Legumes (pulses) and lung cancer.

Lung cancer risk: Data about lung cancer risk was provided by 9 cohorts. Nonsignificant protective effects were found in 2 cohorts examining men & women combined (11, 19), and a significant protective effect was found of an intermediate level of consumption among men in a cohort of very large size (29). No other associations were found.
Lung cancer mortality: Data about lung cancer mortality was provided by 1 cohort (17). A nonsignificant protective effect was found among men, but not women.

Conclusion: No evidence was found for an association between legumes and lung cancer. Among women, all RRs were > 1 (14, 17, 29).

Prospective studies of legumes and lung cancer risk:

Author

Cohort name

Subjects

Years of follow-up

Cases

End point

Consumption of

Relative Risk (RR)

Adjustments

29) Wright ME (2008)

The NIH-AARP Diet and Health Study

472,081 subjects (281,288 men and 190,793 women) aged 50-71.
(USA)

8
(1995-2003)

See variables

Lung cancer risk

Legumes (dried beans, string beans, and peas)

All men (3,834 cases):
RR = 0.92 (0.83-1.02; P = 0.16) for the highest vs lowest quintile of consumption.

Amount specific data (servings per 1000 kcal per day):
0.08: RR = 1.
0.17: RR = 0.98 (0.89-1.07).
0.27: RR = 0.90 (0.81-0.99).
0.40: RR = 0.98 (0.89-1.08).
0.69: RR = 0.92 (0.83-1.02).

An inverse association emerged among men in the top decile of legume consumption (RR = 0.85; 95% CI = 0.74-0.98; P = 0.07) for consumption > 0.69 servings per 1,000 calories/day.

**Men. Stratified by smoking status:**
Never smokers (141? cases)	Former smokers (2,110? cases)	Current smokers (1,583? cases)
RR = 0.87 (0.53-1.43; P = 0.85) for the highest vs lowest quintile of consumption.	RR = 0.86 (0.75-0.99; P = 0.03) for the highest vs lowest quintile of consumption.	RR = 1.00 (0.85-1.17; P = 0.79) for the highest vs lowest quintile of consumption.

All women (2,201 cases):
RR = 1.07 (0.94-1.22; P = 0.65) for the highest vs lowest quintile of consumption.

Amount specific data (servings per 1000 kcal per day):
0.09: RR = 1.
0.19: RR = 1.07 (0.94-1.21).
0.30: RR = 0.95 (0.83-1.08).
0.45: RR = 0.93 (0.81-1.06).
0.81: RR = 1.07 (0.94-1.22).

**Women. Stratified by smoking status:**
Never smokers (170? cases)	Former smokers (835? cases)	Current smokers (1,196? cases)
RR = 0.83 (0.51-1.35; P = 0.59) for the highest vs lowest quintile of consumption.	RR = 1.14 (0.93-1.41; P = 0.26) for the highest vs lowest quintile of consumption.	RR = 1.05 (0.88-1.26; P = 0.87) for the highest vs lowest quintile of consumption.

One serving of vegetables = 1 cup of raw, leafy vegetables, 1/2 cup of other vegetables, or 6 ounces of juice.

Age, energy intake, race, education, BMI, smoking status, smoking dose, time since quitting, alcohol intake, physical activity, and family history of any cancer.

22) Neuhouser ML (2003)

The Beta-carotene And Retinol Efficacy Trial (CARET) (2003)

14,120 current or former heavy smokers (male/female) and asbestos-exposted workers (male) aged 50-69.

12
(1989-2001)

742?
(326 in placebo arm, and 414 in intervention arm)

Primary lung cancer risk

Leguminosae (peas, green beans, other beans (e.g., pinto, lima), tofu, peanuts, and mixed foods with beans)


Intervention arm (daily combination of 30 mg of beta carotene and 25,000 IU of retinyl palmitate): (n = 7072)	Placebo arm: (n = 7048)
RR = 1.10 (0.81-1.50; P = 0.16) for the highest vs lowest quintile of consumption. Amount specific data (servings/week): ≤ 1.8: RR = 1. 1.9-2.6: RR = 0.86 (0.63-1.18). 2.7-4.0: RR = 0.85 (0.62-1.18). 4.1-6.1: RR = 1.15 (0.85-1.56). ≥ 6.2: RR = 1.10 (0.81-1.50).	RR = 1.00 (0.70-1.41; P = 0.85) for the highest vs lowest quintile of consumption. Amount specific data (servings/week): ≤ 1.8: RR = 1. 1.9-2.6: RR = 0.91 (0.64-1.29). 2.7-4.0: RR = 0.94 (0.67-1.33). 4.1-6.1: RR = 0.99 (0.70-1.40). ≥ 6.2: RR = 1.00 (0.70-1.41).

