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Kuru-Yaşar R, Üstün-Aytekin Ö. The Crucial Roles of Diet, Microbiota, and Postbiotics in Colorectal Cancer. Curr Nutr Rep 2024; 13:126-151. [PMID: 38483752 PMCID: PMC11133122 DOI: 10.1007/s13668-024-00525-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE OF REVIEW Colorectal cancer is the second deadliest cancer in the world, and its prevalence has been increasing alarmingly in recent years. After researchers discovered the existence of dysbiosis in colorectal cancer, they considered the use of probiotics in the treatment of colorectal cancer. However, for various reasons, including the low safety profile of probiotics in susceptible and immunocompromised patient5s, and the risk of developing antibiotic resistance, researchers have shifted their focus to non-living cells, their components, and metabolites. This review aims to comprehensively evaluate the literature on the effects of diet, microbiota, and postbiotics on colorectal cancer and the future of postbiotics. RECENT FINDINGS The link between diet, gut microbiota, and colorectal cancer has been established primarily as a relationship rather than a cause-effect relationship. The gut microbiota can convert gastrointestinal tract and dietary factors into either onco-metabolites or tumor suppressor metabolites. There is serious dysbiosis in the microbiota in colorectal cancer. Postbiotics appear to be promising agents in the prevention and treatment of colorectal cancer. It has been shown that various postbiotics can selectively induce apoptosis in CRC, inhibit cell proliferation, growth, invasion, and migration, modulate the immune system, suppress carcinogenic signaling pathways, maintain intestinal epithelial integrity, and have a synergistic effect with chemotherapy drugs. However, it is also reported that some postbiotics are ineffective and may be risky in terms of safety profile in some patients. Many issues need to be researched about postbiotics. Large-scale, randomized, double-blind clinical studies are needed.
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Affiliation(s)
- Rüya Kuru-Yaşar
- Department of Nutrition and Dietetics, Hamidiye Faculty of Health Sciences, University of Health Sciences, 34668, Istanbul, Türkiye
| | - Özlem Üstün-Aytekin
- Department of Nutrition and Dietetics, Hamidiye Faculty of Health Sciences, University of Health Sciences, 34668, Istanbul, Türkiye.
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2
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Harborg S, Kjærgaard KA, Thomsen RW, Borgquist S, Cronin-Fenton D, Hjorth CF. New Horizons: Epidemiology of Obesity, Diabetes Mellitus, and Cancer Prognosis. J Clin Endocrinol Metab 2024; 109:924-935. [PMID: 37552777 DOI: 10.1210/clinem/dgad450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/30/2023] [Accepted: 07/31/2023] [Indexed: 08/10/2023]
Abstract
The global prevalence of obesity and diabetes mellitus has increased in parallel with increasing cancer incidence, due to environmental and lifestyle factors and population aging. Metabolic diseases are associated with increased cancer risk, so a growing number of patients with cancer have coexistent obesity and/or diabetes mellitus. In this narrative review, we highlight recent evidence on the clinical impact of obesity and diabetes mellitus on the prognosis of prostate, breast, and colorectal cancer, and provide an overview of the underlying mechanisms. There is evidence that obesity is associated with increased risk of recurrence, and all-cause and cancer-specific mortality among adults with prostate, breast, and colorectal cancer. Diabetes mellitus is associated with increased all-cause and cancer-specific mortality for these 3 cancers, beyond any impact of obesity. Evidence also suggests increased risk of colorectal cancer recurrence in patients with diabetes mellitus. The underlying mechanisms are multifactorial and likely include hormonal imbalances and chronic inflammation that promote cancer cell growth. Obesity and diabetes mellitus are associated with increased risk of complications and side effects of cancer treatment. Associated comorbidities such as impaired kidney function, cardiovascular disease, and neuropathies may preclude the use of guideline cancer treatment and are competing causes of death. Cancer patients with metabolic diseases require a designated clinical program and a multidisciplinary approach involving oncologists, endocrinologists, surgeons, nutritionists, and physiotherapists, to ensure coordinated and optimized patient care.
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Affiliation(s)
- Sixten Harborg
- Department of Oncology, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital, Aarhus University, 8200 Aarhus N, Denmark
| | - Kasper A Kjærgaard
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital, Aarhus University, 8200 Aarhus N, Denmark
| | - Reimar Wernich Thomsen
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital, Aarhus University, 8200 Aarhus N, Denmark
| | - Signe Borgquist
- Department of Oncology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Deirdre Cronin-Fenton
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital, Aarhus University, 8200 Aarhus N, Denmark
| | - Cathrine F Hjorth
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital, Aarhus University, 8200 Aarhus N, Denmark
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Schwärzler J, Mayr L, Grabherr F, Tilg H, Adolph TE. Epithelial metabolism as a rheostat for intestinal inflammation and malignancy. Trends Cell Biol 2024:S0962-8924(24)00004-7. [PMID: 38341347 DOI: 10.1016/j.tcb.2024.01.004] [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: 11/20/2023] [Revised: 01/06/2024] [Accepted: 01/12/2024] [Indexed: 02/12/2024]
Abstract
The gut epithelium protects the host from a potentially hostile environment while allowing nutrient uptake that is vital for the organism. To maintain this delicate task, the gut epithelium has evolved multilayered cellular functions ranging from mucus production to hormone release and orchestration of mucosal immunity. Here, we review the execution of intestinal epithelial metabolism in health and illustrate how perturbation of epithelial metabolism affects experimental gut inflammation and tumorigenesis. We also discuss the impact of environmental factors and host-microbe interactions on epithelial metabolism in the context of inflammatory bowel disease and colorectal cancer. Insights into epithelial metabolism hold promise to unravel mechanisms of organismal health that may be therapeutically exploited in humans in the future.
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Affiliation(s)
- Julian Schwärzler
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, and Metabolism, Medical University of Innsbruck, Innsbruck, Austria.
| | - Lisa Mayr
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, and Metabolism, Medical University of Innsbruck, Innsbruck, Austria
| | - Felix Grabherr
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, and Metabolism, Medical University of Innsbruck, Innsbruck, Austria
| | - Herbert Tilg
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, and Metabolism, Medical University of Innsbruck, Innsbruck, Austria
| | - Timon E Adolph
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, and Metabolism, Medical University of Innsbruck, Innsbruck, Austria.
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Barot S, Rantanen P, Nordenvall C, Lindforss U, Hallqvist Everhov Å, Larsson SC, Lindblom A, Liljegren A. Combined associations of a healthy lifestyle and body mass index with colorectal cancer recurrence and survival: a cohort study. Cancer Causes Control 2024; 35:367-376. [PMID: 37782382 PMCID: PMC10787671 DOI: 10.1007/s10552-023-01802-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 09/12/2023] [Indexed: 10/03/2023]
Abstract
PURPOSE Colorectal cancer (CRC) risk is associated with modifiable lifestyle factors including smoking, physical inactivity, Western diet, and excess body weight. The impact of lifestyle factors on survival is less known. A cohort study was conducted to investigate the combined effects of a healthy lifestyle and body mass index on prognosis following CRC diagnosis. METHODS Treatment and follow-up data were collected from the patient files of 1098 participants from the Colorectal cancer low-risk study cohort including stage I-III CRC patients. A healthy lifestyle and BMI (HL) score was computed using self-reported data on smoking status, physical activity, adherence to a Mediterranean diet pattern, and BMI, and divided into four categories ranging from least to most healthy. Survival analyses were performed to assess recurrence-free survival and overall survival across categories of exposure, using the Kaplan-Meier method and Cox proportional hazards models adjusted for age, sex, and educational level. RESULTS Among 1098 participants with stage I-III CRC, 233 (21.2%) had an HL score of 0-1 (least healthy), 354 (32.2%) HL score of 2, 357 (32.5%) HL score of 3 and 154 (14.0) HL score 4 (most healthy). Patients with the healthiest lifestyle (HL score 4) compared to the least healthy (HL score 0-1) had an improved recurrence-free survival (HL 4 vs HL 0-1, HRadj 0.51 (95% CI 0.31-0.83) and overall survival (HL 4 vs HL 0-1, HRadj 0.52 (95% CI 0.38-0.70). CONCLUSION Adherence to a healthy lifestyle may increase the recurrence-free and overall survival of patients with stage I-III CRC.
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Affiliation(s)
- Shabane Barot
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
- Department of Oncology, Södersjukhuset, 118 83, Stockholm, Sweden.
| | - Petri Rantanen
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Pelvic Cancer, GI Oncology and Colorectal Surgery Unit, Karolinska University Hospital, Stockholm, Sweden
| | - Caroline Nordenvall
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Pelvic Cancer, GI Oncology and Colorectal Surgery Unit, Karolinska University Hospital, Stockholm, Sweden
| | - Ulrik Lindforss
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Pelvic Cancer, GI Oncology and Colorectal Surgery Unit, Karolinska University Hospital, Stockholm, Sweden
| | - Åsa Hallqvist Everhov
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - Susanna C Larsson
- Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Annelie Liljegren
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Internal Medicine, Södersjukhuset, Stockholm, Sweden
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Spei ME, Bellos I, Samoli E, Benetou V. Post-Diagnosis Dietary Patterns among Cancer Survivors in Relation to All-Cause Mortality and Cancer-Specific Mortality: A Systematic Review and Meta-Analysis of Cohort Studies. Nutrients 2023; 15:3860. [PMID: 37686892 PMCID: PMC10490392 DOI: 10.3390/nu15173860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
The role of overall diet on longevity among cancer survivors (CS) needs further elucidation. We performed a systematic review of the literature and a meta-analysis of related cohort studies published up to October 2022 investigating post-diagnosis a priori (diet quality indices) and a posteriori (data-driven) dietary patterns (DPs) in relation to all-cause and cancer-specific mortality. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using random-effects meta-analyses comparing highest versus lowest categories of adherence to DPs. We assessed heterogeneity and risk of bias in the selected studies. A total of 19 cohort studies with 38,846 adult CS, some assessing various DPs, were included in the meta-analyses. Higher adherence to a priori DPs was associated with lower all-cause mortality by 22% (HR = 0.78, 95% CI: 0.73-0.83, I2 = 22.6%) among all CS, by 22% (HR = 0.78, 95% CI: 0.73-0.84, I2 = 0%) among breast CS and by 27% (HR = 0.73, 95% CI: 0.62-0.86, I2 = 41.4%) among colorectal CS. Higher adherence to a "prudent/healthy" DP was associated with lower all-cause mortality (HR = 0.79, 95% CI: 0.64-0.97 I2 = 49.3%), whereas higher adherence to a "western/unhealthy" DP was associated with increased all-cause mortality (HR = 1.48, 95% CI: 1.26-1.74, I2 = 0%) among all CS. Results for cancer-specific mortality were less clear. In conclusion, higher adherence to a "healthy" DP, either a priori or a posteriori, was inversely associated with all-cause mortality among CS. A "healthy" overall diet after cancer diagnosis could protect and promote longevity and well-being.
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Affiliation(s)
| | | | | | - Vassiliki Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 115 27 Athens, Greece; (M.-E.S.); (I.B.); (E.S.)
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Abd Rashid AA, Ashari LS, Shafiee NH, Raja Ali RA, Yeong Yeh L, Shahril MR, Jan Mohamed HJ. Dietary patterns associated with colorectal cancer risk in the Malaysian population: a case-control study with exploratory factor and regression analysis. BMC Public Health 2023; 23:1386. [PMID: 37468880 DOI: 10.1186/s12889-023-16283-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/10/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Studies on the relationship between diet and colorectal cancer (CRC) risk using single food or nutrient approach are widely conducted as opposed to dietary pattern approach. Therefore, this study aimed to determine the major dietary patterns and their association with CRC risk among Malaysians. METHODS Patients aged between 18 and 80 years old from two teaching hospitals in Peninsular Malaysia were recruited through purposive sampling. Socio-demographic information and anthropometry data were assessed before the colonoscopy procedure, and dietary intake was also recorded using a validated semi-quantitative food frequency questionnaire (FFQ). Cases were those patients having histopathologically proven CRC, while controls were those without. RESULTS Four major dietary patterns were identified: the allergenic diet, plant-based diet, processed diet, and energy-dense diet pattern. After adjusting for potential covariates, the processed diet pattern was consistently associated with CRC (OR = 3.45; 95% CI = 1.25-9.52; P = 0.017) while the plant-based diet, energy-dense diet, and allergenic diet were not associated with CRC risk. CONCLUSIONS The processed diet pattern attributed to a diet high in confectionaries and fast foods was associated with an increased risk of CRC in the Malaysian population. In order to give prevention measures through lifestyle change, more research could be done on the effect of food patterns on faecal microbiota associated with CRC.
