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Zhang J, Nyvang D, Ibsen DB, Olsen A, Tjønneland A, Overvad K, Dahm CC. Adherence to the Danish food-based dietary guidelines and risk of colorectal cancer: a cohort study. Br J Cancer 2021; 125:1726-1733. [PMID: 34593992 PMCID: PMC8651800 DOI: 10.1038/s41416-021-01556-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 08/12/2021] [Accepted: 09/17/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND National dietary guidelines contribute to primary prevention of a wide range of diseases. Yet, the importance of adhering to the Danish dietary guidelines for colorectal cancer prevention is unclear. METHODS We used the Danish Diet, Cancer and Health cohort (n = 55,744) to investigate adherence to the Danish dietary guidelines and the risk of colorectal cancer. Cox proportional hazard models were used to estimate hazard ratios (HRs) for colorectal cancer and subtypes across the Danish Dietary Guidelines Index score (ranging 0-6 points, 6 being the greatest adherence). Effect modification by BMI was explored on multiplicative and additive scales. RESULTS During a median follow-up of 18.9 years, 1030 men and 849 women developed colorectal cancer. Higher index scores were associated with a lower risk of colorectal cancer (HR 0.66; 95% confidence interval (CI) 0.53, 0.84, highest (≥5) versus lowest index score (<3 points) group). Similar inverse associations were observed between index scores and colon cancer. The risk difference was -0.8% (95% CI: -1.6, -0.1) among the overweight/obese group and 0.1% (95% CI: -0.7, 1.0) in the normal weight group for high compared to low adherence. CONCLUSION Adherence to the Danish Dietary Guidelines was associated with a lower risk of colorectal cancer, particularly among people with overweight/obesity.
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Affiliation(s)
- Jie Zhang
- grid.7048.b0000 0001 1956 2722Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Dorthe Nyvang
- grid.7048.b0000 0001 1956 2722Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Daniel B. Ibsen
- grid.7048.b0000 0001 1956 2722Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Anja Olsen
- grid.7048.b0000 0001 1956 2722Department of Public Health, Aarhus University, Aarhus, Denmark ,grid.417390.80000 0001 2175 6024Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anne Tjønneland
- grid.417390.80000 0001 2175 6024Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kim Overvad
- grid.7048.b0000 0001 1956 2722Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Christina C. Dahm
- grid.7048.b0000 0001 1956 2722Department of Public Health, Aarhus University, Aarhus, Denmark
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Jacobs I, Taljaard-Krugell C, Wicks M, Badham JM, Cubasch H, Joffe M, Laubscher R, Romieu I, Biessy C, Gunter MJ, Rinaldi S, Huybrechts I. Adherence to the South African food based dietary guidelines may reduce breast cancer risk in black South African women: the South African Breast Cancer (SABC) study. Public Health Nutr 2021; 25:1-17. [PMID: 34839846 PMCID: PMC9991845 DOI: 10.1017/s1368980021004675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/20/2021] [Accepted: 11/24/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine the level of adherence and to assess the association between higher adherence to the South African food based dietary guidelines (SAFBDG) and breast cancer risk. DESIGN Population-based, case-control study (the South African Breast Cancer study) matched on age and demographic settings. Validated questionnaires were used to collect dietary and epidemiological data. To assess adherence to the SAFBDG, a nine-point adherence score (out of eleven guidelines) was developed, using suggested adherence cut-points for scoring each recommendation (0 and 1). When the association between higher adherence to the SAFBDG and breast cancer risk was assessed, data-driven tertiles among controls were used as cut-points for scoring each recommendation (0, 0·5 and 1). OR and 95 % CI were estimated using multivariate logistic regression models. SETTING Soweto, South Africa. PARTICIPANTS Black urban women, 396 breast cancer cases and 396 controls. RESULTS After adjusting for potential confounders, higher adherence (>5·0) to the SAFBDG v. lower adherence (<3·5) was statistically significantly inversely associated with breast cancer risk overall (OR = 0·56, 95 % CI 0·38, 0·85), among postmenopausal women (OR = 0·64, 95 % CI 0·40, 0·97) as well as for oestrogen-positive breast cancers (OR = 0·51, 95 % CI 0·32, 0·89). Only 32·3 % of cases and 39·1 % of controls adhered to at least half (a score >4·5) of the SAFBDG. CONCLUSIONS Higher adherence to the SAFBDG may reduce breast cancer risk in this population. The concerning low levels of adherence to the SAFBDG emphasise the need for education campaigns and to create healthy food environments in South Africa to increase adherence to the SAFBDG.
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Affiliation(s)
- Inarie Jacobs
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, Potchefstroom2520, South Africa
| | - Christine Taljaard-Krugell
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, Potchefstroom2520, South Africa
| | - Mariaan Wicks
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, Potchefstroom2520, South Africa
| | | | - Herbert Cubasch
- Department of Surgery, Faculty of Health Sciences, University of Witwatersrand, Houghton, Johannesburg, South Africa
- Non-Communicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Parktown, Johannesburg, South Africa
| | - Maureen Joffe
- Non-Communicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Parktown, Johannesburg, South Africa
- MRC Developmental Pathways to Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Ria Laubscher
- Biostatistics Unit, South African Medical Research Council, Tygerberg, Cape Town, South Africa
| | - Isabelle Romieu
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
- Hubert Department of Global Health, Emory University, Atlanta, GA, USA
| | - Carine Biessy
- Nutrition and Metabolism Branch, International Agency for Research on Cancer – WHO, Albert Thomas, Lyon, France
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer – WHO, Albert Thomas, Lyon, France
| | - Sabina Rinaldi
- Nutrition and Metabolism Branch, International Agency for Research on Cancer – WHO, Albert Thomas, Lyon, France
| | - Inge Huybrechts
- Nutrition and Metabolism Branch, International Agency for Research on Cancer – WHO, Albert Thomas, Lyon, France
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Yatsuya H, Tsugane S. What constitutes healthiness of Washoku or Japanese diet? Eur J Clin Nutr 2021; 75:863-864. [PMID: 33603149 PMCID: PMC7890542 DOI: 10.1038/s41430-021-00872-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/12/2021] [Accepted: 01/26/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Hiroshi Yatsuya
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
| | - Shoichiro Tsugane
- Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, Japan
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