Chia Jui Yen, Yu Cheng Lu, Chun Yen Ou, Ya Ling Weng, Sen Tien Tsai, Chan Chi Chang, Yuan Hua Wu, Wei Ting Hsueh, Jehn Shyun Huang, Yu Hsuan Lin, Yao Chou Lee, Jiunn Liang Wu, Jang Yang Chang, Ken Chung Chen, Cheng Chih Huang, Wei Ting Lee, Sheen Yie Fang, Tung Yiu Wong, Han Chien Yang, Yu Shan Chen, Jenn Ren Hsiao, Jeffrey S. Chang, Yu Hsuan Lai, Shang Yin Wu, and Chen Lin Lin
// Chan-Chi Chang 1, 2, * , Wei-Ting Lee 1, 2, * , Yao-Chou Lee 2, 3 , Cheng-Chih Huang 1 , Chun-Yen Ou 1 , Yu-Hsuan Lin 1 , Jehn-Shyun Huang 4 , Tung-Yiu Wong 4 , Ken-Chung Chen 4 , Jenn-Ren Hsiao 1, 2 , Yu-Cheng Lu 1 , Sen-Tien Tsai 1 , Yu-Hsuan Lai 2, 5 , Yuan-Hua Wu 5 , Wei-Ting Hsueh 5 , Chia-Jui Yen 6 , Shang-Yin Wu 2, 6 , Jang-Yang Chang 6, 7 , Sheen-Yie Fang 1 , Jiunn-Liang Wu 1 , Chen-Lin Lin 8 , Ya-Ling Weng 7 , Han-Chien Yang 7 , Yu-Shan Chen 1 and Jeffrey S. Chang 7 1 Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan 2 Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan 3 Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan 4 Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan 5 Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan 6 Division of Hematology/Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan 7 National Institute of Cancer Research, National Health Research Institutes, Tainan 70456, Taiwan 8 Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan * These authors have contributed equally to this work Correspondence to: Jeffrey S. Chang, email: jeffreychang@nhri.org.tw Keywords: head and neck cancer, diet, vegetables and fruits, risk factor, Taiwan Abbreviations: confidence interval (CI); head and neck cancer (HNC); Nutrition and Heath Surveys in Taiwan (NAHSIT); OR (odds ratio); upper aerodigestive tract (UADT) Received: July 23, 2017 Accepted: September 30, 2017 Published: October 24, 2017 ABSTRACT Most studies reporting an inverse association between the consumption of vegetables and fruits and head and neck cancer (HNC) risk were conducted in Western populations and only a few included East Asians. The current case-control study investigated the association between diet and HNC risk using data of 838 HNC cases and 998 controls from a case-control study of HNC conducted in Taiwan. Each participant was asked about their consumption of fresh vegetables, pickled vegetables, fresh fruits, citrus fruits, meat, processed meat, fish, egg, and dairy products. Unconditional logistic regression was performed to estimate the odds ratio (OR) and 95% confidence interval (CI) of HNC risk associated with each food category, adjusted for sex, age, education, and use of alcohol, betel quid and cigarette. An inverse association was observed between HNC risk and daily intake of fresh vegetables (OR = 0.44, 95% CI: 0.20-0.95, p -trend = 0.002) or fruits (OR = 0.55, 95% CI: 0.43-0.72, p -trend = 0.00001). Individuals who did not consume fresh fruits and vegetables daily had more than double the risk of HNC compared to those with daily intake of vegetables and fruits (OR= 2.24, 95% CI: 1.54-3.25). The results of the current study supported an inverse association between the consumption of fresh vegetables and fruits and HNC risk. In addition to cessation of cigarette smoking and betel quid chewing and reduction of alcohol drinking, a public health campaign for preventing the occurrence of HNC should promote a healthy diet that contains plenty of fresh vegetables and fruits.