***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Venous thromboembolism ( VTE ) and cardiovascular disease ( CVD ) share some risk factors , including obesity , but it is unclear how dietary patterns associated with reduced risk of CVD relate to risk of VTE . OBJECTIVE To compare the relationships of adherence to a Dietary Approaches to Stop Hypertension (DASH)-style diet with the risks of CVD and VTE . PATIENTS / METHODS We confirmed by medical record review 1094 incident cases of CVD and 675 incident VTEs during a mean follow-up of 14.6 years in 34 827 initially healthy participants in the Women 's Health Study who completed at baseline a 133-item food frequency question naire scored for adherence to a DASH diet .  We compared estimated associations of dietary patterns with CVD and VTE from proportional hazards models in a competing risk framework . RESULTS Initial analyses adjusted for age , energy intake and r and omized treatments showed 36 - 41 % reduced hazards of CVD among women in the top two quintiles of DASH score relative to those in the bottom quintile ( P(trend ) < 0.001 ) . In multivariate analysis , women in the top two quintiles had 12 - 23 % reduced hazards of CVD relative to women in the bottom quintile ( P(trend ) = 0.04 ) . Analyses restricted to coronary events showed more variable 10 - 33 % reduced hazards in the top two quintiles ( P(trend ) = 0.09 ) . In contrast , higher DASH scores were unrelated to risk of VTE , with a 1 % reduced hazard for the top vs. bottom quintile ( P(trend ) = 0.95 ) . CONCLUSION An apparently strong association of adherence to the DASH diet with incidence of CVD was attenuated upon control for confounding variables . Adherence to the DASH diet was not associated with risk of VTE in women BACKGROUND Fruit and vegetables is a heterogeneous food group with different content of dietary fiber , vitamins , minerals , carotenoids , and bioactive phytochemicals . Our objective was to examine the relation between specific consumption of fruit and vegetable subgroups and stroke risk in a cohort of Swedish women and men . METHODS AND RESULTS We prospect ively followed 74,961 participants ( 34,670 women and 40,291 men ) who had completed a food frequency question naire in the autumn of 1997 and were free from stroke , coronary heart disease , and cancer at baseline . Diagnoses of stroke in the cohort during follow-up were ascertained from the Swedish Hospital Discharge Registry . A total of 4089 stroke cases , including 3159 cerebral infa rct ions , 435 intracerebral hemorrhages , 148 subarachnoid hemorrhages , and 347 unspecified strokes , were ascertained during 10.2 years of follow-up . The multivariable relative risk ( RR ) of total stroke for the highest vs. lowest category of total fruit and vegetable consumption was 0.87 ( 95 % confidence interval [ CI ] 0.78 - 0.97 ; P for trend = 0.01 ) . The association was confined to individuals without hypertension ( corresponding RR , 0.81 ; 95 % CI , 0.71 - 0.93 ; P for trend = 0.01 ) . Among individual fruits and vegetable subgroups , inverse associations with total stroke were observed for apples/pears ( RR , 0.89 ; 95 % CI , 0.80 - 0.98 ; P for trend = 0.02 ) and green leafy vegetables ( RR , 0.92 ; 95 % CI , 0.81 - 1.04 ; P for trend = 0.03 ) . CONCLUSION This study shows an inverse association of fruit and vegetable consumption with stroke risk . Particularly consumption of apples and pears and green leafy vegetables was inversely associated with stroke Dietary factors are thought to be closely associated with the development of human cancers and hence numerous studies in this area have already been conducted in the United States and other Western countries . Comparatively few prospect i ve studies have been published in Japan , especially for Hokkaido people . The present investigation was therefore performed to assess links between four leading cancers and some of the Japanese  common dietary factors through a cohort study  ( 1984 - 2002 ) in Hokkaido by analyzing 1,524 men and 1,634 women separately aged 40 and over . Adjusted Cox proportional hazard regression was used to calculate the relative risk ( RR ) for each dietary factor . For men , two