Association of total energy intake and macronutrient consumption with colorectal cancer risk: results from a large population-based case-control study in Newfoundland and Labrador and Ontario, Canada (original) (raw)
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Food Science and Nutrition, 2022
The risk of colorectal cancer (CRC) can be influenced by dietary components. This study aims to investigate the association between dietary intake and CRC in Iranian adults. This hospital‐based case–control study was performed on 160 patients with CRC and 320 healthy people. General and pathological data were collected through face‐to‐face interviews. A validated food frequency questionnaire (FFQ) was used to assess the intake of calories, macronutrients, and micronutrients. The case group had a significantly higher intake of calories, carbohydrates, vitamin A, vitamin K, fluoride, and molybdenum and a lower intake of vitamin E, vitamin B1, beta carotene, biotin, folate, magnesium, selenium, manganese, and fiber (all p < .001). CRC was positively associated with the intake of carbohydrate (OR: 1.01, CI% 1.03–1.01, p = .001), and vitamin A (OR: 1.009, CI 95% 1.006–1.01, p = .001) and negatively associated with intake of fiber (OR: 0.67, CI 95% 0.59–0.76, p = .001), beta carotene (OR: 0.99, CI 95% 0.99–0.99, p = .001), vitamin E (OR: 0.27, CI 95% 0.15–0.47, p = .001), folate (OR: 0.98 CI 95% 0.97–0.98, p = .001), and biotin (OR: 0.83, CI 95% 0.77–0.90, p = .001). The associations remained significant after adjusting for age and sex. Further adjustments for physical activity, alcohol consumption, and smoking did not change the results. The results identified that the risk of colorectal cancer can be influenced by dietary intake. Further longitudinal studies are needed to confirm these findings and to identify the underlying mechanisms of the effects of dietary components on the risk of colorectal cancer.
Nutrition journal, 2018
Dietary patterns are commonly used in epidemiological research, yet there have been few studies assessing if and how research results may vary across dietary patterns. This study aimed to estimate the risk of mortality/recurrence/metastasis using different dietary patterns and comparison amongst the patterns. Dietary patterns were identified by Cluster Analysis (CA), Principal Component Analysis (PCA), Alternate Mediterranean Diet score (altMED), Recommended Food Score (RFS) and Dietary Inflammatory Index (DII) scores using a 169-item food frequency questionnaire. Five hundred thirty-two colorectal cancer patients diagnosed between 1999 and 2003 in Newfoundland were followed-up until 2010. Overall Mortality (OM) and combined Mortality, Recurrence or Metastasis (cMRM) were identified. Comparisons were made with adjusted Cox proportional Hazards Ratios (HRs), correlation coefficients and the distributions of individuals in defined clusters by quartiles of factor and index scores. One ...
Dietary Energy Sources and Colon Cancer Risk
American Journal of Epidemiology, 1997
Because energy-contnbuting nutrients are highly correlated with total energy, the association with colon cancer from energy versus other components of energy-providing nutrients is often not clear. Dietary data from a population-based case-control study of colon cancer were analyzed in subjects from California, Utah, and Minnesota in 1991-1994 to assess the colon cancer nsk associated with consumption of energy, fat, protein, and carbohydrate. After adjustment for long-term physical activity, total energy intake increased risk of colon cancer in men (odds ratio = 1 74, 95% confidence interval 1.14-2.67 for highest vs. lowest quartile) and in women (odds ratio = 1.70, 95% confidence interval 1.07-2.70). Various methods of analysis suggested that intakes of individual sources of energy (dietary fat, protein, and carbohydrate) were not associated with colon cancer nsk after total energy intake was taken into account. People who consumed a high-calone diet that was dense in fiber and calcium appeared to be at lower nsk than people with the same caloric intake who consumed smaller amounts of dietary fiber and calcium. Individuals with a first-degree relative with colorectal cancer, especially those diagnosed at a younger age, were at a greater risk from a diet high in energy than were individuals without a family history of colorectal cancer.
