Research table: Fruits and vegetables and breast cancer risk

This summary table contains detailed information about research studies. Summary tables are a useful way to look at the science behind many breast cancer guidelines and recommendations. However, to get the most out of the tables, it’s important to understand some key concepts. Learn how to read a research table.

Introduction: Findings from individual studies on fruits and vegetables have been mixed. However, large pooled analyses and meta-analyses (that combine data from many studies) show eating fruits and vegetables may be linked to a decreased risk of breast cancer.

Eating vegetables may be linked to a decreased risk of certain breast cancers. A pooled analysis that combined data from 20 studies found eating vegetables was linked to a decreased risk of estrogen receptor-negative breast cancers, but not estrogen receptor-positive breast cancers [1].

Eating fruit may also be linked to a decreased risk of breast cancer. A meta-analysis that combined the results of 15 studies found eating fruit was linked to a decreased risk of breast cancer [2].

Learn more about fruits and vegetables and breast cancer risk.

Learn about the strengths and weaknesses of different types of studies. 

See how this risk factor compares with other risk factors for breast cancer. 

Study selection criteria: Prospective cohort studies with at least 400 breast cancer cases, pooled analyses and meta-analyses. 

Table note: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk.

Study	Study Population (number of participants)	Follow-up (years)	Fruit and Vegetable Intake (categories compared)	Relative Risk of Breast Cancer of Women with the Highest Fruit and/or Vegetable Intake versus Women with the Lowest Intake RR (95% CI)
Prospective cohort studies
EPIC [3]	335,054 (10,197 cases)	12	Highest vs. lowest fruit intake	1.01 (0.94-1.09)
			Highest vs. lowest vegetable intake	0.86 (0.80-0.94)
Nurses’ Health Study and Nurses’ Health Study II [4]	182,145 (10,911 cases)	24	6 or more vs. less than 3 servings/day fruits and vegetables	0.89 (0.83-0.96)
			3 or more servings/day vs. 4 or fewer servings/week fruits	0.91 (0.84-0.99)
			4-5 vs. fewer than 2 servings/day vegetables	0.89 (0.82-0.96)
			5 or more vs. fewer than 2 servings/day vegetables	0.91 (0.84-1.00)
Swedish Mammography Cohort [5]	61,463 (1,932 cases)	13	Highest vs. lowest vegetable intake	0.91 (0.79-1.05)
UK Women’s Cohort Study [6]	32,228 (1,822 cases)	18	Highest vs. lowest fruit intake	1.01 (0.97-1.05)
			Highest vs. lowest vegetable intake	0.97 (0.91-1.02)
Canadian National Breast Screening Study [7]	32,379 (1,676 cases)	17	5 or more vs. fewer than 5 servings/day vegetables	0.92 (0.83-1.01)
Nurses’ Health Study [8]	44,223 (1,347 cases)	22	Highest vs. lowest fruit intake during the teen years	0.75 (0.62-0.90)
			Highest vs. lowest vegetable intake during the teen years	0.85 (0.71-1.01)
Black Women’s Health Study [9]	51,928 (1,268 cases)	12	4 or more vs. less than 1 serving/day fruits and vegetables	0.87 (0.71-1.07)
			2 or more servings/day vs. fewer than 2 servings/week fruits	0.91 (0.74-1.11)
			2 or more servings/day vs. fewer than 4 servings/week vegetables	Overall breast cancer: 0.87 (0.73-1.05) Estrogen receptor-negative breast cancer: 0.57 (0.38-0.85)
Iowa Women’s Health Study [10-11]	34,406 (1,130 cases)	9	Increase fruit and vegetable intake by 1 serving/day	1.00 (0.98-1.02)*
Netherlands Cohort Study [11-12]	62,412 (937 cases)	6	Increase fruit and vegetable intake by 1 serving/day	0.96 (0.91-1.01)*
Melbourne Collaborative Cohort Study [13]	20,967 (815 cases)	14	Highest vs. lowest fruit and salad intake	0.81 (0.63-1.03)
			Highest vs. lowest vegetable intake	Overall breast cancer: 0.98 (0.76-1.28) Estrogen receptor-negative breast cancer: 0.55 (0.32-0.93)
Singapore Chinese Health Study [14]	34,028 (629 cases)	11	Highest vs. lowest fruit intake	1.03 (0.77-1.38)
			Highest vs. lowest vegetable intake	0.86 (0.63-1.16)
Japan Public Health Center-based Prospective Study [15]	47,289 (452 cases)	10	Highest vs. lowest fruit intake	1.28 (0.89-1.85)
			Highest vs. lowest vegetable intake	1.02 (0.77-1.34)
Diet, Cancer and Health Cohort-Denmark [16]	23,798 (425 cases)	5	Increase fruit and vegetable intake by 1 serving/day	Overall breast cancer: 1.02 (0.98-1.06) Estrogen receptor-negative breast cancer: 0.90 (0.81-0.99)
Pooled and meta-analyses
Jung et al. [1]	993,466 (24,690 cases)		Highest vs. lowest fruit and vegetable intake	0.98 (0.93-1.02)
			Highest vs. lowest fruit intake	0.99 (0.95-1.03)
			Highest vs. lowest vegetable intake	Overall breast cancer: 0.99 (0.95-1.04) Estrogen receptor-negative breast cancer: 0.82 (0.74-0.90)
Smith-Warner, et al. [11]	351,825 (7,377 cases)		Increase fruit and vegetable intake by 1 serving/day	0.99 (0.98-1.00)
Farvid et al. [17]	15 studies		Highest vs. lowest fruit intake	0.93 (0.88-0.99)
	15 studies		Highest vs. lowest vegetable intake	0.96 (0.91-1.00)
	8 studies		Highest vs. lowest fruit and vegetable intake	0.91 (0.87-0.95)
Aune et al. [2]	15 studies		Highest vs. lowest fruit and vegetable intake	0.89 (0.80-0.99)
			Highest vs. lowest fruit intake	0.92 (0.86-0.98)
			Highest vs. lowest vegetable intake	0.99 (0.92-1.06)
Liu et al. [18]	13 studies		Highest vs. lowest vegetable intake	0.85 (0.77-0.94)†
Liu et al. [19]	7 studies (Chinese women only)		Highest vs. lowest fruit intake	0.66 (0.47-0.91)
	9 studies (Chinese women only)		Highest vs. lowest vegetable intake	0.72 (0.51-1.02)

