Adherence to Mediterranean diet and its association with multiple colonic polyps of unknown origin: a case-control study (original) (raw)
Related papers
World Journal of Gastroenterology
AIM To evaluate the association between the Mediterranean diet (MD) pattern and its components, and advanced colorectal polyps (adenoma and serrated adenoma). METHODS A case-control study among patients undergoing screening, diagnostic or surveillance colonoscopies during 2010-2015 at the Tel-Aviv Medical Center, Gastroenterology Department. Cases with advanced polyps were defined as: Advanced adenoma [> 10 mm, with features of high grade dysplasia (HGD) or villous histology], advanced serrated adenoma (> 10 mm or with dysplasia) or multiple (≥ 3) non-advanced adenomas or serrated adenomas. Cases of non-advanced adenomas were defined as adenomas < 10 mm, without features of HGD or villous histology. Controls were defined as those 2617 June 28, 2018|Volume 24|Issue 24| WJG|www.wjgnet.com
Nutrition and Cancer, 2014
The aim of this study was to evaluate the association between health-related characteristics and CRC in the context of the MD. This was a case-control study conducted on a sample of 338 consecutive patients with a first diagnosis of CRC recruited in an urban facility in the city of Catania, southern Italy, and matched with 676 apparently healthy subjects without clinical symptoms or signs of any type of cancer. Data regarding sociodemographic, clinical, and lifestyle characteristics were collected, and adherence to the Mediterranean diet pattern was assessed using the MedDietScore. A significant association between a greater adherence to the MD and lower odds of having cancer (odds ratio = 0.46, 95% confi-dence interval: 0.28-0.75) was found. Also, smoking status, family history of CRC, obesity, diabetes, physical activity, and high intake of alcohol were significantly associated with CRC, but only among subjects less adherent to the MD. MD was associated with a less detrimental effects of several health-related characteristics associated with CRC, suggesting potential benefits of adherence to this dietary pattern with regards to CRC risk factors.
European journal of nutrition, 2018
To assess if the associations found between three previously identified dietary patterns with breast, prostate and gastric cancer are also observed for colorectal cancer (CRC). MCC-Spain is a multicase-control study that collected information of 1629 incident cases of CRC and 3509 population-based controls from 11 Spanish provinces. Western, Prudent and Mediterranean data-driven dietary patterns-derived in another Spanish case-control study-were reconstructed in MCC-Spain. Their association with CRC was assessed using mixed multivariable logistic regression models considering a possible interaction with sex. Risk by tumor site (proximal colon, distal colon, and rectum) was evaluated using multinomial regression models. While no effect of the Prudent pattern on CRC risk was observed, a high adherence to the Western dietary pattern was associated with increased CRC risk for both males [OR(95% CI): 1.45 (1.11;1.91)] and females [OR(95% CI): 1.50 (1.07;2.09)] but seem to be confined to ...
Lifestyle Factors and Their Combined Impact on the Risk of Colorectal Polyps
American Journal of Epidemiology, 2012
Understanding patterns of shared and type-specific etiologies for colorectal polyps may provide insights into colorectal carcinogenesis. The authors present the first systematic comparison of risk factors by colorectal polyp type in a large colonoscopy-based case-control study of 3,764 polyp-free controls and 2,543 polyp patients, including 1,444 cases with adenomas only, 662 cases with hyperplastic polyps (HPPs) only, and 437 cases with synchronous HPPs and adenomas. Surveys were completed to obtain information on usual dietary intake and other lifestyle factors. Six lifestyle factors, including cigarette smoking, obesity, no regular use of nonsteroidal antiinflammatory drugs, high intake of red meat, low intake of fiber, and low intake of calcium, were found to be independently associated with the risk of polyps. The risk of polyps increased progressively with an increasing number of adverse lifestyle factors. Compared with participants with no or only 1 risk factor, odds ratios for those with 5 to 6 risk factors were 2.72 (95% confidence interval: 1.94, 3.79) for adenoma only, 4.12 (95% confidence interval: 2.78, 6.09) for HPPs only, and 9.03 (95% confidence interval: 5.69, 14.34) for synchronous HPPs and adenomas. This study provides strong evidence that lifestyle modification is important for the prevention of colorectal polyps, especially advanced and multiple adenomas, which are established precursors of colorectal cancer. cancer prevention; colorectal neoplasia; epidemiology; risk factors Abbreviations: BMI, body mass index; HPP, hyperplastic polyp; NSAID, nonsteroidal anti-inflammatory drug.
