Fruit, vegetables and cancer – why it’s still worth getting your five a day

My wife has not smoked or drunk alcohol for over thirty years, dislikes sweet food, loves eating lots of vegetables, keeps slim and active, yet five years ago she developed breast cancer, which she beat. Now she has just been diagnosed with incurable advanced kidney cancer.

People who think eating “five-a-day” will prevent cancer are just kidding themselves: the evidence is non-existent for MOST cancers, and – at best – slim for a few others.

There seems to be a lot of head in the sand type comments here. Cancer research have intelligently and in a considered manner explained why the study is defensible and fair. They also point out that the report dosn’t contracdict the fact that fruit & veg still help to significantly reduce certain types of cancer. Why are people so defensive over the foundings? or cancer researchs response. Firstly theres the freedom of speech point, if we agree with it we have to defnd it, especially when we dont agree with someones argument (not say ‘there should be a law against the media saying such things’) and especially not when the article and cancer research’s response are both quite considered and intelligently point. You just need a critical mind. The findings are helpful because it can move the focus on to other things like fibre, water, sunlight, toxins, genetics and so on.

Thanks for the email Cancer Research, i am glad that people are being properly informed of all the facts. Perhaps it is time to start promoting 8 A Day instead of 5 A Day if that is what the research is suggesting. It may be an unrealistic goal for the nation, but it may shock people into realising how few fruit and vegetables they do eat.

I was pleased to pick up this blog via Twitter – thank goodness – as all the media headlines (including BBC Radio News!) seemed to suggest that fruit and veg are a waste of time. Even a 1% reduction in cancer rates would be more than welcome. Keep up the good work, CRUK!

My apologies. My last posting was leading this discussion in the wrong direction, I was making some irrelevant and uncheckable speculations about the media. Let me get back on track. Cancer is a very complex issue. Its causes could be one of, or any combination of, a number of factors: genetic, environmental, cigarettes, alcohol, diet, amount of exercise, obesity. Cure (and prevention of recurrence) is just as complex; one of, or any combination of: chemotherapy, radiation treatment, love and support from friends and family, “attitude” (e.g. belief in your doctor, belief that your going to get better, religious or other belief, meditation, “finding a meaning in life” etc.), diet, exercise, work, fresh air… I therefore suggest that in such complex issues, the media should refrain from simplistic analysis (or maybe in this case zero analysis?). Additionally, it seems plain to me that 5-a-day is much better for our general health than 5-a-week or zero-a-week. I don’t think we need to survey half a million people to figure that out.

I had bowel cancer about 15 yrs ago and was one of the lucky ones to have survived healthily till now. Frienda were surprised I got it as I’ve never smoked,I exercised regularly and ate a good well balanced, mainly veggie diet. I still eat the same good diet with more than 5-a-day, exercise regularly and live every day gratefully. I am 62, still working and loving every minute.
I read all these sensationalist headlines and try to read between the lines to get at the truth. Nothing is ever as cut and dried as the papers make out.

Did they measure cancer incidence of vegans ?
What I know from my readings; plant based diet works only if it excludes animal protein

Like many of the people who commented above, I felt that the EPIC study was reported in a biased and incorrect way in the media. It occurred to me that it would be in the interest of the fast-food industry, and other food, cereal and snack companies to have it reported in such a way, but there’s obviously no way I can check if there is any such connection. Perhaps R.J. Hanlon’s adage is more likely here: “Never attribute to malice that which can be adequately explained by stupidity.”

Probability is just a statistic not a fact. Like many others I know people who according to statistics should have died of cancer and are still alive and my husband who eat healthily, took regular exercise and never smoked died nearly 10 years ago of bowel cancer aged 46 – statistically he should be alive. We need to live for now and a healthy diet makes us healthier now so we can enjoy life more. It may / may not have an impact later in life. Statistics are about whole populations not individuals and should be reported by the media that way.

Thanks everyone for your comments. We’re glad that the post was useful and has helped to cut through some of the confusion caused by the coverage of this study.

Because EPIC is a large international study, with different centres taking the lead for different papers, we sometimes don’t hear about publications before they come out. When they do, we can only say so much in our media responses and our quotes are often cut anyway. This is why we chose to do a lengthier piece in the blog to provide some much-needed historical context to the debate.