dietary factors , miso soup ( RR=0.2 , 95 % confidence interval (95%CI)=0.1 - 0.8 ) and pickled vegetables ( RR=0.2 , 95%CI=0.1 - 0.8 ) were associated with lower risk for stomach and colorectal cancer respectively . For women , three factors , namely salty confectionary ( RR=3.5 , 95%CI=1.1 - 10.9 ) , black tea ( RR=3.8 , 95%CI=1.1 - 13.6 ) , and carbonated drink/juice ( RR=3.9 , 95 % CI=1.4 - 11.1 ) appeared related to an elevated risk of stomach cancer . However , further analysis simultaneously with all other adjusted factors indicated only carbonated drink/juice ( RR=3.1 , 95%CI=1.1 - 8.9 ) to present a significant risk factor for stomach cancer . One factor , namely wild edible plants ( RR=3.3 , 95%CI=1.1 - 9.8 ) , increased the risk for colorectal cancer in women . None of the dietary components were significantly associated with lung or pancreatic cancers . This study also indicated a wide variation in the impact of dietary factors  by sex and cancer site , in line with earlier work , pointing to a necessity for careful interpretation . Further epidemiological investigations by sex with more study subjects and confounding factors will be useful for determining the contribution of individual dietary factors to development of human cancers in Hokkaido , Japan Study objective : To examine associations between  food and nutrient intake , measured in childhood , and adult cancer in a cohort with over 60 years follow up . Design and setting : The study is based on the Boyd Orr cohort . Intake of fruit and vegetables , energy , vitamins C and E , carotene , and retinol was assessed from seven day household food inventories carried out during a study of family diet and health in 16 rural and urban areas of Engl and and Scotl and in 1937–39 . Participants : 4999 men and women , from largely working class background s , who had been children in the households participating in the pre-war survey . Analyses are based on 3878 traced subjects with full data on diet and social circumstances . Main results : Over the follow up period there were 483 incident malignant neoplasms . Increased childhood fruit intake was associated with reduced risk of incident cancer . In fully adjusted logistic regression models , odds ratios ( 95 % confidence intervals ) with increasing quartiles of fruit consumption were 1.0 ( reference ) , 0.66 ( 0.48 to 0.90 ) , 0.70 ( 0.51 to 0.97 ) , 0.62 ( 0.43 to 0.90 ) ; p value for linear trend=0.02 . The association was weaker for cancer mortality . There was no clear pattern of association between the other dietary factors and total cancer risk . Conclusions : Childhood fruit consumption may have a long term protective effect on cancer risk in adults . Further prospect i ve studies , with individual measures of diet are required to further eluci date these relations Background and Purpose — The color of the edible portion of fruits and vegetables reflects the presence of pigmented bioactive compounds , ( eg , carotenoids , anthocyanidins , and flavonoids ) . Which fruit and vegetable color groups contribute most to the beneficial association of fruit and vegetables with stroke incidence is unknown . Therefore , we examined associations between consumption of fruit and vegetable color groups with 10-year stroke incidence . Methods — This was a prospect i ve , population -based cohort study , including 20 069 men and women age 20 to 65 years and free of cardiovascular diseases at baseline . Participants completed a vali date d , 178-item food frequency question naire . Hazard ratios ( HR ) were calculated for stroke incidence using multivariate Cox proportional hazards models adjusting for age , sex , lifestyle , and dietary factors . Results — During 10 years of follow-up , 233 incident cases of stroke were documented . Fruits and vegetables were classified into 4 color groups . Medians of green , orange/yellow , red/purple , and white fruit and vegetable consumption were 62 , 87 , 57 , and 118 g/d , respectively . Green , orange/yellow , and red/purple fruits and vegetables were not related to incident stroke . Higher intake of white fruits and vegetables  was inversely associated with incident stroke ( Q4 , > 171 g/d , versus Q1 , ⩽78 g/d ; HR , 0.48 ; 95 % CI , 0.29–0.77 ) . Each 25-g/d increase in white fruit and vegetable consumption was associated with a 9 % lower risk of stroke ( HR , 0.91 ; 95 % CI , 0.85–0.97 ) . Apples and pears were the most commonly consumed white fruit and vegetables ( 55 % ) . Conclusions — High intake of white fruits and vegetables may protect against stroke Purpose Cancer is the second leading cause of death in the United States and mortality varies by ethnicity . The objective of this study was to examine the association between cancer mortality and dietary intake among a large multiethnic population . Methods A prospect i ve cohort design was used to examine cancer mortality among 146,389 participants . Multiethnic cohort study participants represent five ethnic groups : African American , Native Hawaiian , Japanese American , Latino , and Caucasian .  Hazard ratios for cancer mortality by intake levels of five food groups and discretionary fat were calculated using Cox proportional hazards models stratified by sex and ethnicity . Results There were a total of 2,028 male and 1,464 female fatal cancer cases at the end of follow-up . Among Japanese American men only , there was a significant protective effect seen in those reporting a high grain intake ( HR = 0.49 , 95 % CI 0.35–0.69 ) ; there was no effect of grain consumption in any other ethnic-sex group . There was no evidence that ethnicity modified associations between fruit , vegetable , meat , dairy , or discretionary fat intake and cancer mortality among men . Associations between food group consumption and risk for cancer mortality among women were similar across ethnic groups . Conclusions The considerable reduction in cancer risk associated with high grain consumption among a specific ethnic-sex group , Japanese American men , warrants further investigation . Additional research is needed to vali date this observation and determine whether this was a chance finding , or possibly due to differential intake of specific grain subtypes , and /or related to a sex-specific cancer type Fruit and vegetable consumption has been hypothesized to reduce the risk of renal cell cancer .  We conducted a pooled analysis of 13 prospect i ve studies , including 1,478 incident cases of renal cell cancer ( 709 women and 769 men ) among 530,469 women and 244,483 men followed for up to 7 to 20 years . Participants completed a vali date d food-frequency question naire at baseline . Using the primary data from each study , the study -specific relative risks ( RR ) were calculated using the Cox proportional hazards model and then pooled using a r and om effects model . We found that fruit and vegetable consumption was associated with a reduced risk of renal cell cancer .  Compared with < 200 g/d of fruit and vegetable intake , the pooled multivariate RR for ≥600 g/d was 0.68 [ 95 % confidence interval ( 95 % CI ) = 0.54 - 0.87 ; P for between- studies heterogeneity = 0.86 ; P for trend = 0.001 ] . Compared with < 100 g/d , the pooled multivariate RRs ( 95 % CI ) for ≥400 g/d were 0.79 ( 0.63 - 0.99 ; P for trend = 0.03 ) for total fruit and 0.72 ( 0.48 - 1.08 ; P for trend = 0.07 ) for  total vegetables . For specific carotenoids , the pooled multivariate RRs ( 95 % CIs ) comparing the highest and lowest quintiles were 0.87 ( 0.73 - 1.03 ) for α-carotene , 0.82 ( 0.69 - 0.98 ) for β-carotene , 0.86 ( 0.73 - 1.01 ) for β-cryptoxanthin , 0.82 ( 0.64 - 1.06 ) for lutein/zeaxanthin , and 1.13 ( 0.95 - 1.34 ) for lycopene . In conclusion , increasing fruit and vegetable consumption is associated with decreasing risk of renal cell cancer ;  carotenoids present in fruit and vegetables may partly contribute to this protection . ( Cancer Epidemiol Biomarkers Prev 2009;18(6):173 
    Output:
    
Inverse associations were observed between the intake of apples and pears , citrus fruits , green leafy vegetables , cruciferous vegetables , and salads and cardiovascular disease and all-cause mortality , and between the intake of green-yellow vegetables and cruciferous vegetables and total cancer risk .
Conclusions Fruit and vegetable intakes were associated with reduced risk of cardiovascular disease , cancer and all-cause mortality .