Dietary risk factors for colorectal adenomatous polyps: a mini review
2010
ABSTRACT At least 6 million deaths occurred worldwide are due to cancer and this figure is expected to rise to 15 millions by the year 2020. Colorectal cancer is among the most commonly occurring cancers both globally and in Malaysia. Numerous studies have shown significant relationships between various dietary components and the risks for colorectal cancer. Meanwhile, several theories have been suggested as etiological explanations, one of which is the influence of dietary factors on the cell proliferation rate.
Italian mediterranean index and risk of colorectal cancer in the Italian section of the EPIC cohort
International Journal of Cancer, 2013
Colorectal cancer is among the commonest cancers worldwide. Dietary factors have been linked to colorectal cancer risk, however, few studies have evaluated the relationship between a priori dietary patterns and colorectal cancer risk. We evaluated the effect of adherence to a Mediterranean dietary pattern, as measured by the Italian Mediterranean Index, on the risk of colorectal cancer in the 45,275 participants of the Italian section of the EPIC study who completed a dietary questionnaire. Hazard ratios (HRs) with 95% confidence intervals (CIs) for colorectal cancer in relation to categories of Italian Mediterranean Index score were estimated by multivariate Cox models adjusted for known risk factors, on the whole cohort, on men and women and according to cancer subsite. During a mean follow-up of 11.28 years, 435 colorectal cancer cases were identified. The Italian Mediterranean Index was inversely associated with colorectal cancer risk (HR: 0.50; 95% CI: 0.35-0.71 for the highest category compared to the lowest, P-trend: 0.043). Results did not differ by sex. Highest Italian Mediterranean Index score was also significantly associated with reduced risks of any colon cancer (HR: 0.54, 95% CI: 0.36-0.81), distal colon cancer (HR: 0.44, 95% CI: 0.26-0.75) and rectal cancer (HR: 0.41, 95% CI: 0.20-0.81), but not of proximal colon cancer. These findings suggest that adherence to a Mediterranean diet (as measured by the Italian Mediterranean Index) protects against colorectal cancer in general but not against cancer developing in the proximal colon.
The Association of Lifestyle and Dietary Factors with the Risk for Serrated Polyps of the Colorectum
Cancer Epidemiology Biomarkers & Prevention, 2009
Some serrated polyps of the colorectum are likely preinvasive lesions, evolving through a newly recognized serrated pathway to colorectal cancer. To assess possible risk and protective factors for serrated polyps and particularly to explore differences in risk factors between polyps in the right and left colorectum, we pooled data from three large multicenter chemoprevention trials. A serrated polyp was defined broadly as any serrated lesion (hyperplastic, sessile serrated adenoma, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;traditional&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; serrated adenoma, mixed adenoma) diagnosed during each trial&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s main treatment period of approximately 3 to 4 years. Using generalized linear regression, we computed risk ratios and 95% confidence intervals as measures of the association between risk for serrated polyps and demographic, lifestyle, and dietary variables. Of the 2,830 subjects that completed at least one follow-up exam after randomization, 675 (23.9%) had at least one left-sided serrated polyp and 261 (9.2%) had at least one right-sided lesion. In the left colorectum, obesity, cigarette smoking, dietary fat, total energy intake, and red meat intake were associated with an increased risk for serrated polyps. In the right colon, aspirin treatment was associated with a reduced risk and family history of polyps and folate treatment were associated with an increased risk for serrated polyps. Our results suggest that several common lifestyle and dietary variables are associated with risk for serrated polyps, and some of these may differ for the right and left colorectum.