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Grants
- 203/PPSK/6720021, LRGS/MRUN/FI/02/2018/01, and LR001-2019 Long-Term Research Grant Scheme (LRGS)-Malaysia Research University Network (MRUN)
- 203/PPSK/6720021, LRGS/MRUN/FI/02/2018/01, and LR001-2019 Long-Term Research Grant Scheme (LRGS)-Malaysia Research University Network (MRUN)
- 203/PPSK/6720021, LRGS/MRUN/FI/02/2018/01, and LR001-2019 Long-Term Research Grant Scheme (LRGS)-Malaysia Research University Network (MRUN)
- 203/PPSK/6720021, LRGS/MRUN/FI/02/2018/01, and LR001-2019 Long-Term Research Grant Scheme (LRGS)-Malaysia Research University Network (MRUN)
- 203/PPSK/6720021, LRGS/MRUN/FI/02/2018/01, and LR001-2019 Long-Term Research Grant Scheme (LRGS)-Malaysia Research University Network (MRUN)
- 203/PPSK/6720021, LRGS/MRUN/FI/02/2018/01, and LR001-2019 Long-Term Research Grant Scheme (LRGS)-Malaysia Research University Network (MRUN)
- 203/PPSK/6720021, LRGS/MRUN/FI/02/2018/01, and LR001-2019 Long-Term Research Grant Scheme (LRGS)-Malaysia Research University Network (MRUN)
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Affiliation(s)
- Ainaa Almardhiyah Abd Rashid
- Nutrition Programme, School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia
| | - Lydiatul Shima Ashari
- Nutrition Programme, School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia
| | - Nor Hamizah Shafiee
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Cheras, 56000, Malaysia
| | - Raja Affendi Raja Ali
- Gut Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Cheras, 56000, Malaysia
- School of Medical and Life Sciences, Sunway University, Jalan Universiti, Bandar Sunway, Selangor, 47500, Malaysia
| | - Lee Yeong Yeh
- Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Jalan Raja Perempuan Zainab 2, Kubang Kerian, Kelantan, 16150, Malaysia
- GI Function & Motility Unit, Hospital USM, Jalan Raja Perempuan Zainab 2, Kubang Kerian, Kelantan, 16150, Malaysia
| | - Mohd Razif Shahril
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Hamid Jan Jan Mohamed
- Nutrition Programme, School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia.
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Trauchburg A, Schwingshackl L, Hoffmann G. Association between Dietary Indices and Dietary Patterns and Mortality and Cancer Recurrence among Cancer Survivors: An Updated Systematic Review and Meta-Analysis of Cohort Studies. Nutrients 2023; 15:3151. [PMID: 37513568 PMCID: PMC10385219 DOI: 10.3390/nu15143151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
The number of cancer survivors is growing rapidly; however, specific lifestyle recommendations for these patients are still sparse, including dietary approaches. Thus, the aim of the present systematic review and meta-analysis was to examine the associations between adherence to diet-quality indices and dietary patterns on overall mortality, cancer-specific mortality, and cancer recurrence among cancer survivors. The literature search was conducted in PubMed and Web of Science between 18 May 2016 and 22 May 2022 with no language restrictions. Thirty-nine studies were included for quantitative analysis, providing data from 77,412 participants. Adherence to both diet-quality indices and a healthy/prudent dietary pattern was inversely associated with overall mortality (RR, 0.81; 95% CI, 0.77-0.86; RR, 0.80; 95% CI, 0.70-0.92, respectively) and with cancer-specific mortality (RR, 0.86; 95% CI, 0.79-0.94; RR, 0.79; 95% CI, 0.64-0.97, respectively). These associations could be observed following assessment of dietary patterns either pre- and/or postdiagnosis. For unhealthy/western dietary patterns, high adherence was associated with overall mortality (RR, 1.26; 95% CI, 1.08-1.47). Although the certainty of evidence was rated as low, we conclude that there are no reservations against high adherence to healthy dietary patterns or indices in cancer survivors.
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Affiliation(s)
- Angela Trauchburg
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Josef-Holaubek-Platz 2, UZA II, 1090 Vienna, Austria
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Medical Center, Faculty of Medicine, University of Freiburg, Breisacher Straße 153, 79110 Freiburg, Germany
| | - Georg Hoffmann
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Josef-Holaubek-Platz 2, UZA II, 1090 Vienna, Austria
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Rogers CJ, Petersen K, Kris-Etherton PM. Preventive Nutrition: Heart Disease and Cancer. Med Clin North Am 2022; 106:767-784. [PMID: 36154699 DOI: 10.1016/j.mcna.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Two of the leading chronic diseases are cardiovascular disease (CVD) and cancer. A cornerstone of prevention for CVD and cancer is a healthy dietary pattern throughout the lifespan. Dietary patterns represent the totality of the diet and reflect habitual consumption of combinations and quantities of foods and nutrients that cumulatively affect health and disease. This article summarizes recent evidence on the relationship of diet quality as measured by adherence to healthy dietary patterns and CVD and cancer risk reduction. Optimal adherence to a healthy dietary pattern decreases CVD and cancer risk; even small changes in diet quality are beneficial.
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Affiliation(s)
- Connie J Rogers
- Department of Nutritional Sciences, University of Georgia, 280 Dawson Hall, Athens, GA 30602, USA
| | - Kristina Petersen
- Department of Nutritional Sciences, Texas Tech University, 508 Human Sciences Building, Lubbock, TX 79409 USA
| | - Penny M Kris-Etherton
- Department of Nutritional Sciences, The Pennsylvania State University, 319 Chandlee Lab, University Park, PA 16802 USA.
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Association between Dietary Fiber Intake and Mortality among Colorectal Cancer Survivors: Results from the Newfoundland Familial Colorectal Cancer Cohort Study and a Meta-Analysis of Prospective Studies. Cancers (Basel) 2022; 14:cancers14153801. [PMID: 35954465 PMCID: PMC9367345 DOI: 10.3390/cancers14153801] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/24/2022] [Accepted: 07/27/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary High dietary fiber intake has been linked to a lower risk of Colorectal cancer (CRC), but the role of dietary fiber in CRC survival is understudied. We examined dietary fiber intake for its relevance to CRC survival in a cohort of 504 CRC patients and a meta-analysis including results from four prospective cohort studies. We found that high dietary fiber intake was negatively correlated with all-cause mortality and CRC-specific mortality among CRC survivors. These new findings support the protective effect of dietary fiber on CRC survival. By enhancing fiber intake, this research may contribute to the development of novel therapies that add to our armamentarium for CRC. Abstract We examined dietary fiber intake for its relevance to Colorectal cancer (CRC) survival in a cohort of CRC patients and a meta-analysis including results from four prospective cohort studies. We analyzed 504 CRC patients enrolled in the Newfoundland Familial Colorectal Cancer Study (NFCCS) who were newly diagnosed with CRC between 1999 and 2003. Follow-up for deaths was through April 2010. All participants completed a self-administered food frequency questionnaire to evaluate their dietary intakes one year before diagnosis. Multivariable Cox proportional hazard models were used to explore the associations of dietary fiber intake with all-cause mortality and CRC-specific mortality. In the meta-analysis, we identified prospective cohort studies published between January 1991 and December 2021 by searching PubMed, EMBASE, and Cochrane Library. Fixed-effects or random-effects models were used to combine the study-specific hazard ratio (HR) from our original analysis and three other cohorts. In the NFCCS, we found that CRC patients with the second quartile of dietary fiber intake had a 42% lower risk of all-cause mortality (HR: 0.58, 95% CI: 0.35–0.98) and 58% lower risk of CRC-specific mortality (HR: 0.42, 95% CI: 0.21–0.87) compared with those with the lowest quartile. In the meta-analysis, a similar inverse association between dietary fiber and total mortality was detected among CRC patients; each 10 g/day increase in dietary fiber intake was associated with a 16% decreased risk of total mortality. The dose–response meta-analysis showed a linear relationship between dietary fiber intake and all-cause mortality, with no sign of a plateau. For CRC-specific mortality, intriguingly, the benefit associated with increasing dietary fiber intake achieved its maximum at approximately 22 g/day, and no further reduction in CRC-specific mortality was observed beyond this intake level. Our results suggest that high dietary fiber intake may be associated with prolonged survival among CRC patients. Our findings add to the sparse literature on the role of dietary fiber in CRC survival.
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Prediagnostic consumption of vitamin D, calcium and dairy products and colorectal cancer survival: results from the Newfoundland Colorectal Cancer Registry Cohort Study. Br J Nutr 2022; 128:290-299. [PMID: 34435555 DOI: 10.1017/s0007114521003299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Vitamin D, Ca and dairy products are negatively associated with colorectal cancer (CRC) incidence, but little is known of their influence on CRC survival. To investigate prediagnostic intakes of vitamin D, Ca and dairy products for their relevance to CRC prognosis, we analysed 504 CRC patients enrolled in the Newfoundland Colorectal Cancer Registry Cohort Study who were diagnosed for the first time with CRC between 1999 and 2003. Follow-up for mortality and cancer recurrence was through April 2010. Data on diet and lifestyle factors were gathered via a validated, semi-quantitative FFQ and a Personal History Questionnaire. Multivariate Cox models estimated hazard ratios (HR) and 95 % CI for the relationship of prediagnostic intakes of vitamin D, Ca and dairy products with all-cause mortality (overall survival, OS) and disease-free survival (DFS) among CRC patients. We found that prediagnostic Ca intake from foods, but not total Ca intake, was negatively associated with all-cause mortality (HR for Q2 v. Q1, 0·44; 95 % CI, 0·26, 0·75). An inverse relationship was also seen in a dose-response fashion for prediagnostic cheese intake (HR for Q4 v. Q1, 0·57, 95 % CI, 0·34, 0·95, Ptrend = 0·029). No evidence for modification by sex, physical activity, alcohol drinking and cigarette smoking was observed. In summary, high prediagnostic intakes of cheese and Ca from foods may be associated with increased survival among CRC patients. By manipulating diet, this study may contribute to the development of novel therapies that add to the armamentarium against CRC. Replication studies are required before any nutritional interventions are made available.
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Greathouse KL, Wyatt M, Johnson AJ, Toy EP, Khan JM, Dunn K, Clegg DJ, Reddy S. Diet-microbiome interactions in cancer treatment: Opportunities and challenges for precision nutrition in cancer. Neoplasia 2022; 29:100800. [PMID: 35500546 PMCID: PMC9065883 DOI: 10.1016/j.neo.2022.100800] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 11/23/2022]
Abstract
Dietary patterns contribute to cancer risk. Separately, microbial factors influence the development of several cancers. However, the interaction of diet and the microbiome and their joint contribution to cancer treatment response needs more research. The microbiome significantly impacts drug metabolism, immune activation, and response to immunotherapy. One of the critical factors affecting the microbiome structure and function is diet. Data demonstrate that the diet and microbiome composition affects the immune response. Moreover, malnutrition is a significant confounder to cancer therapy response. There is little understanding of the interaction of malnutrition with the microbiome in the context of cancer. This review aims to address the current knowledge of dietary intake patterns and malnutrition among cancer patients and the impact on treatment outcomes. Second, this review will provide evidence linking the microbiome to cancer treatment response and provide evidence of the potentially strong effect that diet could have on this interaction. This review will formulate critical questions that will need further research to understand the diet-microbiome relationship in cancer treatment response and directions for future research to guide us to precision nutrition therapy to improve cancer outcomes.
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Holowatyj AN, Ose J, Gigic B, Lin T, Ulvik A, Geijsen AJMR, Brezina S, Kiblawi R, van Roekel EH, Baierl A, Böhm J, Bours MJL, Brenner H, Breukink SO, Chang-Claude J, de Wilt JHW, Grady WM, Grünberger T, Gumpenberger T, Herpel E, Hoffmeister M, Keulen ETP, Kok DE, Koole JL, Kosma K, Kouwenhoven EA, Kvalheim G, Li CI, Schirmacher P, Schrotz-King P, Singer MC, van Duijnhoven FJB, van Halteren HK, Vickers K, Vogelaar FJ, Warby CA, Wesselink E, Ueland PM, Ulrich AB, Schneider M, Habermann N, Kampman E, Weijenberg MP, Gsur A, Ulrich CM. Higher vitamin B6 status is associated with improved survival among patients with stage I-III colorectal cancer. Am J Clin Nutr 2022; 116:303-313. [PMID: 35394006 PMCID: PMC9348990 DOI: 10.1093/ajcn/nqac090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 04/04/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Folate-mediated 1-carbon metabolism requires several nutrients, including vitamin B6. Circulating biomarker concentrations indicating high vitamin B6 status are associated with a reduced risk of colorectal cancer (CRC). However, little is known about the effect of B6 status in relation to clinical outcomes in CRC patients. OBJECTIVES We investigated survival outcomes in relation to vitamin B6 status in prospectively followed CRC patients. METHODS A total of 2031 patients with stage I-III CRC participated in 6 prospective patient cohorts in the international FOCUS (folate-dependent 1-carbon metabolism in colorectal cancer recurrence and survival) Consortium. Preoperative blood samples were used to measure vitamin B6 status by the direct marker pyridoxal 5'-phosphate (PLP), as well as the functional marker HK-ratio (HKr)[3'-hydroxykynurenine: (kynurenic acid + xanthurenic acid + 3'-hydroxy anthranilic acid + anthranilic acid)]. Using Cox proportional hazards regression, we examined associations of vitamin B6 status with overall survival (OS), disease-free survival (DFS), and risk of recurrence, adjusted for patient age, sex, circulating creatinine concentrations, tumor site, stage, and cohort. RESULTS After a median follow-up of 3.2 y for OS, higher preoperative vitamin B6 status as assessed by PLP and the functional marker HKr was associated with 16-32% higher all-cause and disease-free survival, although there was no significant association with disease recurrence (doubling in PLP concentration: HROS, 0.68; 95% CI: 0.59, 0.79; HRDFS, 0.84; 95% CI: 0.75, 0.94; HRRecurrence, 0.96; 95% CI: 0.84, 1.09; HKr: HROS, 2.04; 95% CI: 1.67, 2.49; HRDFS, 1.56; 95% CI: 1.31, 1.85; HRRecurrence, 1.21; 95% CI: 0.96,1. 52). The association of PLP with improved OS was consistent across colorectal tumor site (right-sided colon: HROS, 0.75; 95% CI: 0.59, 0.96; left-sided colon: HROS, 0.71; 95% CI: 0.55, 0.92; rectosigmoid junction and rectum: HROS, 0.61; 95% CI: 0.47, 0.78). CONCLUSION Higher preoperative vitamin B6 status is associated with improved OS among stage I-III CRC patients.