We recognise that advice about diet and cancer can be confusing and that headlines seem to constantly swap their positions. Our stance on this topic has been very consistent for years. We have advocated a healthy, balanced diet rather than recommending any particular food or group of foods. When we have discussed five-a-day, it has been in the knowledge that it has some direct benefits against certain cancers and much broader indirect benefits in terms of keeping a healthy body weight and contributing to a generally healthy diet.

This does not come as a surprise to me. Relying on one aspect of diet as a preventative for cancer is only partially helpful at best and potentially misleading. It does little to promote the holistic requirement for good health . By this I mean the reponsibility we all have to maintain balance and equlibrium in all aspects of our life: mind, body and spirit. By all means eat your 5 a day as part of a nutritious and balanced diet; exercise your body, have fun, laugh a lot, meditate and find your source of inner peace and definately Ignore narrow minded, negative & sensationalist headlines.

I will keep eating my five a day (and more). It can only do good. It seems cancers would show themselves more without the five a day. The media love to pick at reports and senationalise them. “Read between the lines” is what I say. Everything in moderation, and definitely no smoking

I think it’s a tad disingenuous to now complain “The problem comes when five-a-day is sold as the be-all-and-end-all of healthy eating”. CRUK has promoted 5-a-day for a long time. In 2007, Henry Scrowcroft in this very blog exclaimed “there is a large amount of evidence that five-a-day can help lower the risk of other cancers” and it’s hard to find any caveat in CRUK’s press release from Sept 2007 titled “UK failing to eat 5 a day” – http://info.cancerresearchuk.org/news/archive/pressrelease/2007-09-21-uk-failing-to-eat-5-a-day.

The 5-a-day message has been very successful – it’s on the lips every nannying health official and in the nutrition section of every Sunday supplement. It’s become part of the nation’s psyche – the incredulous comments above show how 5-a-day has become a dogmatic belief far removed from the original scientific evidence.

CRUK can argued that the original cautionary advice may have been hijacked by politicians and the media but I don’t remember CRUK ever protesting that 5-a-day was being oversold.

i have been a vegan and vegetarian all i am 49 everyone who knows me or meet me for the first time thinks i am much younger, with the excepion of a fue common cold i have never fell ill: therefore eating fruit and veg not only keep you in good health but it keep your weight down and young looking.i thing alot of people like to scare mungering, and want us to eate more meat because its good for busines,because veg and fruit is less proffiting,in a frue years time they will say again that fruit and veg is good for health and not just canser but a way to combat obisity. a fue years ago they said the same thing about coffe and chocholate, now they said its good for us.

GLad you cleared that up, I did not get chance to see the details of the study but people will inevitably jump to the conclusion that eating fruit and veg is not helpful. This is typical of the press getting half a story!!!

Two things come out of this, I never thought that cancers other than of the digestive system would be affected, the relationship between dietary fibre and cancer of the colon has been well known for a long time.

The second thing that people do not realise is that cancer is not of itself a disease but the result of a disease process which itself may have many different causes. People keep on talking of “conquering cancer” as if it were one thing, and it is not.

Yours

Tom Frank

What studies have consistently shown is that people who follow a diet with a high content of fresh fruit and vegetables generally consume lower quantities of(and excrete higher quantities of) damaging fats and therefore have healthier guts and hearts and fewer obesity problems. The lower incidence of certain cancers is simply an additional bonus. No-one will live forever and shouldn’t expect to. It is the quality of the life we live that is at stake. There is no need to be ‘religious’ about food types: moderation and variety are the key.

I think that it is important to eat fruit and vegetables as part of a healthy diet and lifestyle (exercise, effective stress management etc). However I think that we do not truly know enough about the potential carcinogenic effects that pesticides and fetilisers may have in the human diet as an indirect outcome of consuming fruit and vegetables. It seems to me that the jury is still out on this issue. For example, the incidence of oesophageal cancer has increased massively in the last 30 years (whilst 5 year survival rates have remained consistently low at about 8%). I wonder whether we are only now begining to see what the longterm impact of pesticides and fertilisers may be. I think this issue should be addressed so that we can eat our fruit and vegetables with the confidence that we are not simultaneously also exposing ourselves to harmful chemicals as a by-product of attempts to eat healthily.