European Journal of Clinical Nutrition, 2001
Background: Dietary factors are known to be associated with initiation and development of colorectal cancer (CRC), and also with CRC's major precursor, the colorectal polyp. In long-term intervention studies on colorectal polyps, dietary changes may therefore affect potential effects of the study intervention. Objective: To examine potential dietary changes among polyp-patients randomly selected from a 3 y intervention study after 1 y. Design and subjects: Of 116 polyp-bearing outpatients (50% men), aged 50 ± 76 y, who participated in the double-blind 3 y placebo-controlled endoscopic follow-up and intervention study against growth and recurrence of polyps, 30 patients were randomised (strata: sex, age and polyp size) to perform a repeated 5 day dietary record by weighing after 1 y. The patients received a daily mixture of vitamin C (150 mg), a-tocopherol (75 mg), b-carotene (15 mg), selenium (101 mg) and calcium (1.6 g) or placebo (lactose) for a period of 3 y with annual colonoscopic examinations and polyps size measurements to test if the mixture was able to reduce polyp growth and recurrence. Polyps of b 9 mm were removed, whereas the remainders and new discoveries of polyps`9 mm were left in situ until the end of the study. Results: Twenty-nine patients agreed to perform the repeated 5 day dietary record, and 86% performed the second record within 48 ± 58 weeks after the ®rst record. The results showed that, with the exception of vitamin D, milk and milk products, no signi®cant differences were found between the two records. The median value of the Spearman's correlation coef®cient for energy and energy-yielding nutrients was 0.66, for vitamins and minerals 0.58, and for foods 0.58. Individual differences between the records were found for most variables, but most of these were negligible. Conclusion: After 1 y, no major dietary changes were found which could be associated with a changed susceptibly for malignancy, and thereby affect potential effects of the study intervention. We may thus suggest that a potential changed susceptibility towards growth and recurrence of polyps, is due to the speci®c intervention, and not due to other major dietary changes.
Dietary patterns and the risk of colorectal cancer and adenomas
Nutrition Reviews, 2010
The association of colorectal cancer risk with select foods has been evaluated by dietary pattern analysis. This review of the literature was conducted to thoroughly examine the available evidence for the association between dietary patterns and colorectal cancers and adenomas. A total of 32 articles based on worldwide epidemiological studies were identified. Pattern identification was achieved by exploratory data analyses (principal component, factor, and cluster analyses) in most articles, and only a few used a priori-defined scores. Dietary patterns named as healthy, prudent, fruit and vegetables, fat-reduced/diet foods, vegetable/fish/ poultry, fruit/whole grain/dairy, and healthy eating index-2005, recommended food and Mediterranean diet scores were all associated with reduced risk of colorectal cancer and the risk estimates varied from 0.45 to 0.90. In contrast, diets named Western, pork-processed meat-potatoes, meat-eaters, meat and potatoes, traditional patterns, and dietary risk and life summary scores were associated with increased risk of colorectal cancer with risk estimates varying from 1.18 to 11.7. Dietary patterns for adenomas were consistent with those identified for colorectal cancer.
Contemporary Clinical Trials, 2012
This study recruited persons at increased risk of colon cancer to an intensive dietary intervention study that required biopsies of the colon by flexible sigmoidoscopy at baseline and after six months of intervention. A total of 1314 individuals contacted the study, and only 16 individuals indicated that the sigmoidoscopy procedure was an obstacle to study participation. A total of 270 individuals completed a screening visit and signed a screening consent form. Inquiries about the study tended to be fewer in the winter and late summer. Failure to return food records was the most common reason for exclusion. Dietary recall at enrollment indicated that subjects were consuming significantly more vegetables, lower sodium and a lower glycemic load on the day before starting the study vs. during the eligibility phase which might have an impact on biomarker measures. This makes it important to capture dietary changes in the period between determination of eligibility and enrollment. Subjects (n = 120) were randomized to follow a Healthy Eating or a Mediterranean Diet, each of which required substantial dietary record-keeping. The study completion rate was 78%, and subjects reported high satisfaction with study participation. Of the 93 individuals who completed the study, only one refused the flexible sigmoidoscopy at the final visit. These findings suggest that flexible sigmoidoscopy does not appear to be a barrier for recruitment of high-risk individuals to an intensive dietary intervention trial, but that completing food records can be.