Environment and Breast Cancer: Science Review

Evidence From Humans
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Methods to increase fruit and vegetable intake with and without a decrease in fat intake: compliance and effects on body weight in the nutrition and breast health study
Djuric, Z., Poore, K. M., Depper, J. B., Uhley, V. E., Lababidi, S., Covington, C., Klurfeld, D. M., Simon, M. S., Kucuk, O., Heilbrun, L. K. Nutrition & Cancer. 2002. 43:2, 141-51.
Topic area
Body size
Study design
Other: Clinical trial
Study Participants
Number of Cases
122 (women with a family history of breast cancer)
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: pre menopausal women in the Nutrition and Breast Health Study; age 21-50 years old; at least one first-degree relative with breast cancer; current benign mammogram; women with no expected changes in use of oral contraceptives or in lifestyle during study; good general health; women who successfully completed a 4-day food record; women with fat intakes >25% of total energy; fruit and vegetable intake of five or fewer servings per day Ex: women with any diseases; high blood pressure; current smoker; women who had a major surgery within 2 years; women following medically prescribed diets; pregnant or lactating women; women taking anticoagulants; extremely obese women who were >50% over their optimal body weight; women >15% under their optimal body weight; women who took supplements containing >100% of the RDAs for vitamins and minerals
Comment about participation selection
Strengths: analyzed methods to increase fruit and vegetable intake with and without a decrease in fat intake, extensive analysis of food, fat and energy intake; individual contact with participants provided an opportunity to verify self-reported intake records; used a unique fruits and vegetable counting scheme that measures energy content based on caloric content Limitations: fairly small study; large number of exclusion factors could lead to selection bias; potential inaccuracies in reporting of food records; large number of dropouts from the low-fat diet arm; participants had a difficult time achieving secondary goals for maintenance of energy intake
Exposures investigated
Weight, height, and % body fat
How exposure was measured
Questionnaire, in person Anthropometric measurement, researcher-administered
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
Confounders considered
Other breast cancer risk factors, such as family history, age at first birth, and hormone replacement therapy use, that were taken into account in the study.
Adequately controlled
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Results Comments
Mean body weight and percent body fat decreased for women on the low-fat diet arm and increased for women on the high fruits and vegetables diet arm.
Author address
Barbara Ann Karmanos Cancer Institute, Detroit, MI 48201, USA. Djuricz@karmanos.org