I think, as mentioned by the authors in the final paragraph, the most important issue arising from this paper is what importance should be placed on analyses showing very small changes in risk, given the possibility of residual confounding and bias, exposure misclassification etc. This is why the authors are reluctant to highlight your figures for very high consumption of fruit and vegetables.

It would be helpful to the public, were you to translate these figures into reductions in absolute risks. Assuming the inverse association between f and v intake and cancer is causal, the authors give an estimate of around 2.5% of cancers avoided, or 7000 a year, were each person to eat an extra 2 portions. This roughly means that of the 600,000 people who die each year, 7000 fewer of them would die without having had cancer. Each person will have reduced his probability of suffering cancer by 0.016 or 1 in 63. It all depends on how much you dislike vegetables and whether you would much prefer to die before suffering cancer.

It is heartening that CRUK now recognises the superiority of cohort studies over case control studies. It was largely from meta analyses of case control studies displaying small relative risks that evidence for significant harm from passive smoking was concocted. The largest cohort study by Enstrom and Kabat (2003) was published in the BMJ and attracted comments more in keeping with the BBC’s Have Your Say message board, than a supposedly scientific journal. Suffice to say, the righteous weren’t happy and there is no danger of anything other than highly supportive of further measures against smoking being published in the BMJ in future.

I think that CRUK will be more successful in the long term if remains a respected scientific body rather than gives into temptation and turns into an ASH-like propaganda organisation.

So, what rating do I get? How about a bonus for actually reading the paper and not choosing to remain anonymous?

I eat fruits and vegetables because they contain helpful fibres and Iodine. My belly is neatly trimmed because I eat fruits and vegs. What actually makes me sick are some of these unfounded claims by the media.

I thought the BBC 4 report on this particular headline was a bit lacking in balance and therefore dangerous, as it only seemed interested in rather knocking what has previously been thought to be axiomatic. (like eating veg. is good for you.)

It seemed to understate its value in all other respects (ie heart desease, digestive/bowel problems etc etc)- and what’s insignificant of 3% anyway? 7000 cases must be pretty expensive.

The other point worth mentioning is surely that by eating veg. like vegitarians, you will be contributing to the reduction of the demand for meat and therefore assisting in the lowering of the need for cattle and the production of methane.

http://www.all-creatures.org/health/15.html

Personaly i think you should”nt listen to whats been said on the news becouse they are allways changeing there minds about servay”s and everone should eat as much fruit and vegtables for the vitamins minerals they provide

I would have liked to have seen a more robust response from Cancer Research and other organisations arguing that fruit and veg should still be an important part of one’s diet alongside or within these articles in the newspapers. There seemed to be little balance. If Cancer Research were involved in the study in question, could their voice (with some of the details outlined on this page) be more publicised in the media, knowing that this information was going to be published? Nevertheless, I welcome this clarification; I now feel much better informed.

It’s always interesting reading the varying theories about cancer and diet etc over the last 15 years or so. My husband was slim, played sport, didn’t drink very much, didn’t smoke and had a healthy diet with daily fruit and veg, but 16 years ago, he developed bowel cancer at the age of 43 and died less than a year later. I know there are other influences, such as stress-related issues, which could have been affecting him at the time. There was at the time only one chemo drug which could be used in the UK, others were available in the USA, but not in the UK – it seems a shame that these drugs were not available at the time, he was prepared as I am sure many others are, to take the risks to have a chance of surviving. Within a few years other drugs were available.

I don’t think there needs to be a law preventing the media from giving diet advice. We don’t need more laws, we need more common sense, which seems to be sadly diminishing. But I do think it was an irresponsible headline subject.

Eat more fruit and vegetables and do more exercise, like the article said, there is no flipside to that. Good old fashioned common sense, like brush your teeth and and don’t smoke.

What I think is that if you bombard any issue with enough research you can come up with any conclusion you like, which usually means that the prejudices of the researchers come to the fore. So called experts would be better employed finding a cure for cancer than causing inconclusive arguments over what we should and shouldn’t eat. You should never smoke, everything else is a matter for conjecture (in my opinion)

I was quite annoyed when I saw the news yesterday, very irresponsible! Even *if* fruit & veg did have no effect in reducing the chances of getting cancer, it’s still extremely important to get nutritions and balance in your diet.

I think there should be a law preventing the media from giving out diet-advice. You wouldn’t accept an untrained stranger telling you what to eat so why should we be allowed to hear it from a news source.