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Affiliation(s)
- Andreana N Holowatyj
- Huntsman Cancer Institute, Salt Lake City, Utah, USA,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA,Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jennifer Ose
- Huntsman Cancer Institute, Salt Lake City, Utah, USA,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Biljana Gigic
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Germany
| | - Tengda Lin
- Huntsman Cancer Institute, Salt Lake City, Utah, USA,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | | | - Anne J M R Geijsen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Stefanie Brezina
- Institute of Cancer Research, Department of Medicine I, Medical University of Vienna, Austria
| | - Rama Kiblawi
- Huntsman Cancer Institute, Salt Lake City, Utah, USA,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA,Medical Faculty, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Eline H van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, The Netherlands
| | - Andreas Baierl
- Department of Statistics and Operations Research, University of Vienna, Austria
| | - Jürgen Böhm
- Huntsman Cancer Institute, Salt Lake City, Utah, USA,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Martijn J L Bours
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, The Netherlands
| | - Hermann Brenner
- Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany,Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Stéphanie O Breukink
- Department of Surgery, GROW School for Oncology and Development Biology, Maastricht University, The Netherlands
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg Germany
| | - Johannes H W de Wilt
- Department of Surgery, Division of Surgical Oncology and Gastrointestinal Surgery, Radboud University Medical Center, The Netherlands
| | - William M Grady
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | | | - Tanja Gumpenberger
- Institute of Cancer Research, Department of Medicine I, Medical University of Vienna, Austria
| | - Esther Herpel
- Institute of Pathology, University of Heidelberg, Germany
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Eric T P Keulen
- Department of Internal Medicine and Gastroenterology, Zuyderland Medical Center, Sittard, The Netherlands
| | - Dieuwertje E Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Janna L Koole
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, The Netherlands
| | - Katharina Kosma
- Department of Surgery, Kaiser Franz Josef Hospital, Vienna, Austria
| | | | | | - Christopher I Li
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | | | - Petra Schrotz-King
- Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany
| | - Marie C Singer
- Department of Surgery, Kaiser Franz Josef Hospital, Vienna, Austria
| | | | - Henk K van Halteren
- Department of Internal Medicine, Admiraal de Ruyter Hospital, Goes, The Netherlands
| | - Kathy Vickers
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - F Jeroen Vogelaar
- Department of Surgery, VieCuri Medical Center, Venlo, The Netherlands
| | - Christy A Warby
- Huntsman Cancer Institute, Salt Lake City, Utah, USA,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Evertine Wesselink
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | | | - Alexis B Ulrich
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Germany
| | - Martin Schneider
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Germany
| | - Nina Habermann
- Genome Biology, European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Matty P Weijenberg
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, The Netherlands
| | - Andrea Gsur
- Institute of Cancer Research, Department of Medicine I, Medical University of Vienna, Austria
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Ranasinghe R, Mathai M, Zulli A. A synopsis of modern - day colorectal cancer: Where we stand. Biochim Biophys Acta Rev Cancer 2022; 1877:188699. [DOI: 10.1016/j.bbcan.2022.188699] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/30/2022] [Accepted: 02/14/2022] [Indexed: 02/07/2023]
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14
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Castro-Espin C, Agudo A. The Role of Diet in Prognosis among Cancer Survivors: A Systematic Review and Meta-Analysis of Dietary Patterns and Diet Interventions. Nutrients 2022; 14:nu14020348. [PMID: 35057525 PMCID: PMC8779048 DOI: 10.3390/nu14020348] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/11/2022] [Accepted: 01/11/2022] [Indexed: 02/06/2023] Open
Abstract
Cancer survival continues to improve in high-income countries, partly explained by advances in screening and treatment. Previous studies have mainly examined the relationship between individual dietary components and cancer prognosis in tumours with good therapeutic response (breast, colon and prostate cancers). The aim of this review is to assess qualitatively (and quantitatively where appropriate) the associations of dietary patterns and cancer prognosis from published prospective cohort studies, as well as the effect of diet interventions by means of randomised controlled trials (RCT). A systematic search was conducted in PubMed, and a total of 35 prospective cohort studies and 14 RCT published between 2011 and 2021 were selected. Better overall diet quality was associated with improved survival among breast and colorectal cancer survivors; adherence to the Mediterranean diet was associated to lower risk of mortality in colorectal and prostate cancer survivors. A meta-analysis using a random-effects model showed that higher versus lower diet quality was associated with a 23% reduction in overall mortality in breast cancer survivors. There was evidence that dietary interventions, generally combined with physical activity, improved overall quality of life, though most studies were in breast cancer survivors. Further cohort and intervention studies in other cancers are needed to make more specific recommendations.
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Affiliation(s)
- Carlota Castro-Espin
- Unit of Nutrition and Cancer, Catalan Institute of Oncology—ICO, L’Hospitalet de Llobregat, 08908 Barcelona, Spain;
- Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute—IDIBELL, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology—ICO, L’Hospitalet de Llobregat, 08908 Barcelona, Spain;
- Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute—IDIBELL, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-2607401
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15
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Chen WC, Wang TH, Yuan D, Zhao JC. Multiple Splenic Artery Aneurysms: A Case Report and Review of the Literature. Front Surg 2022; 8:763890. [PMID: 35071310 PMCID: PMC8767448 DOI: 10.3389/fsurg.2021.763890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Multiple splenic artery aneurysms (MSAAs) are rare and there are few reports about their treatment. We herein present a rare case of MSAAs treated with splenectomy combined with endovascular embolization.Methods: A 51-year-old female patient was incidentally diagnosed with MSAAs. Splenectomy combined with endovascular embolization was the chosen treatment.Outcomes: The patient recovered uneventfully and was discharged from the hospital 5 days after splenectomy. The patient has been doing well during the 27-months of follow-up.Conclusion: Combined with the experience of the previous literature, we think splenectomy combined with endovascular embolization is a safe, reliable and minimally invasive treatment for some selected multiple SAAs, depending on several patient parameters, such as the age, sex, aneurysm dimension, aneurysm location, complications, and severity of the clinical findings.
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16
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Association between pre-diagnostic dietary pattern and survival of ovarian cancer: Evidence from a prospective cohort study. Clin Nutr 2021; 41:452-459. [PMID: 35007814 DOI: 10.1016/j.clnu.2021.12.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/19/2021] [Accepted: 12/22/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Evidence for a role of single nutrition or foods on ovarian cancer (OC) survival has been limited and inconclusive. Due to the potentially complex interactions in dietary, we applied dietary patterns to this study to firstly explore the relationship between the pre-diagnosis overall diet and OC survival. METHODS The prospective cohort study was conducted among 853 OC patients aged 18-79 years during 2015-2020. Dietary intake was collected using a validated 111-item food frequency questionnaire. Deaths were obtained by medical records and cancer registry up to March 31, 2021. Cox proportional hazards regression models was used to evaluate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of pre-diagnosis dietary patterns with overall survival (OS). RESULTS Overall, during the follow-up period (median: 37.57 months, interquartile: 25.00-50.17 months), 130 (18.49%) OC patients died. Four dietary patterns were identified: healthy pattern, ethnic pattern, animal foods pattern, and sweet pattern. The highest tertile of the healthy pattern scores was related to better OS compared with the lowest tertile scores (HR = 0.54, 95% CI = 0.30-0.98, p trend <0.05), whereas OC patients with highest adherence to the animal foods pattern was associated with worse OS than those with the lowest adherence (HR = 1.90, 95% CI = 1.14-3.17, p trend <0.05). We found no significant associations between adherence to ethnic pattern and sweet pattern and OS of OC patients. CONCLUSION Pre-diagnosis healthy patterns was associated with better OC survival, whereas animal pattern was associated with worse survival among OC survivals.
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17
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Thordardottir GS, Einarsdottir K, Thordardottir M, Tryggvadottir L, Valdimarsdottir UA, Gudnason V, Steingrimsdottir L, Aspelund T, Birgisdottir BE, Torfadottir JE. Dietary patterns in adolescence and risk of colorectal cancer: a population-based study. Cancer Causes Control 2021; 33:205-211. [PMID: 34800195 DOI: 10.1007/s10552-021-01524-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 11/08/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE To study whether dietary patterns in adolescence are associated with risk of colorectal cancer (CRC). METHODS Food frequency data were obtained from the AGES-Reykjavik study, conducted between 2002 and 2006, which included 5,078 (58% women) participants with mean age of 77 (± 5.8) years. Principal component analysis was used to identify dietary patterns. Participants were followed through linkage to the Icelandic Cancer Registry. Multivariable Cox models were used to calculate hazard ratios (HR) of CRC and 95% confidence interval (CI) by dietary patterns. RESULTS During the follow-up period (mean 8.2 years), 136 participants (75 women and 61 men) were diagnosed with CRC. The main dietary pattern in adolescence was characterized by high intake of traditional food items consumed in the earlier half of the twentieth century, namely, salted or smoked meat and fish, milk, offal, rye bread, and oatmeal. Compared to the lowest tertile, the middle tertile of this pattern was associated with increased risk of CRC (HR 1.63, 95% CI 1.04-2.57), while the highest tertile was not statistically associated with CRC (HR 1.48, 95% CI 0.93-2.37), except among women (HR 2.06, 95% CI 1.11-3.84). CONCLUSION These data suggest that strong adherence to a traditional Icelandic diet in adolescence might increase the risk of CRC, particularly among women. More research is need on the association between food items and dietary patterns of relevance to CRC at different points in the life cycle.
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Affiliation(s)
- Guðny Sjofn Thordardottir
- Unit for Nutrition Research, Landspitali The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Kristjana Einarsdottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | - Laufey Tryggvadottir
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,The Icelandic Cancer Registry, Reykjavik, Iceland
| | - Unnur A Valdimarsdottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Vilmundur Gudnason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,The Icelandic Heart Association, Kopavogur, Iceland
| | - Laufey Steingrimsdottir
- Unit for Nutrition Research, Landspitali The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Thor Aspelund
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,The Icelandic Heart Association, Kopavogur, Iceland
| | - Bryndis Eva Birgisdottir
- Unit for Nutrition Research, Landspitali The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Johanna E Torfadottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland. .,The Icelandic Cancer Registry, Reykjavik, Iceland.
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18
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Stewart KL, Gigic B, Himbert C, Warby CA, Ose J, Lin T, Schrotz-King P, Boehm J, Jordan KC, Metos J, Schneider M, Figueiredo JC, Li CI, Shibata D, Siegel E, Toriola AT, Hardikar S, Ulrich CM. Association of Sugar Intake with Inflammation- and Angiogenesis-Related Biomarkers in Newly Diagnosed Colorectal Cancer Patients. Nutr Cancer 2021; 74:1636-1643. [PMID: 34369225 DOI: 10.1080/01635581.2021.1957133] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Evidence suggests a positive association between sugar intake and colorectal cancer (CRC) outcomes. We sought to investigate inflammation and angiogenesis as underlying mechanisms behind increased sugar intake and worse CRC outcomes. Pre-surgery serum samples were obtained from 191 patients diagnosed with primary invasive stage I-IV CRC. Biomarkers of inflammation (CRP, SAA, IL-6, IL-8, MCP-1, TNFα) and angiogenesis (VEGFA, VEGFD, sICAM-1 and sVCAM-1) were analyzed (Meso-Scale-Discovery). Fructose, glucose, sucrose, and total sugar intake (calories/day, % total calories) were assessed by FFQ. Pearson's correlation and multiple linear regression analyses were performed. Patients were on average 64 years old, 64% were male, the majority was diagnosed with stage II-III (58%) cancers, and 67% were either overweight or obese. Among normal-weight individuals (BMI <25 kg/m2), we observed a significant inverse association between VEGFD and any type of sugar intake in cal/day (sucrose: p = 0.01, glucose and fructose: p < 0.001) and MCP-1 and fructose intake (p = 0.05). The magnitude of reduction in VEGF ranged between -1.24 for sucrose to 4.49 for glucose intake, and -2.64 for fructose intake for MCP-1 levels. Sugar intake was associated with some inflammation or angiogenesis biomarkers, among CRC patients; differences were observed by adiposity that warrant further investigation.Supplemental data for this article is available online at at 10.1080/01635581.2021.1957133.
