Intake of fruits and vegetables by pesticide residue status in relation to cancer risk

Affiliations

¹ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Electronic address: hsandov@hsph.harvard.edu.
² Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
³ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
⁴ Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
⁵ Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
⁶ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
⁷ Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
⁸ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
⁹ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. Electronic address: jchavarr@hsph.harvard.edu.

PMID: 34256297
PMCID: PMC8679006
DOI: 10.1016/j.envint.2021.106744

Intake of fruits and vegetables by pesticide residue status in relation to cancer risk

Helena Sandoval-Insausti et al. Environ Int. 2021 Nov.

. 2021 Nov:156:106744.

doi: 10.1016/j.envint.2021.106744. Epub 2021 Jul 10.

Affiliations

¹ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Electronic address: hsandov@hsph.harvard.edu.
² Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
³ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
⁴ Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
⁵ Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
⁶ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
⁷ Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
⁸ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
⁹ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. Electronic address: jchavarr@hsph.harvard.edu.

PMID: 34256297
PMCID: PMC8679006
DOI: 10.1016/j.envint.2021.106744

Abstract

Background: Conventionally grown fruits and vegetables (FVs) are the main source of general population exposure to pesticide residues.

Objective: To evaluate the relation of intake of high- and low-pesticide-residue FVs with cancer risk.

Methods: We followed 150,830 women (Nurses' Health Study, 1998-2016, and Nurses' Health Study II, 1999-2017) and 29,486 men (Health Professionals Follow-up Study, 1998-2016) without a history of cancer. We ascertained FV intake via validated food frequency questionnaires and categorized FVs as having high or low pesticide residue levels based on USDA surveillance data. We used Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI) of total and site-specific cancer related to quintiles of high- and low-pesticide-residue FV intake.

Results: We documented 23,678 incident cancer cases during 2,862,118 person-years of follow-up. In the pooled multivariable analysis, neither high- nor low-pesticide-residue FV intake was associated with cancer. The HRs (95% CI) per 1 serving/day increase in intake were 0.99 (0.97-1.01) for high- and 1.01 (0.99-1.02) for low-pesticide-residue FVs. Additionally, we found no association between high-pesticide-residue FV intake and risk of specific sites, including malignancies previously linked to occupational pesticide exposure ([HR, 95% CI comparing extreme quintiles of intake] lung [1.17 (0.95-1.43)], non-Hodgkin lymphoma [0.89 (0.72-1.09)], prostate [1.31 (0.88-1.93)]) or inversely related to intake of organic foods (breasts [1.03 (0.94-1.31)]).

Conclusions: These findings suggest that overall exposure to pesticides through FV intake is not related to cancer risk, although they do not rule out associations with specific chemicals or sub-types of specific cancers.

Keywords: Cancer; Fruits and vegetables; Pesticide residues.

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Conflict of interest statement

Conflict of interest: The Authors declare that there is no conflict of interest.

Figures

**Figure 1.. Baseline fruit and vegetable intake, considering pesticide residue status, and risk of total cancer.**
¹ Adjusted for age, height (cm), body mass index (BMI) (quintiles), ethnicity (white/non-white), physical activity (quintile of metabolic equivalent task-hours/week), family history of cancer (yes/no), physical examination in the past 2 years (yes/no), history of colonoscopy or sigmoidoscopy (yes/no), mammography in the past 2 years (yes/no, in NHS and NHS II), prostate-specific antigen testing in the past 2 years (yes/no, in HPFS), number of pack-years among ever smokers (never smoker, 1-4.9, 5-19.9, 20-39.9, or ≥40), postmenopausal hormone use (premenopausal/never/past/current, in NHS and NHSII), current multivitamin use (yes/no), regular aspirin use (yes/no), total energy intake (quintiles), alcohol intake (0, 0.1-4.9, 5.0-14.9, 15.0-29.9, or ≥30 g/day), and Alternate Healthy Eating Index score excluding criteria for intake of fruits and vegetables and alcohol (quintiles). ^A Additionally adjusted for intakes of low-pesticide-residue fruits and vegetables (servings/day) and other fruits and vegetables with undetermined residues (servings/day). ^B Additionally adjusted for intakes of high-pesticide-residue fruits and vegetables (servings/day) and other fruits and vegetables with undetermined residues (servings/day).

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Intake of fruits and vegetables by pesticide residue status in relation to cancer risk

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Intake of fruits and vegetables by pesticide residue status in relation to cancer risk

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