* Results for total fruit and vegetable intake for references 9 and 11 were calculated by Smith Warner, et al. (reference 10) and do not appear in the original papers.

† Cruciferous vegetables (such as broccoli, cauliflower, cabbage and brussels sprouts) only.

References

1. Jung S, Spiegelman D, Baglietto L, et al. Fruit and vegetable intake and risk of breast cancer by hormone receptor status. J Natl Cancer Inst. 105(3):219-36, 2013.
2. Aune D, Chan DS, Vieira AR, et al. Fruits, vegetables and breast cancer risk: a systematic review and meta-analysis of prospective studies. Breast Cancer Res Treat. 134(2):479-93, 2012.
3. Emaus MJ, Peeters PH, Bakker MF, et al. Vegetable and fruit consumption and the risk of hormone receptor-defined breast cancer in the EPIC cohort. Am J Clin Nutr. 103(1):168-77, 2016.  
4. Farvid MS, Chen WY, Rosner BA, Tamimi RM, Willett WC, Eliassen AH. Fruit and vegetable consumption and breast cancer incidence: Repeated measures over 30 years of follow-up. Int J Cancer. 144(7):1496-1510, 2019. 
5. Männistö S, Dixon LB, Balder HF, et al. Dietary patterns and breast cancer risk: results from three cohort studies in the DIETSCAN project. Cancer Causes Control. 16(6):725-33, 2005.
6. Dunneram Y, Greenwood DC, Cade JE. Diet and risk of breast, endometrial and ovarian cancer: UK Women’s Cohort Study. Br J Nutr. 122(5):564-574, 2019.
7.  Catsburg C, Miller AB, Rohan TE. Adherence to cancer prevention guidelines and risk of breast cancer. Int J Cancer. 135(10):2444-52, 2014.  
8. Farvid MS, Chen WY, Michels KB, Cho E, Willett WC, Eliassen AH. Fruit and vegetable consumption in adolescence and early adulthood and risk of breast cancer: population based cohort study. BMJ. 353:i2343, 2016.
9. Boggs DA, Palmer JR, Wise LA, et al. Fruit and vegetable intake in relation to risk of breast cancer in the Black Women’s Health Study. Am J Epidemiol. 172(11):1268-79, 2010.
10. Kushi LH, Fee RM, Sellers TA, Zheng W, Folsom AR. Intake of vitamin A, C, and E and postmenopausal breast cancer. The Iowa Women’s Health Study. Am J Epidemiol. 144:165-174, 1996.
11. Smith-Warner SA, Spiegelman D, Yaun SS, et al. Intake of fruits and vegetables and risk of breast cancer: a pooled analysis of cohort studies. JAMA. 285(6): 769-76, 2001.
12. Verhoeven DT, Assen N, Goldbohm RA, et al. Vitamins C and E, retinol, beta-carotene and dietary fibre in relation to breast cancer risk: a prospective cohort study. Br J Cancer. 75:149-155, 1997.
13. Baglietto L, Krishnan K, Severi G, et al. Dietary patterns and risk of breast cancer. Br J Cancer. 104(3):524-31, 2011.
14. Butler LM, Wu AH, Wang R, Koh WP, Yuan JM, Yu MC. A vegetable-fruit-soy dietary pattern protects against breast cancer among postmenopausal Singapore Chinese women. Am J Clin Nutr. 91(4):1013-9, 2010.
15. Suzuki R1, Iwasaki M, Hara A, et al. for the Japan Public Health Center-based Prospective Study Group. Fruit and vegetable intake and breast cancer risk defined by estrogen and progesterone receptor status: the Japan Public Health Center-based Prospective Study. Cancer Causes Control. 24(12):2117-28, 2013.
16. Olsen A, Tjonneland A, Thomsen BL, Loft S, Stripp C, Overvad K, Moller S, Olsen JH. Fruits and vegetables intake differentially affects estrogen receptor negative and positive breast cancer incidence rates. J Nutr. 133(7);2342-7, 2003.
17. Farvid MS, Barnett JB, Spence ND. Fruit and vegetable consumption and incident breast cancer: a systematic review and meta-analysis of prospective studies. Br J Cancer. 125(2):284-298, 2021.
18. Liu X, Lv K. Cruciferous vegetables intake is inversely associated with risk of breast cancer: A meta-analysis. Breast. 22(3):309-13, 2013.
19. Liu XO, Huang YB, Gao Y, et al. Association between dietary factors and breast cancer risk among Chinese females: systematic review and meta-analysis. Asian Pac J Cancer Prev. 15(3):1291-8, 2014.  

Updated 10/15/21