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Affiliation(s)
- Kelly L Stewart
- Department of Nutrition and Integrated Physiology, University of Utah, Salt Lake City, United States
| | - Biljana Gigic
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Caroline Himbert
- Huntsman Cancer Institute, Population Sciences, Salt Lake City, Utah.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Christy A Warby
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Jennifer Ose
- Huntsman Cancer Institute, Population Sciences, Salt Lake City, Utah.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Tengda Lin
- Huntsman Cancer Institute, Population Sciences, Salt Lake City, Utah.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Petra Schrotz-King
- Division of Preventive Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jürgen Boehm
- Huntsman Cancer Institute, Population Sciences, Salt Lake City, Utah.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Kristine C Jordan
- Department of Nutrition and Integrated Physiology, University of Utah, Salt Lake City, United States
| | - Julie Metos
- Department of Nutrition and Integrated Physiology, University of Utah, Salt Lake City, United States
| | - Martin Schneider
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Christopher I Li
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - David Shibata
- The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Erin Siegel
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | | | - Sheetal Hardikar
- Huntsman Cancer Institute, Population Sciences, Salt Lake City, Utah.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah.,Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Cornelia M Ulrich
- Huntsman Cancer Institute, Population Sciences, Salt Lake City, Utah.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
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19
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Ratjen I, Enderle J, Burmeister G, Koch M, Nöthlings U, Hampe J, Lieb W. Post-diagnostic reliance on plant-compared with animal-based foods and all-cause mortality in omnivorous long-term colorectal cancer survivors. Am J Clin Nutr 2021; 114:441-449. [PMID: 33964858 PMCID: PMC8326049 DOI: 10.1093/ajcn/nqab061] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/16/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Plant-rich diets are associated with lower cardiometabolic risks and longer survival in the general population, but their association with mortality in cancer survivors is still unclear. OBJECTIVES We aimed to examine the associations of 3 postdiagnostic plant-based diet indices with all-cause mortality in omnivorous long-term colorectal cancer (CRC) survivors. METHODS Diet was assessed with FFQs at a median of 6 years after diagnosis in 1404 CRC survivors (56% male; median age, 69 years) in a Northern German prospective cohort study. An overall, a healthful plant-based, and an unhealthful plant-based diet index were derived by scoring intakes of animal foods reversely and intakes of healthy (whole grains, vegetables, fruits, legumes, nuts, oils, tea/coffee) and less healthy plant foods (refined grains, fruit juices, sugar-sweetened beverages, potatoes, sweets/desserts) positively or reversely, depending on the index. Vital status follow-up was conducted via population registries. Cox proportional hazards regression was applied to estimate HRs for all-cause mortality according to plant-based diet adherence. RESULTS Within 7 years (median) after diet assessment, 204 deaths occurred. The overall plant-based diet index displayed a significant, inverse association with all-cause mortality (HR per 10-point increase in diet index, 0.72; 95% CI, 0.57-0.91). Although not statistically significant, higher healthful plant-based diet scores showed a strong tendency towards lower mortality (HR, 0.82; 95% CI, 0.67-1.01). The unhealthful plant-based diet index was associated with higher mortality, but lost statistical significance after multivariable adjustment (HR, 1.19; 95% CI, 0.96-1.48). A subgroup analysis revealed that the tendency towards a positive association of the unhealthful plant-based diet with mortality was restricted to less physically active individuals (<95 metabolic equivalent of task hours/week). CONCLUSIONS An overall plant-based diet was inversely associated with all-cause mortality in long-term CRC survivors. However, more research is needed to further disentangle the impacts of different qualities of plant-based diets on cancer survivors' health.
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Affiliation(s)
| | - Janna Enderle
- Institute of Epidemiology, University Hospital Schleswig-Holstein, University of Kiel, Kiel, Germany
| | - Greta Burmeister
- Department of General, Visceral, Vascular, and Transplantation Surgery, University Hospital Rostock, Rostock, Germany
| | - Manja Koch
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ute Nöthlings
- Nutritional Epidemiology, Department of Nutrition and Food Science, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - Jochen Hampe
- Medical Department 1, University Hospital Dresden, Technical University Dresden, Dresden, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology, University Hospital Schleswig-Holstein, University of Kiel, Kiel, Germany
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20
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Chen J, Zheng Y, Wang H, Zhang D, Zhao L, Yu D, Lin Z, Zhang T. Cause of death among patients with colorectal cancer: a population-based study in the United States. Aging (Albany NY) 2020; 12:22927-22948. [PMID: 33289707 PMCID: PMC7746372 DOI: 10.18632/aging.104022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/19/2020] [Indexed: 12/20/2022]
Abstract
CRC (Colorectal cancer) is one of the most common causes of death worldwide and in the US (United States). In this study, we aim to perform a population-based analysis on the cause of death among patients with CRC in the US. A total of 834,510 CRC patients diagnosed between 1975 and 2016 in the US were selected from the SEER (Surveillance, Epidemiology, and End Results) program. Causes of death among CRC patients were characterized and SMRs (standardized mortality ratios) of death from non-cancer causes were calculated. Among all CRC patients included in this study, a total of 531,507 deaths were recorded, of which 51.3% were due to CRC, 10.3% were due to other cancers, and 38.4% were due to non-cancer causes. Recently, there has been a relative decrease in index-cancer deaths and an increase in non-cancer causes among CRC patients. The mortality risk from non-cancer rises with accumulating age and longer follow-up time. Cardiovascular diseases are the most prevalent non-cancer causes, accounting for 20.3% of all deaths among CRC patients. Compared with the general population, the mortality rate of non-cancer deaths among CRC patients is doubled (SMR, 2.02; 95% confidence interval, 2.01-2.03).
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Affiliation(s)
- Jiayuan Chen
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yongqiang Zheng
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Sun Yat-Sen University, Guangzhou 510060, China
| | - Haihong Wang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Dejun Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Lei Zhao
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Dandan Yu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Zhenyu Lin
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Tao Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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Hoang T, Kim H, Kim J. Dietary Intake in Association with All-Cause Mortality and Colorectal Cancer Mortality among Colorectal Cancer Survivors: A Systematic Review and Meta-Analysis of Prospective Studies. Cancers (Basel) 2020; 12:cancers12113391. [PMID: 33207660 PMCID: PMC7697273 DOI: 10.3390/cancers12113391] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/11/2020] [Accepted: 11/13/2020] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Given that an extensive range of dietary factors has not been investigated among colorectal cancer (CRC) survivors to date, we carried out a systematic review and meta-analysis to determine the effects of both prediagnostic and postdiagnostic dietary intake on all-cause mortality and CRC-specific mortality among CRC survivors. In total, 45 studies were included in the final analysis of 35 food items, 8 macronutrients, 27 micronutrients, 2 dietary patterns, and 13 dietary indexes in association with all-cause mortality and CRC-specific mortality. We found that an unhealthy dietary pattern increased the risks of both all-cause mortality and CRC-specific mortality. The role of prediagnostic and postdiagnostic intake such as macronutrients and fatty acids could be different in the risk of all-cause mortality. Overall, comprehensive evidence for the effect of substantial numbers of prediagnostic and postdiagnostic dietary items on mortality outcomes is reported in this study. Abstract We carried out a systematic review and meta-analysis to determine the effects of both prediagnostic and postdiagnostic dietary intake on all-cause mortality and CRC-specific mortality among CRC survivors. An extensive search of PubMed and Embase was conducted to identify eligible studies. We applied a random-effects model to estimate the pooled relative risks (RRs)/hazard ratios (HRs) and their 95% confidence intervals (CIs). As a result, a total of 45 studies were included in the final analysis. Pooled effect sizes from at least three study populations showed that whole grains and calcium were inversely associated with all-cause mortality, with RRs/HRs (95% CIs) of 0.83 (0.69–0.99) and 0.84 (0.73–0.97), respectively. In contrast, a positive association between an unhealthy dietary pattern and both all-cause mortality (RR/HR = 1.47, 95% CI = 1.05–2.05) and CRC-specific mortality (RR/HR = 1.52, 95% CI = 1.13–2.06) was observed among CRC survivors. In the subgroup analysis by CRC diagnosis, prediagnostic and postdiagnostic dietary intake such as carbohydrates, proteins, lipids, and fiber were observed to have different effects on all-cause mortality. Overall, an unhealthy dietary pattern increased the risks of both all-cause mortality and CRC-specific mortality. The role of prediagnostic and postdiagnostic intake of dietary elements such as macronutrients and fatty acids could be different in the risk of all-cause mortality.
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Maximova K, Khodayari Moez E, Dabravolskaj J, Ferdinands AR, Dinu I, Lo Siou G, Al Rajabi A, Veugelers PJ. Co-consumption of Vegetables and Fruit, Whole Grains, and Fiber Reduces the Cancer Risk of Red and Processed Meat in a Large Prospective Cohort of Adults from Alberta's Tomorrow Project. Nutrients 2020; 12:nu12082265. [PMID: 32751091 PMCID: PMC7468967 DOI: 10.3390/nu12082265] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 02/07/2023] Open
Abstract
We examined whether co-consumption of red and processed meat with key foods items and food constituents recommended for cancer prevention (vegetables and fruit, whole grains, and fiber) mitigates cancer incidence. In a prospective cohort of 26,218 adults aged 35–69 years at baseline, dietary intake was collected through 124-item past-year food frequency questionnaire. Incidence of all-cause and 15 cancers previously linked to red and processed meat intake was obtained through data linkage with a cancer registry (average follow-up 13.5 years). Competing risk Cox Proportional Hazard models estimated cancer risk and Accelerated Failure Time models estimated time-to-cancer occurrence for different combinations of intake levels while considering mortality from vital statistics and established confounders. Co-consumption of low vegetables and fruit intake with high processed meat was associated with higher incidence of all-cause and 15 cancers (men: HR = 1.85, 1.91; women: HR = 1.44, 1.49) and accelerated time-to-cancer occurrence (men: 6.5 and 7.1 years and women: 5.6 and 6.3 years, respectively), compared to high vegetables and fruit with low processed meat intake. Less pronounced and less consistent associations were observed for whole grains and fiber and for red meat. The findings provide initial evidence toward refining existing cancer prevention recommendations to optimize the intake and combination of foods in the general adult population.
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Affiliation(s)
- Katerina Maximova
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (E.K.M.); (J.D.); (A.R.F.); (I.D.); (P.J.V.)
- Correspondence: ; Tel.: +1-780-248-2076
| | - Elham Khodayari Moez
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (E.K.M.); (J.D.); (A.R.F.); (I.D.); (P.J.V.)
| | - Julia Dabravolskaj
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (E.K.M.); (J.D.); (A.R.F.); (I.D.); (P.J.V.)
| | - Alexa R. Ferdinands
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (E.K.M.); (J.D.); (A.R.F.); (I.D.); (P.J.V.)
| | - Irina Dinu
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (E.K.M.); (J.D.); (A.R.F.); (I.D.); (P.J.V.)
| | - Geraldine Lo Siou
- Alberta’s Tomorrow Project, Cancer Research & Analytics, CancerControl Alberta, Alberta Health Services, Calgary, AB T2T 5C7, Canada;
| | - Ala Al Rajabi
- Health Sciences Department, College of Natural and Health Sciences, Zayed University, Abu Dhabi 144534, UAE;
| | - Paul J. Veugelers
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (E.K.M.); (J.D.); (A.R.F.); (I.D.); (P.J.V.)
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Kunnavuttivanich V, Pramyothin P, Ithimakin S. Association between dietary patterns and disease recurrence in Thai colorectal cancer patients. Medicine (Baltimore) 2020; 99:e19522. [PMID: 32176103 PMCID: PMC7440110 DOI: 10.1097/md.0000000000019522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Beside established anti-cancer treatment, dietary modification is one of the most promising approaches for reducing the probability of colorectal cancer (CRC) recurrence. Many Western studies showed a relationship between shortened survival and increased amounts of Western diet (meat and processed meat). Given that Thai food is dissimilar to Western diet, we aimed to explore the association between dietary patterns and disease recurrence among Thai CRC patients.Early-stage CRC patients who were disease-free at the end of a 2-year period or patients with disease recurrence within 2 years were enrolled. Patients were administered a food frequency questionnaire to evaluate their dietary lifestyle. Quantitative comparison within individual food groups among patients who were disease-free and among those with recurrence was performed. Proportion of patients with recurrence and disease-free survival was compared between patients who had consumed the lowest and highest tertile of each dietary pattern.A total of 225 CRC patients were enrolled (151 disease-free and 74 recurrence). There were no significant differences in demographic or tumor parameters between patients with or without disease recurrence. From the questionnaire, 45 food items were assigned to 1 of 12 food groups according to similarity in nutritional profile. Patients who consumed high amounts of pickled fish or chili-paste had significantly lower recurrence rates compared to patients who had never eaten those foods (P < .01). From the factor analysis, meat/wheat, vegetarian, and fast-food/processed fruit patterns were identified as the major dietary patterns. There was no significant association between intakes of individual dietary patterns and CRC recurrence.Among CRC patients with Thai dietary lifestyles there was no association between meat/wheat, fast-food/processed fruit, or vegetarian dietary patterns and CRC recurrence. Greater consumption of some unique Thai foods, such as chili-paste or pickled fish, may relate to better outcomes for CRC patients.
