Nutrient dietary patterns and the risk of colorectal cancer: a case–control study from Italy (original) (raw)
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British Journal of Cancer, 2016
Background: Much of the current literature on diet-colorectal cancer (CRC) associations focused on studies of single foods/ nutrients, whereas less is known about nutrient patterns. We investigated the association between major nutrient patterns and CRC risk in participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: Among 477 312 participants, intakes of 23 nutrients were estimated from validated dietary questionnaires. Using results from a previous principal component (PC) analysis, four major nutrient patterns were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed for the association of each of the four patterns and CRC incidence using multivariate Cox proportional hazards models with adjustment for established CRC risk factors. Results: During an average of 11 years of follow-up, 4517 incident cases of CRC were documented. A nutrient pattern characterised by high intakes of vitamins and minerals was inversely associated with CRC (HR per 1 s.d. ¼ 0.94, 95% CI: 0.92-0.98) as was a pattern characterised by total protein, riboflavin, phosphorus and calcium (HR (1 s.d.) ¼ 0.96, 95% CI: 0.93-0.99). The remaining two patterns were not significantly associated with CRC risk. Conclusions: Analysing nutrient patterns may improve our understanding of how groups of nutrients relate to CRC. In 2012, colorectal cancer (CRC) was the fourth most common cancer worldwide, with B1 360 000 cases diagnosed (Ferlay et al, 2015). Dietary and other lifestyle choices play a significant role in
The American journal of clinical nutrition, 2004
An analysis of dietary patterns or combinations of foods may provide insight regarding the influence of diet on the risk of colon and rectal cancer. A primary aim of the Dietary Patterns and Cancer (DIETSCAN) Project was to develop and apply a common methodologic approach to study dietary patterns and cancer in 4 European cohorts: the Alpha-Tocopherol Beta-Carotene Cancer Prevention Study (Finland-ATBC), the Netherlands Cohort Study (NLCS) on Diet and Cancer, the Swedish Mammography Cohort (SMC), and the Ormoni e Dieta nella Eziologia dei Tumori (Italy-ORDET). Three cohorts (ATBC, NLCS, and SMC) provided data on colon and rectal cancer for the present study. The cohorts were established between 1985 and 1992; follow-up data were obtained from national cancer registries. The participants completed validated semiquantitative food-frequency questionnaires at baseline. Exploratory factor analysis, conducted within each cohort, identified 3-5 stable dietary patterns. Two dietary patterns...
Background: An analysis of dietary patterns or combinations of foods may provide insight regarding the influence of diet on the risk of colon and rectal cancer. Objective: A primary aim of the Dietary Patterns and Cancer (DIETSCAN) Project was to develop and apply a common method- ologic approach to study dietary patterns and cancer in 4 European cohorts: the Alpha-Tocopherol Beta-Carotene Cancer Prevention Study (Finland-ATBC), the Netherlands Cohort Study (NLCS) on Diet and Cancer, the Swedish Mammography Cohort (SMC), and the Ormoni e Dieta nella Eziologia dei Tumori (Italy-ORDET). Three cohorts (ATBC, NLCS, and SMC) provided data on colon and rectal cancer for the present study. Design: The cohorts were established between 1985 and 1992; follow-up data were obtained from national cancer registries. The participants completed validated semiquantitative food-frequency questionnaires at baseline. Results: Exploratory factor analysis, conducted within each cohort, identified 3-5 sta...