Sex, age, smoking status, total pack-years of smoking, asbestos exposure, race-ethnicity, enrollment center, and total vegetables.

19) Miller AB (2002)

The EPIC Study

127,892 men and 289,946 women.

247? men and 245? women

Lung cancer incidence

Legumes (not defined)

HR = 0.71 (0.51-1.00) for the highest vs lowest quartile of consumption.

Amount specific data (Quartiles not defined):
Q1: HR = 1.
Q2: HR = 0.74 (0.57-0.98).
Q3: HR = 0.83 (0.62-1.10).
Q4: HR = 0.71 (0.51-1.00).

Stratified by centre and gender and adjusted for time of follow-up and smoking.

14) Feskanich D (2000)

The Nurses' Health Study

&

The Health Professionals' Follow-up Study

77,283 US women (38-63 years) and 47,778 men (40-75 years)

Women: 1984-1996.

Men: 1986-1996.

516? women, and
258? men

Total lung cancer risk

Legumes (include peas/lima beans, tofu/soybeans, and beans/lentils)


Women:	Men:
RR = 1.07 (0.77-1.49) for the highest vs lowest quintile of consumption. Amount specific data (servings/wk): < 0.5: RR = 1. 0.5-1.0: RR = 0.81 (0.58-1.14). 1.1-1.4: RR = 0.93 (0.68-1.27). 1.5-2.0: RR = 1.09 (0.79-1.51). > 2.0: RR = 1.07 (0.77-1.49).	RR = 1.21 (0.81-1.81) for the highest vs lowest quintile of consumption. Amount specific data (servings/wk): < 0.7: RR = 1. 0.7-1.3: RR = 1.05 (0.73-1.52). 1.4-1.8: RR = 1.47 (0.99-2.18). 1.9-3.1: RR = 0.84 (0.55-1.29). > 3.1: RR = 1.21 (0.81-1.81).

age, follow-up cycle, smoking status,years since quitting among past smokers, cigarettes smoked/day among current smokers, age at start of smoking, total energy intake, and availability of diet data after baseline measure

14) Speizer FE (1999)

The Nurses' Health Study.

89,284 women aged 34-59 years.
(USA)

12
(1980-1992)

399?

Lung cancer risk

Beans (not defined)

RR = 1.1 (No 95% CI; P = 0.23) for the highest vs the lowest quartile of consumption.

Amount specific data (Frequency of consumption):
Never: RR = 1.
1-3/mo: RR = 1.0.
1/wk: RR = 1.0.
≥ 2/wk: RR = 1.1.

age, smoking (past, current, amount in 1980), and age of starting to smoke

11) Voorrips LE (2000)

The Netherlands Cohort Study

62,573 women and 58,279 men aged 55-69.

6.3
(1986-1992)

910

lung cancer risk

Legumes (defined as: string beans; broad beans)


In g/day:	In frequency:
RR = 0.8 (0.6-1.2; P = 0.07) for the highest vs lowest quintile of consumption. Amount specific data: 10: RR = 1. 19: RR = 1.0 (0.7-1.3). 28: RR = 0.7 (0.5-1.0). 39: RR = 0.9 (0.6-1.2). 60: RR = 0.8 (0.6-1.2).	RR = 1.0 (0.6-1.8; P = 0.77) for the highest vs lowest quintile of consumption. Amount specific data: ≤ 1 x/month: RR = 1. 2-3 x/month: RR = 1.0 (0.6-1.6). 1 x/week: RR = 0.9 (0.5-1.4). 2 x/week: RR = 0.9 (0.5-1.4). ≥ 3 x/week: RR = 1.0 (0.6-1.8).