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Affiliation(s)
| | - Pornpoj Pramyothin
- Division of Nutrition, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Soltani S, Jayedi A, Shab-Bidar S, Becerra-Tomás N, Salas-Salvadó J. Adherence to the Mediterranean Diet in Relation to All-Cause Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Adv Nutr 2019; 10:1029-1039. [PMID: 31111871 PMCID: PMC6855973 DOI: 10.1093/advances/nmz041] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/11/2018] [Accepted: 03/25/2019] [Indexed: 02/07/2023] Open
Abstract
A previous meta-analysis provided convincing evidence for an inverse association between adherence to a Mediterranean diet (MedDiet) and the risk of all-cause mortality. Since then, 19 prospective studies have been published. We updated the evidence from these prospective studies and conducted a dose-response meta-analysis to test the linear and potential nonlinear dose-response associations between adherence to a MedDiet and the risk of all-cause mortality. The PubMed, Scopus, ISI Web of Knowledge, and Embase bibliographic databases were systematically searched up to August 24, 2018. Summary HRs were estimated with the use of a random-effects meta-analysis to assess the association between a 2-point increment in MedDiet adherence and the risk of all-cause mortality. Sensitivity and subgroup analyses were performed and potential publication bias was tested. Twenty-nine prospective studies with 1,676,901 participants and 221,603 cases of all-cause mortality were included in the final analysis. The pooled HR of all-cause mortality was 0.90 (95% CI: 0.89, 0.91; I2 = 81.1%) for a 2-point increment in adherence to a MedDiet. Subgroup analyses showed that a significant inverse association was stronger in participants who lived in the Mediterranean region compared with non-Mediterranean areas (HRs: 0.82 compared with 0.92, respectively), and in studies that used the Panagiotakos MedDiet score. A nonlinear dose-response meta-analysis indicated that the risk of all-cause mortality linearly decreased with the increase in adherence to a MedDiet. The robustness of findings was confirmed in the sensitivity analyses. In conclusion, low-quality evidence from prospective cohort studies suggests an inverse association between adherence to a MedDiet and the risk of all-cause mortality, especially in Mediterranean regions. An inverse linear dose-response relation was also observed between adherence to a MedDiet and the risk of all-cause mortality.
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Affiliation(s)
- Sepideh Soltani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Jayedi
- Food (Salt) Safety Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran,Address correspondence to SS-B (e-mail: )
| | - Nerea Becerra-Tomás
- Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
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Simard J, Kamath S, Kircher S. Survivorship Guidance for Patients with Colorectal Cancer. Curr Treat Options Oncol 2019; 20:38. [DOI: 10.1007/s11864-019-0635-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Thanikachalam K, Khan G. Colorectal Cancer and Nutrition. Nutrients 2019; 11:nu11010164. [PMID: 30646512 PMCID: PMC6357054 DOI: 10.3390/nu11010164] [Citation(s) in RCA: 372] [Impact Index Per Article: 74.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/10/2019] [Accepted: 01/10/2019] [Indexed: 12/13/2022] Open
Abstract
Colorectal Cancer is the third most common cancer diagnosed in the US. While the incidence and the mortality rate of colorectal cancer has decreased due to effective cancer screening measures, there has been an increase in number of young patients diagnosed in colon cancer due to unclear reasons at this point of time. While environmental and genetic factors play a major role in the pathogenesis of colon cancer, extensive research has suggested that nutrition may play both a causal and protective role in the development of colon cancer. In this review article, we aim to provide a review of factors that play a major role in development of colorectal cancer.
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Affiliation(s)
- Kannan Thanikachalam
- Department of Hematology/Oncology, Henry Ford Health System, Detroit, MI 48202, USA.
| | - Gazala Khan
- Department of Hematology/Oncology, Henry Ford Health System, Detroit, MI 48202, USA.
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Guinter MA, McCullough ML, Gapstur SM, Campbell PT. Associations of Pre- and Postdiagnosis Diet Quality With Risk of Mortality Among Men and Women With Colorectal Cancer. J Clin Oncol 2018; 36:JCO1800714. [PMID: 30339519 PMCID: PMC6269128 DOI: 10.1200/jco.18.00714] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
PURPOSE Dietary patterns, indicators of overall diet quality, are associated with colorectal cancer (CRC) incidence but less consistently with mortality among CRC survivors. We prospectively evaluated associations of diet quality pre- and postdiagnosis with risk of mortality among men and women with CRC. PATIENTS AND METHODS In the Cancer Prevention Study-II Nutrition Cohort, 2,801 participants were cancer free at baseline in 1992/1993 and subsequently diagnosed with invasive, nonmetastatic CRC during follow-up through June 2013. Pre- and postdiagnosis diet data were available for 2,671 and 1,321 participants, respectively, among whom 1,414 and 722 died. Concordance with the Dietary Approaches to Stop Hypertension (DASH), American Cancer Society nutrition guidelines (ACS-score), prudent, and Western dietary patterns was used to evaluate diet quality. RESULTS Extreme scoring group comparisons showed that prediagnosis ACS-score was inversely associated with all-cause (hazard ratio high v low [HRHigh vLow], 0.78; 95% CI, 0.65 to 0.95) and CRC-specific (HRHigh vLow, 0.74; 95% CI, 0.54 to 1.03) mortality, whereas the Western diet score was associated with higher all-cause mortality (HRHigh vLow, 1.30; 95% CI, 1.03 to 1.64). For postdiagnosis diet, the ACS-score was associated with lower risk of all-cause (HRHigh vLow, 0.62; 95% CI, 0.47 to 0.83) and CRC-specific (HRHigh vLow, 0.35; 95% CI, 0.17 to 0.73) mortality, the DASH score was inversely associated with all-cause (HRHigh vLow, 0.79; 95% CI, 0.62 to 0.99) and CRC-specific (HRHigh vLow, 0.56; 95% CI, 0.35 to 0.89) mortality, and the prudent score was inversely associated with all-cause mortality (HRHigh vLow, 0.72; 95% CI, 0.56 to 0.93). Among participants with a low diet quality before diagnosis, improved DASH (HR, 0.54; 95% CI, 0.31 to 0.92) and prudent (HR, 0.53; 95% CI, 0.29 to 0.95) scores from pre- to postdiagnosis were inversely associated with CRC-specific mortality. CONCLUSION Dietary patterns reflective of high intakes of plant foods and low intakes of animal products before and after CRC diagnosis are associated with longer survival.
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Block KI, Block PB, Gyllenhaal C. Integrative Treatment for Colorectal Cancer: A Comprehensive Approach. J Altern Complement Med 2018; 24:890-901. [PMID: 30247965 DOI: 10.1089/acm.2018.0125] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A comprehensive approach to integrative treatment of colorectal cancer (CRC) patients involves three spheres of intervention: lifestyle, biology, and conventional treatment. Individualization of treatment is emphasized. The lifestyle sphere includes nutritional therapies, biobehavioral strategies with circadian interventions, and physical care modalities. The biology sphere comprises six host factors in the patient's internal biochemical environment or "terrain": inflammation, glycemia, oxidative stress, immune dysregulation, coagulopathy, and stress chemistries. Laboratory testing of these factors guides integrative lifestyle and supplement recommendations. The conventional treatment sphere includes individualized lifestyle recommendations, and supplements or drugs used to enhance tolerability or effectiveness of conventional treatments. Innovative strategies are implemented, including chronomodulated chemotherapy, chemosensitivity testing, and using results of molecular genomic testing to guide nutritional infusions and supplement recommendations. In the lifestyle sphere, substantial evidence from cohort studies supports recommendations for a diet that emphasizes plant and fish proteins, healthful fats in amounts that are tailored to the clinical circumstance of the patient, and carbohydrates based on unrefined whole grains, vegetables and whole fruits. High glycemic diets and refined carbohydrates, especially sugar-sweetened beverages, should be avoided. Biobehavioral strategies include practice of the relaxation response and related approaches. In addition, specific strategies to promote robust circadian organization (CO) are used to combat quality of life concerns and worsened survival that accompany disrupted CO. Physical activity, including aerobic activity and muscle strengthening, is recommended at all disease stages. In the biology sphere, supplements and lifestyle recommendations for inflammation and glycemia are discussed. In the conventional treatment sphere, supplements and innovative and complementary therapies that may remedy treatment toxicities are reviewed. Approaching CRC treatment with a comprehensive, individualized intervention enables safe and beneficial outcomes in this patient population, which can vary widely in individual biology, treatment toxicities, and disease complications. Further research in integrative therapies for CRC patients is needed.
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Affiliation(s)
- Keith I Block
- Block Center for Integrative Cancer Treatment , Skokie, IL
| | - Penny B Block
- Block Center for Integrative Cancer Treatment , Skokie, IL
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Shi F, Yan F, Jin M, Chang H, Zhou Q, Zhao L, Hu Z, Song Q, Li J, He Y, Qu C. Pre-diagnosis consumption of preserved vegetables and prognosis of invasive oesophageal squamous cell carcinoma: a prospective cohort study in one high-risk area in China. J Int Med Res 2018; 46:4306-4314. [PMID: 30157675 PMCID: PMC6166350 DOI: 10.1177/0300060518775585] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Objective To investigate the prognostic effect of pre-diagnosis preserved vegetable
consumption on oesophageal squamous cell carcinoma (ESCC) in Yanting County,
China. Methods This prospective cohort study enrolled consecutive patients with ESCC. The
pre-diagnosis diet consumption data were collected using a food frequency
questionnaire at baseline. Preserved vegetable consumption was categorized
into two groups: < 1/week and ≥1/week. Kaplan–Meier survival curve
analysis with a log-rank test and a Cox proportional hazard regression model
analysis were undertaken to compare the two consumption groups. Results The study enrolled 185 patients (121 males and 64 females) with ESCC.
Patients consuming preserved vegetables ≥1/week had a median survival time
of 41 months, but patients consuming preserved vegetables <1/week did not
achieve a median survival time. The adjusted hazard ratio (HR) for an intake
of ≥1/week was 1.58 (95% confidence interval [CI] 1.01, 2.47). Among ‘ever
smokers’, the HR increased to 2.04 (95% CI 1.10, 3.77) and among ‘ever
alcohol drinkers’, the HR increased to 2.50 (95% CI 1.33, 4.73). Among
‘never smokers’ or ‘never alcohol drinkers’, no significant association was
observed. Conclusion A high consumption of preserved vegetables was associated with a poorer
prognosis among patients with ESCC.
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Affiliation(s)
- Feng Shi
- 1 Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.,2 Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Fengcai Yan
- 1 Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.,2 Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Mulan Jin
- 1 Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Hong Chang
- 2 Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Quan Zhou
- 2 Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Lin Zhao
- 3 Department of Medical Records and Statistics, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhiping Hu
- 4 Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing, China
| | - Qingkun Song
- 5 Department of Science and Technology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Jun Li
- 6 Department of Cancer Early Detection and Early Treatment, Yanting Cancer Hospital, Mianyang, Sichuan Province, China
| | - Yongming He
- 6 Department of Cancer Early Detection and Early Treatment, Yanting Cancer Hospital, Mianyang, Sichuan Province, China
| | - Chenxu Qu
- 7 Gruber Laboratory, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
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Garcia-Larsen V, Morton V, Norat T, Moreira A, Potts JF, Reeves T, Bakolis I. Dietary patterns derived from principal component analysis (PCA) and risk of colorectal cancer: a systematic review and meta-analysis. Eur J Clin Nutr 2018; 73:366-386. [DOI: 10.1038/s41430-018-0234-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 05/16/2018] [Accepted: 05/25/2018] [Indexed: 12/12/2022]
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Jochems SHJ, Van Osch FHM, Bryan RT, Wesselius A, van Schooten FJ, Cheng KK, Zeegers MP. Impact of dietary patterns and the main food groups on mortality and recurrence in cancer survivors: a systematic review of current epidemiological literature. BMJ Open 2018; 8:e014530. [PMID: 29459359 PMCID: PMC5857700 DOI: 10.1136/bmjopen-2016-014530] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To determine whether there is an association between dietary patterns/indices and foods from the main food groups (highest vs lowest intakes) prior to or after cancer diagnosis and mortality and cancer recurrence in cancer survivors. PARTICIPANTS Survivors of common cancers with a 10-year survival rate of ≥50%: bladder, bowel, breast, cervical, kidney, laryngeal, prostate, testicular, uterine cancer, malignant melanoma and (non-)Hodgkin's lymphoma. OUTCOME MEASURES Mortality (overall, cancer-specific, from other causes) and cancer recurrence. INFORMATION SOURCES PubMed, Embase and the Cochrane Library were searched from inception to April 2017. Additional studies were identified by searching reference lists. Two authors independently screened titles and abstracts, assessed study quality and extracted the data. RESULTS A total of 38 studies were included. The risk of bias was rated low for the included randomised controlled trials (RCTs) and moderate for the cohort studies. The quality of evidence was assessed with the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach and was rated moderate (RCTs), and (very)low (cohort studies). Reducing the amount of fat after diagnosis appears to decrease the risk of breast cancer recurrence. Adherence to a high-quality diet and prudent diet after diagnosis appears to decrease the risk of death from other causes (and overall mortality for high-quality diet) in breast cancer survivors. Adherence to a Western diet, before and after diagnosis, appears to increase the risk of overall mortality and death from other causes among breast cancer survivors. Evidence from studies among other cancer survivors was too limited or could not be identified. CONCLUSION For many cancer survivors, there is little evidence to date to indicate that particular dietary behaviours influence outcomes with regard to recurrence and mortality. Notwithstanding, limited evidence suggests that a low-fat diet, a high-quality diet and a prudent diet are beneficial for breast cancer survivors, while a Western diet is detrimental for breast cancer survivors.