International Journal of Cancer, 2009
Colorectal cancer is a major cause of cancer mortality and is considered to be largely attributable to inappropriate lifestyle and behavior patterns. The purpose of this review was to undertake a comparison of the strength of the associations between known and putative risk factors for colorectal cancer by conducting 10 independent meta-analyses of prospective cohort studies. Studies published between 1966 and January 2008 were identified through EMBASE and MEDLINE, using a combined text word and MESH heading search strategy. Studies were eligible if they reported estimates of the relative risk for colorectal cancer with any of the following: alcohol, smoking, diabetes, physical activity, meat, fish, poultry, fruits and vegetables. Studies were excluded if the estimates were not adjusted at least for age. Overall, data from 103 cohort studies were included. The risk of colorectal cancer was significantly associated with alcohol: individuals consuming the most alcohol had 60% greater risk of colorectal cancer compared with non- or light drinkers (relative risk 1.56, 95% CI 1.42–1.70). Smoking, diabetes, obesity and high meat intakes were each associated with a significant 20% increased risk of colorectal cancer (compared with individuals in the lowest categories for each) with little evidence of between-study heterogeneity or publication bias. Physical activity was protective against colorectal cancer. Public-health strategies that promote modest alcohol consumption, smoking cessation, weight loss, increased physical activity and moderate consumption of red and processed meat are likely to have significant benefits at the population level for reducing the incidence of colorectal cancer. © 2009 UICC
Cancer causes & control : CCC, 1997
The objective of this study was to examine the effects of the intake of dietary fat upon colorectal cancer risk in a combined analysis of data from 13 case-control studies previously conducted in populations with differing colorectal cancer rates and dietary practices. Original data records for 5,287 cases of colorectal cancer and 10,470 controls were combined. Logistic regression analysis was used to estimate odds ratios (OR) for intakes of total energy, total fat and its components, and cholesterol. Positive associations with energy intake were observed for 11 of the 13 studies. However, there was little, if any, evidence of any energy-independent effect of either total fat with ORs of 1.00, 0.95, 1.01, 1.02, and 0.92 for quintiles of residuals of total fat intake (P trend = 0.67) or for saturated fat with ORs of 1.00, 1.08, 1.06, 1.21, and 1.06 (P trend = 0.39). The analysis suggests that, among these case-control studies, there is no energy-independent association between dietar...
Role of Diet in Colorectal Cancer Incidence
JAMA Network Open
IMPORTANCE Several meta-analyses have summarized evidence for the association between dietary factors and the incidence of colorectal cancer (CRC). However, to date, there has been little synthesis of the strength, precision, and quality of this evidence in aggregate. OBJECTIVE To grade the evidence from published meta-analyses of prospective observational studies that assessed the association of dietary patterns, specific foods, food groups, beverages (including alcohol), macronutrients, and micronutrients with the incidence of CRC. DATA SOURCES MEDLINE, Embase, and the Cochrane Library were searched from database inception to September 2019. EVIDENCE REVIEW Only meta-analyses of prospective observational studies with a cohort study design were eligible. Evidence of association was graded according to established criteria as follows: convincing, highly suggestive, suggestive, weak, or not significant. RESULTS From 9954 publications, 222 full-text articles (2.2%) were evaluated for eligibility, and 45 meta-analyses (20.3%) that described 109 associations between dietary factors and CRC incidence were selected. Overall, 35 of the 109 associations (32.1%) were nominally statistically significant using random-effects meta-analysis models; 17 associations (15.6%) demonstrated large heterogeneity between studies (I 2 > 50%), whereas small-study effects were found for 11 associations (10.1%). Excess significance bias was not detected for any association between diet and CRC. The primary analysis identified 5 (4.6%) convincing, 2 (1.8%) highly suggestive, 10 (9.2%) suggestive, and 18 (16.5%) weak associations between diet and CRC, while there was no evidence for 74 (67.9%) associations. There was convincing evidence of an association of intake of red meat (high vs low) and alcohol (Ն4 drinks/d vs 0 or occasional drinks) with the incidence of CRC and an inverse association of higher vs lower intakes of dietary fiber, calcium, and yogurt with CRC risk. The evidence for convincing associations remained robust following sensitivity analyses. CONCLUSIONS AND RELEVANCE This umbrella review found convincing evidence of an association between lower CRC risk and higher intakes of dietary fiber, dietary calcium, and yogurt and lower intakes of alcohol and red meat. More research is needed on specific foods for which evidence remains suggestive, including other dairy products, whole grains, processed meat, and specific dietary patterns.
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.
Macro- and Micronutrients Consumption and the Risk for Colorectal Cancer among Jordanians
Nutrients, 2015
Objective: Diet and lifestyle have been reported to be important risk factors for the development of colorectal cancer (CRC). However, the association between total energy and nutrient intake and the risk of developing CRC has not been clearly explained. The aim of our study is to examine the relationship between total energy intake and other nutrients and the development of CRC in the Jordanian population. Research Methods and Procedures: Dietary data was collected from 169 subjects who were previously diagnosed with CRC, and 248 control subjects (matched by age, gender, occupation and marital
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
Nutritional risks and colorectal cancer in a Portuguese population
Nutrición hospitalaria
Food and nutrition as major causes of colorectal cancer (CRC) are still debatable. This cross-sectional study in a Portuguese population aimed to characterize and identify "high-risk" diets/life-styles and explore their associations with colorectal cancer. In 70 colorectal cancer patients and 70 sex, age-matched subjects without cancer history, we evaluated: diet history and detailed nutrient intake (DIET-PLAN5 2002, UK), alcohol (amount, type, years), smoking (number packages/year, years), physical activity, co-morbidities and body mass index. Age-adjusted Relative Risks were calculated, Proportional Hazards models adjusted the analysis for multiple risk factors. Smoking was a risk factor (1.90). Increased colorectal cancer risk regarding the lowest vs the highest intake quartile emerged for: vitamin B12 (3.41), cholesterol (3.15), total fat (2.87), saturated fat (1.98), animal protein (1.95), energy (1.85), alcohol (1.70), iron (1.49), refined carbohydrates (1.39). Reduc...