Age, sex, family history of lung cancer, education, current smoking, years of smoking, number of cigarettes/day and total vegetables.

8) Knekt P (1999)

The Finnish Mobile Clinic Health Examination Survey.

4545 men aged 20-69.

25
(1967-72 to 1991)

138?

Lung cancer risk

Legumes (not defined)

RR = 0.88 (0.58-1.34; P = 0.55) for the highest vs lowest tertile of consumption.

Amount specific data (Tertiles):
T1: RR = 1.
T2: RR = 1.24 (0.83-1.85).
T3: RR = 0.88 (0.58-1.34).

Tertiles are defined as "Low" (4 g/day) and "High" (8 g/day).

Age and smoking status.

7) Fraser GE (1991)

The Adventist Health Study

34,198 white California seventh-day adventists.
(USA)

6
(1977-1982)

No data shown (for other foods: 52-59)

Lung cancer risk

Beans (not defined)

No evidence of an important association was found (data not shown).

Age, sex, and smoking history

2) Kvale G (1983)

No cohort name.

10,602 men.
(Norway)

11.5
(1967-1978)

All: 68.
Squamous and small cell: 42.

Lung cancer risk

Beans (not defined)


Primary tumours:	Squamous and small-cell carcinomas:
Relative odds = 1.49 (P = 0.53) for the highest vs lowest quartile of consumption (> 6 vs < 1 times/month).	Relative odds = 0.39 (P = 0.51) for the highest vs lowest quartile of consumption (> 6 vs < 1 times/month).

Age, cigarette smoking, region and urban/rural place of residence.

Prospective studies of legumes and lung cancer mortality:

Author

Cohort name

Subjects

Years of follow-up

Cases

End point

Consumption of

Relative Risk (RR)

Adjustments

17) Iso H (2007)

The JACC Study.

41,816 men, and 57,985 women.
(Japan)

Not defined.

682 men, and
237 women.

Lung cancer mortality

Boiled beans (not defined)


Men:	Women:
HR = 0.81 (0.66-1.00; P = < 0.10) for the highest vs lowest tertile of consumption. Amount specific data: < 1/w: HR = 1. 1-2/w: HR = 0.76 (0.63-0.92; P = < 0.01). ≥ 3/w: HR = 0.81 (0.66-1.00).	HR = 1.04 (0.72-1.50) for the highest vs lowest tertile of consumption. Amount specific data: < 1/w: HR = 1. 1-2/w: HR = 1.04 (0.74-1.47). ≥ 3/w: HR = 1.04 (0.72-1.50).

Age and study area.

17) Ozasa K (2001)

The JACC Study.

42,940 Japanese men (22,465 current smokers, 11,308 ex-smokers, 9,167 nonsmokers) and 55,308 women (2,868 current smokers, 852 ex-smokers, 51,588 nonsmokers) aged 40-79.

7.7
(1988-90 to 1997)

315 men, and 87 women

Lung cancer mortality

Boiled beans (not defined)

**Stratified by sex:**
Men	Women
HR = 0.90 (0.67-1.21; P = 0.26) for the highest vs lowest tertile of consumption. Amount specific data (times): ≤ 2/mo: HR = 1. 1-2/we: HR = 0.74 (0.56-0.99). ≥ 3/we: HR = 0.90 (0.67-1.21).	HR = 0.81 (0.46-1.44; P = 0.50) for the highest vs lowest tertile of consumption. Amount specific data (times): ≤ 2/mo: HR = 1. 1-2/we: HR = 0.96 (0.58-1.60). ≥ 3/we: HR = 0.81 (0.46-1.44).

Age, parents' history of lung cancer, smoking status, smoking index and time since quitting smoking.

Cancer & Diet. A systematic review.

Literature review.

Relating various aspects of our diet
to lung cancer risk & mortality.

Legumes (pulses) and lung cancer.

Cancer & Diet. A systematic review.

Literature review.

Relating various aspects of our dietto lung cancer risk & mortality.

Legumes (pulses) and lung cancer.

Relating various aspects of our diet
to lung cancer risk & mortality.