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Affiliation(s)
- Sylvia H J Jochems
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Frits H M Van Osch
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Richard T Bryan
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Anke Wesselius
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Frederik J van Schooten
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Kar Keung Cheng
- Institute of Applied Health Research, Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
| | - Maurice P Zeegers
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
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Abstract
The analysis of dietary patterns has recently drawn considerable attention as a method of investigating the association between the overall whole diet and the risk of colorectal cancer. However, the results have yielded conflicting findings. Here, we carried out a meta-analysis to identify the association between dietary patterns and the risk of colorectal cancer. A total of 40 studies fulfilled the inclusion criteria and were included in this meta-analysis. The highest category of 'healthy' dietary pattern compared with the lowest category was apparently associated with a decreased risk for colorectal cancer [odds ratio (OR)=0.75; confidence interval (CI): 0.68-0.83; P<0.00001]. An increased risk of colorectal cancer was shown for the highest compared with the lowest category of a 'western-style' dietary pattern (OR=1.40; CI: 1.26-1.56; P<0.00001). There was an increased risk of colorectal cancer in the highest compared with the lowest category of 'alcohol-consumption' pattern (OR=1.44; CI: 1.13-1.82; P=0.003). The results of this meta-analysis indicate that a 'healthy' dietary pattern may decrease the risk of colorectal cancer, whereas 'western-style' and 'alcohol-consumption' patterns may increase the risk of colorectal cancer.
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Inaccurate data in meta-analysis 'Dietary patterns and colorectal cancer risk: a meta-analysis'. Eur J Cancer Prev 2018; 28:58-59. [PMID: 29424754 DOI: 10.1097/cej.0000000000000413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Chen M, Zhang J, Sampieri K, Clohessy JG, Mendez L, Gonzalez-Billalabeitia E, Liu XS, Lee YR, Fung J, Katon JM, Menon AV, Webster KA, Ng C, Palumbieri MD, Diolombi MS, Breitkopf SB, Teruya-Feldstein J, Signoretti S, Bronson RT, Asara JM, Castillo-Martin M, Cordon-Cardo C, Pandolfi PP. An aberrant SREBP-dependent lipogenic program promotes metastatic prostate cancer. Nat Genet 2018; 50:206-218. [PMID: 29335545 DOI: 10.1038/s41588-017-0027-2] [Citation(s) in RCA: 197] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 12/01/2017] [Indexed: 12/15/2022]
Abstract
Lipids, either endogenously synthesized or exogenous, have been linked to human cancer. Here we found that PML is frequently co-deleted with PTEN in metastatic human prostate cancer (CaP). We demonstrated that conditional inactivation of Pml in the mouse prostate morphs indolent Pten-null tumors into lethal metastatic disease. We identified MAPK reactivation, subsequent hyperactivation of an aberrant SREBP prometastatic lipogenic program, and a distinctive lipidomic profile as key characteristic features of metastatic Pml and Pten double-null CaP. Furthermore, targeting SREBP in vivo by fatostatin blocked both tumor growth and distant metastasis. Importantly, a high-fat diet (HFD) induced lipid accumulation in prostate tumors and was sufficient to drive metastasis in a nonmetastatic Pten-null mouse model of CaP, and an SREBP signature was highly enriched in metastatic human CaP. Thus, our findings uncover a prometastatic lipogenic program and lend direct genetic and experimental support to the notion that a Western HFD can promote metastasis.
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Affiliation(s)
- Ming Chen
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jiangwen Zhang
- School of Biological Sciences, University of Hong Kong, Hong Kong, China
| | - Katia Sampieri
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.,GSK Vaccines, Antigen Identification and Molecular Biology, Siena, Italy
| | - John G Clohessy
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.,Preclinical Murine Pharmacogenetics Facility and Mouse Hospital, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Lourdes Mendez
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Enrique Gonzalez-Billalabeitia
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Xue-Song Liu
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Yu-Ru Lee
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jacqueline Fung
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jesse M Katon
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Archita Venugopal Menon
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Kaitlyn A Webster
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Christopher Ng
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Maria Dilia Palumbieri
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Moussa S Diolombi
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Susanne B Breitkopf
- Division of Signal Transduction, Beth Israel Deaconess Medical Center and Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Julie Teruya-Feldstein
- Department of Pathology, Sloan-Kettering Institute, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.,Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sabina Signoretti
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Roderick T Bronson
- Department of Microbiology and Immunobiology, Harvard Medical School, Boston, MA, USA
| | - John M Asara
- Division of Signal Transduction, Beth Israel Deaconess Medical Center and Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Mireia Castillo-Martin
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Pathology, Champalimaud Center for the Unknown, Lisbon, Portugal
| | - Carlos Cordon-Cardo
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pier Paolo Pandolfi
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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Is vegetarian diet associated with a lower risk of breast cancer in Taiwanese women? BMC Public Health 2017; 17:800. [PMID: 29017525 PMCID: PMC5635543 DOI: 10.1186/s12889-017-4819-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 10/03/2017] [Indexed: 01/30/2023] Open
Abstract
Background Studies on the relationship between vegetarian diet and breast cancer in Asian populations are limited. This study aimed to investigate the relationship between vegetarian diet, dietary patterns, and breast cancer in Taiwanese women. Methods This case-control study compared the dietary patterns of 233 breast cancer patients and 236 age-matched controls. A questionnaire about vegetarian diets and 28 frequently-consumed food items was administered to these 469 patients in the surgical department of Taipei Tzu Chi Hospital. Serum biochemical status was also examined. Results There were no significant differences between the two groups for age, education, family history, oral contraceptive usage, or regular exercise. However, the cancer group presented with both a higher body mass index and an older age of primiparity (P < 0.05). Two food items (shellfish and seafood) were highly correlated (correlation coefficient = 0.77), so shellfish was excluded to avoid multicollinearity. A factor analysis of 27 food items produced five dietary patterns: meat, processed meat, fruit/vegetable/soybean, dessert/sugar, and fermented food. Multivariate logistic regression showed that meat/fat and processed meat dietary patterns were associated with breast cancer risk (odds ratio (OR): 2.22, 95% CI 1.67–2.94, P < 0.001; OR: 1.49, 95% CI 1.09–2.04, P = 0.013, respectively). Vegetarian diet, high isoflavone intake, and high albumin levels were inversely associated with breast cancer risk (P < 0.05). Vegetarians had a higher daily soy isoflavone intake than non-vegetarians (25.9 ± 25.6 mg vs. 18.1 ± 15.6 mg, P < 0.001). Conclusions Vegetarian diets show as protective role against breast cancer risk, while meat and processed meat dietary patterns are associated with a higher breast cancer risk. Electronic supplementary material The online version of this article (10.1186/s12889-017-4819-1) contains supplementary material, which is available to authorized users.
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Schwedhelm C, Boeing H, Hoffmann G, Aleksandrova K, Schwingshackl L. Effect of diet on mortality and cancer recurrence among cancer survivors: a systematic review and meta-analysis of cohort studies. Nutr Rev 2017; 74:737-748. [PMID: 27864535 PMCID: PMC5181206 DOI: 10.1093/nutrit/nuw045] [Citation(s) in RCA: 164] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Context: Evidence of an association between dietary patterns and individual foods and the risk of overall mortality among cancer survivors has not been reviewed systematically. Objective: The aim of this meta-analysis of cohort studies was to investigate the association between food intake and dietary patterns and overall mortality among cancer survivors. Data Sources: The PubMed and Embase databases were searched. Study Selection: A total of 117 studies enrolling 209 597 cancer survivors were included. Data Extraction: The following data were extracted: study location, types of outcome, population characteristics, dietary assessment method, risk estimates, and adjustment factors. Results: Higher intakes of vegetables and fish were inversely associated with overall mortality, and higher alcohol consumption was positively associated with overall mortality (RR, 1.08; 95%CI, 1.02–1.16). Adherence to the highest category of diet quality was inversely associated with overall mortality (RR, 0.78; 95%CI, 0.72–0.85; postdiagnosis RR, 0.79; 95%CI, 0.71–0.89), as was adherence to the highest category of a prudent/healthy dietary pattern (RR, 0.81; 95%CI, 0.67–0.98; postdiagnosis RR, 0.77; 95%CI, 0.60–0.99). The Western dietary pattern was associated with increased risk of overall mortality (RR, 1.46; 95%CI, 1.27–1.68; postdiagnosis RR, 1.51; 95%CI, 1.24–1.85). Conclusion: Adherence to a high-quality diet and a prudent/healthy dietary pattern is inversely associated with overall mortality among cancer survivors, whereas a Western dietary pattern is positively associated with overall mortality in this population.
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Affiliation(s)
- Carolina Schwedhelm
- C. Schwedhelm, H. Boeing, and L. Schwingshackl are with the Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany. G. Hoffmann is with the Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria. K. Aleksandrova is with the Nutrition, Immunity, and Metabolism Start-up Lab, Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany
| | - Heiner Boeing
- C. Schwedhelm, H. Boeing, and L. Schwingshackl are with the Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany. G. Hoffmann is with the Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria. K. Aleksandrova is with the Nutrition, Immunity, and Metabolism Start-up Lab, Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany
| | - Georg Hoffmann
- C. Schwedhelm, H. Boeing, and L. Schwingshackl are with the Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany. G. Hoffmann is with the Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria. K. Aleksandrova is with the Nutrition, Immunity, and Metabolism Start-up Lab, Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany
| | - Krasimira Aleksandrova
- C. Schwedhelm, H. Boeing, and L. Schwingshackl are with the Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany. G. Hoffmann is with the Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria. K. Aleksandrova is with the Nutrition, Immunity, and Metabolism Start-up Lab, Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany
| | - Lukas Schwingshackl
- C. Schwedhelm, H. Boeing, and L. Schwingshackl are with the Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany. G. Hoffmann is with the Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria. K. Aleksandrova is with the Nutrition, Immunity, and Metabolism Start-up Lab, Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany.
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Henriksen HB, Ræder H, Bøhn SK, Paur I, Kværner AS, Billington SÅ, Eriksen MT, Wiedsvang G, Erlund I, Færden A, Veierød MB, Zucknick M, Smeland S, Blomhoff R. The Norwegian dietary guidelines and colorectal cancer survival (CRC-NORDIET) study: a food-based multicentre randomized controlled trial. BMC Cancer 2017; 17:83. [PMID: 28137255 PMCID: PMC5282711 DOI: 10.1186/s12885-017-3072-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Accepted: 01/18/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Colorectal cancer survivors are not only at risk for recurrent disease but also at increased risk of comorbidities such as other cancers, cardiovascular disease, diabetes, hypertension and functional decline. In this trial, we aim at investigating whether a diet in accordance with the Norwegian food-based dietary guidelines and focusing at dampening inflammation and oxidative stress will improve long-term disease outcomes and survival in colorectal cancer patients. METHODS/DESIGN This paper presents the study protocol of the Norwegian Dietary Guidelines and Colorectal Cancer Survival study. Men and women aged 50-80 years diagnosed with primary invasive colorectal cancer (Stage I-III) are invited to this randomized controlled, parallel two-arm trial 2-9 months after curative surgery. The intervention group (n = 250) receives an intensive dietary intervention lasting for 12 months and a subsequent maintenance intervention for 14 years. The control group (n = 250) receives no dietary intervention other than standard clinical care. Both groups are offered equal general advice of physical activity. Patients are followed-up at 6 months and 1, 3, 5, 7, 10 and 15 years after baseline. The study center is located at the Department of Nutrition, University of Oslo, and patients are recruited from two hospitals within the South-Eastern Norway Regional Health Authority. Primary outcomes are disease-free survival and overall survival. Secondary outcomes are time to recurrence, cardiovascular disease-free survival, compliance to the dietary recommendations and the effects of the intervention on new comorbidities, intermediate biomarkers, nutrition status, physical activity, physical function and quality of life. DISCUSSION The current study is designed to gain a better understanding of the role of a healthy diet aimed at dampening inflammation and oxidative stress on long-term disease outcomes and survival in colorectal cancer patients. Since previous research on the role of diet for colorectal cancer survivors is limited, the study may be of great importance for this cancer population. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01570010 .
