The European Prospective Investigation into Cancer and Nutrition (EPIC) is a prospective multi-centre cohort study aimed at investigating the role of dietary, lifestyle, genetic, and metabolic factors in the development of cancer and other chronic diseases. It was initiated in 1992 with the recruitment of more than half a million participants from ten European countries, and the collection of detailed data on lifestyle and health and anthropometric measurements. In addition blood samples were drawn and storing for future studies on metabolic and genetic characteristics. From the baseline data collection through 2009, more than 63,000 EPIC participants have been diagnosed with cancer, approximately 14,000 with diabetes and 12,000 with Myocardial infarction.

EPIC has contributed to increase the scientific knowledge on the effects of fruit, vegetable and cereal consumption on health. In the last decade, EPIC has generated more than 400 dedicated articles in peer-reviewed journals, and an important part of these publications emerge from research on the association between the consumption of fruit and vegetables, dietary patterns rich in plant foods (i.e. Mediterranean diet), or nutrients provided by these foods (i.e. fibre) and risk of developing chronic diseases.

In this newsletter, recent publications based on the EPIC cohort focussed on the association between fruit and vegetable consumption and several health outcomes are reviewed. Data of the Italian branch of EPIC, a Mediterranean population characterized by a high and varied consumption of plant foods, reported that the consumption of vegetables was associated with a reduction in the risk of developing breast cancer. Results of the EPIC-PANACEA study, conducted among 373,803 EPIC participants, showed that fruit and vegetable consumption was not associated with weight change in the overall sample; however high fruit and vegetable consumption was associated with a lower weight gain in those who quit smoking during followup. Finally, the EPIC-DiOGenes study based on data from five EPIC countries, demonstrated that fruit consumption, mostly when consumed as part of a healthy dietary pattern, was associated with a lower increase in abdominal adiposity, measured as the gain in waist circumference that was independent of the concurrent gain in body mass index.

As stated by the authors of these studies, these findings have important public health implications: first, vegetable consumption is one of the few modifiable risk factors for breast cancer that have been documented; at such, plant food consumption should be promoted for cancer prevention, in line with current dietary guidelines. Secondly, given that weight gain is an important contributor to relapse after smoking cessation, those who quit smoking should be encouraged to follow a diet rich in fruit and vegetable to maintain a healthy weight. And finally, although fruit and vegetable consumption seems not to be associated with midterm weight change in this observational study, it might be possible that plant foods, and specifically fruit intake, has specific effects on the distribution of body fatness, reducing the accumulation of abdominal fat mass which seems to encompass the major disease risk associated with obesity.

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