Nutrient-derived Dietary Patterns and Risk of Colorectal Cancer: a Factor Analysis in Uruguay
Asian Pacific Journal of Cancer Prevention, 2012
In order to explore the role of nutrients and bioactive related substances in colorectal cancer, we conducted a case-control in Uruguay, which is the country with the highest production of beef in the world. Six hundred and eleven (611) cases afflicted with colorectal cancer and 1,362 controls drawn from the same hospitals in the same time period were analyzed through unconditional multiple logistic regression. This base population was submitted to a principal components factor analysis and three factors were retained. They were labeled as the meat-based, plant-based, and carbohydrates patterns. They were rotated using orthogonal varimax method. The highest risk was positively associated with the meat-based pattern (OR for the highest quartile versus the lowest one 1.63, 95 % CI 1.22-2.18, P value for trend = 0.001), whereas the plant-based pattern was strongly protective (OR 0.60, 95 % CI 0.45-0.81, P value for trend <0.0001. The carbohydrates pattern was only positively associated with colon cancer risk (OR 1.46, 95 % CI 1.02-2.09). The meat-based pattern was rich in saturated fat, animal protein, cholesterol, and phosphorus, nutrients originated in red meat. Since herocyclic amines are formed in the well-done red meat through the action of amino acids and creatine, it is suggestive that this pattern could be an important etiologic agent for colorectal cancer.
Dietary patterns and colorectal cancer
European Journal of Cancer Prevention, 2011
Studies on the association between single foods or nutrients and colorectal cancer have provided inconsistent results. Previous reviews did not conduct a quantitative synthesis of the relation with dietary patterns. We conducted a systematic review and meta-analysis of studies addressing the association between dietary patterns and colorectal cancer. Studies quantifying the association between dietary patterns (defined a posteriori) and colorectal cancer were identified in PubMed (until 01.08.2010) and through backward and forward citation tracking (ISI Web of Science and Scopus). Summary relative risk (RR) estimates and 95% confidence intervals (95% CI) were computed for highest versus lowest levels of exposure, for colon cancer (CC) and rectal cancer (RC), and for proximal and distal CC, by random effects meta-analysis. Heterogeneity was quantified using the I 2 statistic. Eight cohort and eight case-control studies defining patterns through principal components and factor analyses were included in the systematic review. Meta-analyses were conducted for three patterns: (i) 'drinker, ' characterized by high alcohol consumption (CC: RR combined = 0.96, 95% CI: 0.82-1.12, I 2 = 0.6%; RC: RR combined = 0.83, 95% CI: 0.47-1.45, I 2 = 65.1%); (ii) 'healthy, ' characterized by high fruit/vegetables consumption (CC: RR combined = 0.80, 95% CI: 0.70-0.90, I 2 = 55.1%; RC: RR combined = 1.02, 95% CI: 0.89-1.17, I 2 = 10.8%); (iii) 'western, ' characterized by high red/ processed meat consumption (CC: RR combined = 1.29, 95% CI: 1.13-1.48, I 2 = 31.7%; RC: RR combined = 1.13, 95% CI: 0.92-1.39, I 2 = 40.6%). Summary estimates for proximal and distal CC were similar. The risk of CC was increased with patterns characterized by high intake of red and processed meat and decreased with those labelled as 'healthy. ' No significant associations were observed for RC.
The role of dietary patterns in colorectal cancer: a 2019 update
Expert Review of Gastroenterology & Hepatology, 2020
Introduction: Colorectal cancer (CRC) is a major public health problem, both in terms of incidence and mortality. Lifestyle, particularly diet, plays an important role in the development of this cancer. Areas covered: The aim of the present review was to provide an overview of systematic reviews/meta-analysis published in the last 10 years regarding the association between dietary patterns and CRC risk. Three databases were explored (Pubmed, Scopus and Web of Science), and 13 articles were finally included. The most common a priori methods used were Healthy Eating Index, Mediterranean diet, and Dietary Inflammatory Index, while factor or principal component analyses, cluster analysis and reduced rank regression were the most frequent a posteriori methods used. All the studies analyzed in the present review showed that a diet characterized mainly by a high intake of fruits and vegetables and low intake of red and processed meats decreased the risk of CRC. Expert opinion: Important nutritional health campaigns and CRC screening programs are being done across the globe; nevertheless, we believe that those strategies are still inadequate as CRC incidence is increasing worldwide More effort is required at different institutional levels and public health policy advice to help the population shift towards healthier dietary habits.