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Affiliation(s)
- Hege Berg Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Hanna Ræder
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Siv Kjølsrud Bøhn
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Ingvild Paur
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Ane Sørlie Kværner
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Siv Åshild Billington
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Morten Tandberg Eriksen
- Department of Gastroenterological Surgery, Oslo University Hospital, Ullevål, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gro Wiedsvang
- Department of Gastroenterological Surgery, Oslo University Hospital, Ullevål, Norway
| | - Iris Erlund
- National Institute for Health and Welfare, Helsinki, Finland
| | - Arne Færden
- Department of Digestive and Paediatric Surgery, Akershus University Hospital, Lørenskog, Norway
| | - Marit Bragelien Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Manuela Zucknick
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Sigbjørn Smeland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway. .,Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway.
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38
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Jacobs S, Harmon BE, Ollberding NJ, Wilkens LR, Monroe KR, Kolonel LN, Le Marchand L, Boushey CJ, Maskarinec G. Among 4 Diet Quality Indexes, Only the Alternate Mediterranean Diet Score Is Associated with Better Colorectal Cancer Survival and Only in African American Women in the Multiethnic Cohort. J Nutr 2016; 146:1746-55. [PMID: 27511927 PMCID: PMC4997287 DOI: 10.3945/jn.116.234237] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 07/05/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is the second leading cause of cancer-related death in the United States, with a 5-y survival rate of ∼65%. Therefore, the identification of modifiable health factors to improve CRC survival is crucial. OBJECTIVE We investigated the association of 4 prediagnostic a priori diet quality indexes with CRC-specific and all-cause mortality in the Multiethnic Cohort (MEC). METHODS The MEC included >215,000 African-American, Native Hawaiian, Japanese-American, Latino, and white adults living in Hawaii and California who completed a validated quantitative food-frequency questionnaire in 1993-1996. CRC cases and deaths were identified through linkages to cancer registries and to state and national vital registries. Sex-specific HRs and 95% CIs were estimated for the Healthy Eating Index (HEI) 2010, the Alternative HEI (AHEI) 2010, the alternate Mediterranean Diet (aMED) score, and the Dietary Approaches to Stop Hypertension (DASH) index with CRC-specific and overall mortality as the primary outcomes. Ethnicity-specific analyses were the secondary outcomes. RESULTS Among 4204 MEC participants diagnosed with invasive CRC through 2010, 1976 all-cause and 1095 CRC-specific deaths were identified. A higher aMED score was associated with lower CRC-specific mortality in women [HR continuous pattern score divided by its respective SD (HR1SD): 0.86; 95% CI: 0.77, 0.96] but not in men (HR1SD: 1.01; 95% CI: 0.92, 1.11). A higher aMED score was also associated with lower all-cause mortality in women (HR1SD: 0.88; 95% CI: 0.81, 0.96) but not in men (HR1SD: 1.00; 95% CI: 0.93, 1.07). The HEI-2010, AHEI-2010, and DASH index were not significantly associated with CRC-specific or with all-cause mortality. The inverse relation for the aMED score was limited to African Americans and to colon (compared with rectal) cancer. CONCLUSIONS The aMED score was related to lower mortality only in African-American women (1 of 5 ethnic groups studied). The results should be interpreted with caution due to the small numbers of cases within ethnic groups and the issue of multiple testing.
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Affiliation(s)
| | - Brook E Harmon
- School of Public Health, University of Memphis, Memphis, TN
| | | | | | - Kristine R Monroe
- University of Southern California, Health Sciences Campus, Los Angeles, CA
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Ward HA, Norat T, Overvad K, Dahm CC, Bueno-de-Mesquita HB, Jenab M, Fedirko V, van Duijnhoven FJB, Skeie G, Romaguera-Bosch D, Tjønneland A, Olsen A, Carbonnel F, Affret A, Boutron-Ruault MC, Katzke V, Kühn T, Aleksandrova K, Boeing H, Trichopoulou A, Lagiou P, Bamia C, Palli D, Sieri S, Tumino R, Naccarati A, Mattiello A, Peeters PH, Weiderpass E, Åsli LA, Jakszyn P, Ramón Quirós J, Sánchez MJ, Dorronsoro M, Huerta JM, Barricarte A, Jirström K, Ericson U, Johansson I, Gylling B, Bradbury KE, Khaw KT, Wareham NJ, Stepien M, Freisling H, Murphy N, Cross AJ, Riboli E. Pre-diagnostic meat and fibre intakes in relation to colorectal cancer survival in the European Prospective Investigation into Cancer and Nutrition. Br J Nutr 2016; 116:316-25. [PMID: 27193442 PMCID: PMC5570524 DOI: 10.1017/s0007114516001859] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Improvements in colorectal cancer (CRC) detection and treatment have led to greater numbers of CRC survivors, for whom there is limited evidence on which to provide dietary guidelines to improve survival outcomes. Higher intake of red and processed meat and lower intake of fibre are associated with greater risk of developing CRC, but there is limited evidence regarding associations with survival after CRC diagnosis. Among 3789 CRC cases in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, pre-diagnostic consumption of red meat, processed meat, poultry and dietary fibre was examined in relation to CRC-specific mortality (n 1008) and all-cause mortality (n 1262) using multivariable Cox regression models, adjusted for CRC risk factors. Pre-diagnostic red meat, processed meat or fibre intakes (defined as quartiles and continuous grams per day) were not associated with CRC-specific or all-cause mortality among CRC survivors; however, a marginal trend across quartiles of processed meat in relation to CRC mortality was detected (P 0·053). Pre-diagnostic poultry intake was inversely associated with all-cause mortality among women (hazard ratio (HR)/20 g/d 0·92; 95 % CI 0·84, 1·00), but not among men (HR 1·00; 95 % CI 0·91, 1·09) (P for heterogeneity=0·10). Pre-diagnostic intake of red meat or fibre is not associated with CRC survival in the EPIC cohort. There is suggestive evidence of an association between poultry intake and all-cause mortality among female CRC survivors and between processed meat intake and CRC-specific mortality; however, further research using post-diagnostic dietary data is required to confirm this relationship.
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Affiliation(s)
| | | | - Kim Overvad
- 2Section for Epidemiology,Department of Public Health,Aarhus University,Bartholins Allé 2 - Building 1260,DK-8000 Aarhus C,Denmark
| | - Christina C Dahm
- 2Section for Epidemiology,Department of Public Health,Aarhus University,Bartholins Allé 2 - Building 1260,DK-8000 Aarhus C,Denmark
| | | | - Mazda Jenab
- 6International Agency for Research on Cancer (WHO-IARC),150 Cours Albert Thomas,69372 Lyon CEDEX 08,France
| | - Veronika Fedirko
- 7Department of Epidemiology,Rollins School of Public Health,Emory University,201 Dowman Drive, Atlanta, GA 30322,USA
| | | | - Guri Skeie
- 10UiT The Arctic University of Norway,Postboks 6050, Langnes, 9037 Tromsø,Norway
| | | | - Anne Tjønneland
- 13Danish Cancer Society Research Center,Strandboulevarden 49, DK-2100 København Ø,Denmark
| | - Anja Olsen
- 13Danish Cancer Society Research Center,Strandboulevarden 49, DK-2100 København Ø,Denmark
| | - Franck Carbonnel
- 14Center for Research in Epidemiology and Population Health (CESP),U1018,Lifestyle, Genes and Health: Integrative Trans-Generational Epidemiology,Institut National de la Santé et de la Recherche Médicale,F-94805 Villejuif,France
| | - Aurélie Affret
- 14Center for Research in Epidemiology and Population Health (CESP),U1018,Lifestyle, Genes and Health: Integrative Trans-Generational Epidemiology,Institut National de la Santé et de la Recherche Médicale,F-94805 Villejuif,France
| | - Marie-Christine Boutron-Ruault
- 14Center for Research in Epidemiology and Population Health (CESP),U1018,Lifestyle, Genes and Health: Integrative Trans-Generational Epidemiology,Institut National de la Santé et de la Recherche Médicale,F-94805 Villejuif,France
| | - Verena Katzke
- 17German Cancer Research Center (DKFZ),Division of Cancer Epidemiology,Im Neuenheimer Feld 280, 69120 Heidelberg,Germany
| | - Tilman Kühn
- 17German Cancer Research Center (DKFZ),Division of Cancer Epidemiology,Im Neuenheimer Feld 280, 69120 Heidelberg,Germany
| | - Krassimira Aleksandrova
- 18Department of Epidemiology,German Institute of Human Nutrition (DIfE),Arthur-Scheunert-Allee 114-116, 14558 Bergholz-Rehbrücke,Germany
| | - Heiner Boeing
- 18Department of Epidemiology,German Institute of Human Nutrition (DIfE),Arthur-Scheunert-Allee 114-116, 14558 Bergholz-Rehbrücke,Germany
| | - Antonia Trichopoulou
- 19Hellenic Health Foundation,Kaisareias 13 & Alexandroupoleos, GR-115 27, Athens,Greece
| | - Pagona Lagiou
- 19Hellenic Health Foundation,Kaisareias 13 & Alexandroupoleos, GR-115 27, Athens,Greece
| | - Christina Bamia
- 19Hellenic Health Foundation,Kaisareias 13 & Alexandroupoleos, GR-115 27, Athens,Greece
| | - Domenico Palli
- 22ISPO - Cancer Research and Prevention Institute,Clinical and Descriptive Epidemiology Unit,Via delle Oblate 2, 50141,Florence, Italy
| | - Sabina Sieri
- 23Epidemiology and Prevention Unit,Fondazione IRCCS Istituto Nazionale dei Tumouri,Via Giacomo Venezian 1, 20133 Milan,Italy
| | - Rosario Tumino
- 24Cancer Registry and Histopathology Unit,'Civic-M.P.Arezzo' Hospital,ASP, Via Dante No. 109, Ragusa 97100,Italy
| | - Alessio Naccarati
- 25Molecular and Genetic Epidemiology Unit,Human Genetics Foundation (HuGeF),Via Nizza 52, 10126 Torino,Italy
| | - Amalia Mattiello
- 26Dipartimento di Medicina Clinica e Chirurgia,Federico II University,Via Pansini, 5-80131 - Naples,Italy
| | | | - Elisabete Weiderpass
- 28Department of Community Medicine, Faculty of Health Sciences,University of Tromsø - The Arctic University of Norway,Postboks 6050 Langnes, 9037 Tromsø,Norway
| | - Lene Angell Åsli
- 28Department of Community Medicine, Faculty of Health Sciences,University of Tromsø - The Arctic University of Norway,Postboks 6050 Langnes, 9037 Tromsø,Norway
| | - Paula Jakszyn
- 32Unit of Nutrition, Environment and Cancer,Catalan Institute of Oncology,Avda Gran Via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona,Spain
| | - J Ramón Quirós
- 33Public Health Directorate,Asturias, Ciriaco Miguel Vigil St 9,Oviedo 33006,Spain
| | - María-José Sánchez
- 34Escuela Andaluza de Salud Pública,Instituto de Investigación Biosanitaria ibs,Hospitales Universitarios de Granada/Universidad de Granada,Cuesta del Observatorio, 4, Campus Universitario de Cartuja,Granada 18080,Spain
| | - Miren Dorronsoro
- 36Basque Regional Health Department,Public Health Direction and Biodonostia Research Institute - CIBERESP,Avenida de Navarra, 4, 20013 Donostia-San Sebastián,Spain
| | - José-María Huerta
- 35CIBER de Epidemiología y Salud Pública (CIBERESP),Melchor Fernández Almagro,3-5, Madrid 28029,Spain
| | - Aurelio Barricarte
- 35CIBER de Epidemiología y Salud Pública (CIBERESP),Melchor Fernández Almagro,3-5, Madrid 28029,Spain
| | - Karin Jirström
- 40Department of Clinical Sciences,Division of Oncology and Pathology,Lund University,Box 117, SE-221 00 Lund,Sweden
| | - Ulrika Ericson
- 41Diabetes and Cardiovascular Disease - Genetic Epidemiology,Department of Clinical Sciences,Lund University,Box 117, SE-221 00 Lund,Sweden
| | | | - Björn Gylling
- 43Department of Pathology,Umeå University, SE-901 87 Umeå,Sweden
| | - Kathryn E Bradbury
- 44Cancer Epidemiology Unit,Nuffield Department of Population Health, University of Oxford,Richard Doll Building, Oxford OX3 7LF,UK
| | - Kay-Tee Khaw
- 45Department of Public Health and Primary Care,University of Cambridge, Addenbrooke's Hospital, Hills Rd,Cambridge CB2 0SP,UK
| | - Nicholas J Wareham
- 46Medical Research Council Epidemiology Unit,University of Cambridge, Institute of Metabolic Science,Box 285, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ,UK
| | - Magdalena Stepien
- 6International Agency for Research on Cancer (WHO-IARC),150 Cours Albert Thomas,69372 Lyon CEDEX 08,France
| | - Heinz Freisling
- 6International Agency for Research on Cancer (WHO-IARC),150 Cours Albert Thomas,69372 Lyon CEDEX 08,France
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40
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Alegria-Lertxundi I, Alvarez M, Rocandio AM, de Pancorbo MM, Arroyo-Izaga M. Nutritional Adequacy and Diet Quality in Colorectal Cancer Patients Postsurgery: A Pilot Study. Nutr Cancer 2016; 68:577-88. [PMID: 27144653 DOI: 10.1080/01635581.2016.1158299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Recent evidence has shown that an unhealthy diet is associated with a higher risk of tumor recurrence, metastasis, and death among patients with colorectal cancer (CRC). The aims of this study were to assess nutritional adequacy and diet quality in a group of CRC patients postsurgery and to identify possible associations between dietary and nutritional aspects and environmental factors and weight status. This was an observational study conducted on a random sample of 74 patients, aged 50-69 years. Dietary intake was evaluated utilizing a validated frequency questionnaire, and diet quality was evaluated utilizing the Healthy Eating Index for Spanish Diet and the MedDietScore. Data regarding socioeconomic, demographic, lifestyles, dietary supplements use, and body mass index were collected. Subjects followed a diet characterized by a low carbohydrate intake (94% of the cases), excessive protein (48%), high fat intake (67%), and some micronutrient deficiencies. The inadequacy of some nutrients was associated with male gender, overweight/obesity, smoking, and low educational level; and low adherence to the MedDiet was identified in those with a low educational level (adjusted odds ratio = 4.16, P < 0.05). Therefore, such patients should be an important target group when applying educational programs and giving individualized nutritional advice to improve their quality of life.
