers then followed them from 1997 to 2009 for first fibroid diagnoses confirmed by ultrasonography or surgery. The fruit association appeared in cases diagnosed by ultrasonography (IRR: 0.83; 95% CI: 0.74, 0.94) but not by surgery (IRR: 1.02; 95% CI: 0.87, 1.19). Medical records confirmed the self-reported diagnosis in 122 of 127 women whose records were obtained. The authors note that not all participants were screened for fibroids, so some cases may have been missed.

RRM Context

Fibroids are the main reason for hysterectomy in the United States. Black women develop them 2–3 times as often as white women, the paper reports. Restorative reproductive medicine looks for modifiable contributors to gynecologic conditions, and diet is one. This cohort of Black women offers a nutrition lead on fibroid risk.

Our editorial summary of this paper, not the article's abstract.

Abstract

Background

US black women have higher rates of uterine leiomyomata (UL) and lower intakes of fruit and vegetables than do white women. Whether fruit and vegetable intake is associated with UL in black women has not been studied.

Objective

We assessed the association of dietary intake of fruit, vegetables, carotenoids, folate, fiber, and vitamins A, C, and E with UL in the Black Women's Health Study.

Design

In this prospective cohort study, we followed 22,583 premenopausal women for incident UL (1997-2009). Diet was estimated by using food-frequency questionnaires in 1995 and 2001. Cox regression was used to derive incidence rate ratios (IRRs) and 95% CIs for the association between each dietary variable (in quintiles) and UL.

Results

There were 6627 incident cases of UL diagnosed by ultrasonography (n = 4346) or surgery (n = 2281). Fruit and vegetable intake was inversely associated with UL (≥4 compared with <1 serving/d; IRR: 0.90; 95% CI: 0.82, 0.98; P-trend = 0.03). The association was stronger for fruit (≥2 servings/d compared with <2 servings/wk; IRR: 0.89; 95% CI: 0.81, 0.98; P-trend = 0.07) than for vegetables (≥2 servings/d compared with <4 servings/wk: IRR: 0.97; 95% CI: 0.89, 1.05; P-trend = 0.51). Citrus fruit intake was inversely associated with UL (≥3 servings/wk compared with <1 serving/mo: IRR: 0.92; 95% CI: 0.86, 1.00; P-trend = 0.01). The inverse association for dietary vitamin A (upper compared with lower quintiles: IRR: 0.89; 95% CI: 0.83, 0.97; P-trend = 0.01) appeared to be driven by preformed vitamin A (animal sources), not provitamin A (fruit and vegetable sources). UL was not materially associated with dietary intake of vitamins C and E, folate, fiber, or any of the carotenoids, including lycopene.

Conclusion

These data suggest a reduced risk of UL among women with a greater dietary intake of fruit and preformed vitamin A.

Topics

Lifestyle and Environment › Nutrition and Metabolic Health › Dietary Patterns · General Gynecology › Screening and Prevention › Metabolic and Cardiovascular Screening

Lauren A Wise, Rose G Radin, Julie R Palmer, Shiriki K Kumanyika, Deborah A Boggs, Lynn Rosenberg

L Wise, R Radin, J Palmer, S Kumanyika, Debbie Boggs, Deb Boggs, D Boggs, L Rosenberg

PMID 22071705 22071705 DOI 10.3945/ajcn.111.016600 10.3945/ajcn.111.016600 Wise et al. 2011, Wise 2011

Intake of fruit, vegetables, and carotenoids in relation to risk of uterine leiomyomata

Higher fruit intake is linked to lower fibroid risk in Black women

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

Related research