Food groups and risk of colorectal cancer in Italy
… journal of cancer, 1997
The proportion of colorectal cancer attributed to dietary habits is high, but several inconsistencies remain, especially with respect to the influence of some food groups. To further elucidate the role of dietary habits, 1,225 subjects with cancer of the colon, 728 with cancer of the rectum and 4,154 controls, hospitalized with acute non-neoplastic diseases, were interviewed between 1992 and 1996 in 6 different Italian areas. The validated food-frequency questionnaire included 79 questions on food items and recipes, categorised into 16 food groups. After allowance for non-dietary confounding factors and total energy intake, significant trends of increasing risk of colorectal cancer with increasing intake emerged for bread and cereal dishes (odds ratio [OR] in highest vs. lowest quintile 5 1.7), potatoes (OR 5 1.2), cakes and desserts (OR 5 1.1), and refined sugar (OR 5 1.4). Intakes of fish (OR 5 0.7), raw and cooked vegetables (OR 5 0.6 for both) and fruit other than citrus fruit (OR 5 0.7) showed a negative association with risk. Consumption of eggs and meat (white, red or processed meats) seemed uninfluential. Most findings were similar for colon and rectum, but some negative associations (i.e., coffee and tea, and fish) appeared stronger for colon cancer. Our findings lead us to reconsider the role of starchy foods and refined sugar in light of recent knowledge on the digestive physiology of carbohydrates and the insulin/ colon cancer hypothesis. The beneficial role of most vegetables is confirmed, with more than 20% reduction in risk of colorectal cancer from the addition of one daily serving. Int.
Low-risk diet for colorectal cancer in Italy
European Journal of Cancer Prevention, 2001
An innovative approach was used to define a low-risk diet for colorectal cancer from a multicentric case-control study of 1953 incident cases and 4154 hospital controls from Italy. A logistic regression model was fitted on the reported intake of five macronutrients, and the estimated coefficients were used to compute () a diet-related logistic risk score LRS. The mean of LRS within risk decile ranged from 0.89 to 1.86. Total energy intake and absolute consumption of each macronutrient increased with increasing LRS. In relative terms, however, starch intake showed an almost threefold increase across subsequent score levels, while a decline was observed for unsaturated fat, sugar and protein. Saturated fat consumption remained fairly stable in relative terms. When food groups were considered, bread and cereals dishes, cakes and desserts and refined sugar were positively associated, while the consumption of vegetables, fruit, fish, poultry and olive oils was inversely associated with LRS.
Background: Although diet has long been suspected as an etiological factor for colorectal cancer, studies of single foods and nutrients have provided inconsistent results. Objective: We used factor analysis methods to study associations between dietary patterns and colorectal cancer in middle-aged Americans. Design: Diet was assessed among 293 615 men and 198 767 women in the National Institutes of Health-AARP Diet and Health Study. Principal components factor analysis identified 3 primary dietary patterns: a fruit and vegetables, a diet foods, and a red meat and potatoes pattern. State cancer registries identified 2151 incident cases of colorectal cancer in men and 959 in women between 1995 and 2000. Results: Men with high scores on the fruit and vegetable pattern were at decreased risk [relative risk (RR) for quintile (Q) 5 versus Q1: 0.81; 95% CI: 0.70, 0.93; P for trend ҃ 0.004]. Both men and women had a similar risk reduction with high scores on the diet food factor: men (RR: 0.82; 95% CI: 0.72, 0.94; P for trend ҃ 0.001) and women (RR: 0.87; 95% CI: 0.71, 1.07; P for trend ҃ 0.06). High scores on the red meat factor were associated with increased risk: men (RR: 1.17; 95% CI: 1.02, 1.35; P for trend ҃ 0.14) and women (RR: 1.48; 95% CI: 1.20, 1.83; P for trend ҃ 0.0002). Conclusions: These results suggest that dietary patterns characterized by a low frequency of meat and potato consumption and frequent consumption of fruit and vegetables and fat-reduced foods are consistent with a decreased risk of colorectal cancer.
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.