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Affiliation(s)
- Iker Alegria-Lertxundi
- a Department of Pharmacy and Food Sciences , University of the Basque Country UPV/EHU , Vitoria-Gasteiz , Spain
| | - Maider Alvarez
- a Department of Pharmacy and Food Sciences , University of the Basque Country UPV/EHU , Vitoria-Gasteiz , Spain
| | - Ana M Rocandio
- a Department of Pharmacy and Food Sciences , University of the Basque Country UPV/EHU , Vitoria-Gasteiz , Spain.,b BIOMICs Research Group, Lascaray Research Center, University of the Basque Country UPV/EHU , Vitoria-Gasteiz , Spain
| | - Marian M de Pancorbo
- b BIOMICs Research Group, Lascaray Research Center, University of the Basque Country UPV/EHU , Vitoria-Gasteiz , Spain.,c Department of Zoology and Cellular Biology Animal , University of the Basque Country UPV/EHU , Vitoria-Gasteiz , Spain
| | - Marta Arroyo-Izaga
- a Department of Pharmacy and Food Sciences , University of the Basque Country UPV/EHU , Vitoria-Gasteiz , Spain.,b BIOMICs Research Group, Lascaray Research Center, University of the Basque Country UPV/EHU , Vitoria-Gasteiz , Spain
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41
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Racine A, Carbonnel F, Chan SSM, Hart AR, Bueno-de-Mesquita HB, Oldenburg B, van Schaik FDM, Tjønneland A, Olsen A, Dahm CC, Key T, Luben R, Khaw KT, Riboli E, Grip O, Lindgren S, Hallmans G, Karling P, Clavel-Chapelon F, Bergman MM, Boeing H, Kaaks R, Katzke VA, Palli D, Masala G, Jantchou P, Boutron-Ruault MC. Dietary Patterns and Risk of Inflammatory Bowel Disease in Europe: Results from the EPIC Study. Inflamm Bowel Dis 2016; 22:345-54. [PMID: 26717318 DOI: 10.1097/mib.0000000000000638] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Specific nutrients or foods have been inconsistently associated with ulcerative colitis (UC) or Crohn's disease (CD) risks. Thus, we investigated associations between diet as a whole, as dietary patterns, and UC and CD risks. METHODS Within the prospective EPIC (European Prospective Investigation into Cancer) study, we set up a nested matched case-control study among 366,351 participants with inflammatory bowel disease data, including 256 incident cases of UC and 117 of CD, and 4 matched controls per case. Dietary intake was recorded at baseline from validated food frequency questionnaires. Incidence rate ratios of developing UC and CD were calculated for quintiles of the Mediterranean diet score and a posteriori dietary patterns produced by factor analysis. RESULTS No dietary pattern was associated with either UC or CD risks. However, when excluding cases occurring within the first 2 years after dietary assessment, there was a positive association between a "high sugar and soft drinks" pattern and UC risk (incidence rate ratios for the fifth versus first quintile, 1.68 [1.00-2.82]; Ptrend = 0.02). When considering the foods most associated with the pattern, high consumers of sugar and soft drinks were at higher UC risk only if they had low vegetables intakes. CONCLUSIONS A diet imbalance with high consumption of sugar and soft drinks and low consumption of vegetables was associated with UC risk. Further studies are needed to investigate whether microbiota alterations or other mechanisms mediate this association.
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Affiliation(s)
- Antoine Racine
- 1INSERM, Centre for Research in Epidemiology and Population, Health, UMR1018, Institut Gustave Roussy, Université Paris Sud, Villejuif, France; 2Department of Gastroenterology, University Hospital of Bicêtre, Assistance Publique Hôpitaux de Paris, Université Paris-Sud, Le Kremlin Bicêtre, France; 3Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom; 4Department of Gastroenterology, Norfolk and Norwich University Hospital NHS Trust, Norwich, United Kingdom; 5Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; 6Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, the Netherlands; 7Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom; 8Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; 9Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark; 10Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark; 11Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom; 12Strangeways Research Laboratory, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom; 13Division of Epidemiology, Imperial College London, London, United Kingdom; 14Department of Gastroenterology and Hepatology, University Hospital Malmö, Malmö, Sweden; 15Department of Public Health and Clinical Medicine, Nutritional Research, Umea University, Umea, Sweden; 16Department of Public Health and Clinical Medicine, GI unit, Umea University, Umea, Sweden; 17Department of Epidemiology, German Institute of Human Nutrition, Potsdam, Germany; 18Division of Clinical Epidemiology, DKFZ-German Cancer Research Centre Heidelberg, Heidelberg, Germany; 19Molecular and Nutritional Epidemio
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42
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Hawkins NA, Berkowitz Z, Rodriguez JL. Awareness of Dietary and Alcohol Guidelines Among Colorectal Cancer Survivors. Am J Prev Med 2015; 49:S509-17. [PMID: 26590646 PMCID: PMC5833984 DOI: 10.1016/j.amepre.2015.08.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 08/04/2015] [Accepted: 08/19/2015] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Although dietary habits can affect colorectal cancer (CRC) survivors' health, it is unclear how familiar survivors are with dietary guidelines, what they believe about healthy eating and alcohol consumption, and what hinders healthy dietary habits after cancer. This study assessed CRC survivors' familiarity with dietary guidelines, their eating and drinking habits, and perceived facilitators and barriers to healthy eating after cancer, including social support and self-efficacy for maintaining a healthy diet and limiting alcohol. METHODS A total of 593 individuals (50% female; mean age, 74 years) diagnosed with CRC approximately 6 years prior to study entry in early 2010 were identified through California Cancer Registry records and participated in a cross-sectional mailed survey assessing health behavior after cancer (46% adjusted response rate). Analyses were conducted in 2014-2015. RESULTS Survivors were most familiar with-and most likely to follow-recommendations to choose low-fat foods; 15% had never heard of recommendations to limit alcohol. Survivors were more aware of recommendations involving messages to limit/avoid versus approach/choose certain foods. The most common barrier to a healthy diet involved the effort required (26%). Survivors received more family/friend support and provider recommendations for healthy eating than limiting alcohol. CONCLUSIONS Results provide an overview of awareness of and adherence to dietary recommendations among CRC survivors, highlighting the need for increasing awareness of recommendations that are especially relevant for survivors. Suggestions are made for modifying diet-related messages to facilitate comprehension and recall among CRC survivors, and increasing awareness among groups with the lowest awareness levels.
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Affiliation(s)
- Nikki A Hawkins
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
| | - Zahava Berkowitz
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Juan L Rodriguez
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
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43
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Lee J, Jeon JY, Meyerhardt JA. Diet and lifestyle in survivors of colorectal cancer. Hematol Oncol Clin North Am 2015; 29:1-27. [PMID: 25475570 DOI: 10.1016/j.hoc.2014.09.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Much research supports the association between diet and lifestyle in the development of colorectal cancer. Recent studies have demonstrated an association between various energy balance host factors (obesity, physical inactivity, and certain dietary factors) and outcomes. This review summarizes the impact of modifiable lifestyle factors, including prediagnosis and postdiagnosis adiposity, physical activity, and diet, on the prognosis of patients with colorectal cancer. The article focuses on associations of these factors in survivors of stage I to III colorectal cancer, and summarizes the possible mechanisms for the association between modifiable lifestyle factors and the prognosis of patients with colorectal cancer.
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Affiliation(s)
- Junga Lee
- Exercise Medicine Center for Cancer and Diabetes Patients, Department of Sport and Leisure Studies, 50 Yonsei-ro, Yonsei University, Seoul 120-749, Korea
| | - Justin Y Jeon
- Exercise Medicine Center for Cancer and Diabetes Patients, Department of Sport and Leisure Studies, 50 Yonsei-ro, Yonsei University, Seoul 120-749, Korea
| | - Jeffrey A Meyerhardt
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA.
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Chen Z, Wang PP, Shi L, Zhu Y, Liu L, Gao Z, Woodrow J, Roebothan B. Comparison in dietary patterns derived for the Canadian Newfoundland and Labrador population through two time-separated studies. Nutr J 2015; 14:75. [PMID: 26231925 PMCID: PMC4522097 DOI: 10.1186/s12937-015-0064-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 07/27/2015] [Indexed: 11/30/2022] Open
Abstract
Background While a dietary pattern is often believed to be stable in a population, there is limited research assessing its stability over time. The objective of this study is to explore and compare major dietary patterns derived for the Canadian subpopulation residing in Newfoundland and Labrador (NL), through two time-separated studies using an identical method. Methods In this study, we derived and compared the major dietary patterns derived from two independent studies in the NL adult population. The first study was based on the healthy controls from a large population-based case–control study (CCS) in 2005. The second was from a food-frequency questionnaire validation project (FFQVP) conducted in 2012. In both studies, participants were recruited in the same manner and dietary information was collected by an identical self-administered food-frequency questionnaire (FFQ). Exploratory common factor analysis was conducted to identify major dietary patterns. A comparison was conducted between the two study populations. Results Four major dietary patterns were identified: Meat, Vegetables/fruits, Fish, and Grains explaining 22 %, 20 %, 12 % and 9 % variance respectively, with a total variance of 63 %. Three major dietary patterns were derived for the controls of the CCS: Meat, Plant-based diet, and Fish explaining 24 %, 20 %, and 10 % variance respectively, with a total variance of 54 %. As the Plant-based diet pattern derived for the CCS was a combination of the Vegetables/fruits and Grains patterns derived for the FFQVP, no considerable difference in dietary patterns was found between the two studies. Conclusion A comparison between two time-separated studies suggests that dietary patterns of the NL adult population have remained reasonably stable over almost a decade.
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Affiliation(s)
- Zhi Chen
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, A1B 3V6, Canada.
| | - Peizhong Peter Wang
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, A1B 3V6, Canada.
| | - Lian Shi
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, A1B 3V6, Canada.
| | - Yun Zhu
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, A1B 3V6, Canada.
| | - Lin Liu
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, A1B 3V6, Canada.
| | - Zhiwei Gao
- Clinical Epidemiology Unit, Faculty of Medicine, Memorial University of Newfoundland, St John's, NL, Canada.
| | - Janine Woodrow
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, A1B 3V6, Canada.
| | - Barbara Roebothan
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, A1B 3V6, Canada.
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45
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Van Blarigan EL, Meyerhardt JA. Role of physical activity and diet after colorectal cancer diagnosis. J Clin Oncol 2015; 33:1825-34. [PMID: 25918293 PMCID: PMC4438267 DOI: 10.1200/jco.2014.59.7799] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
This review summarizes the evidence regarding physical activity and diet after colorectal cancer diagnosis in relation to quality of life, disease recurrence, and survival. There have been extensive reports on adiposity, inactivity, and certain diets, particularly those high in red and processed meats, and increased risk of colorectal cancer. Only in the past decade have data emerged on how such lifestyle factors are associated with outcomes in colorectal cancer survivors. Prospective observational studies have consistently reported that physical activity after colorectal cancer diagnosis reduces mortality. A meta-analysis estimated that each 15 metabolic equivalent task-hour per week increase in physical activity after colorectal cancer diagnosis was associated with a 38% lower risk of mortality. No randomized controlled trials have been completed to confirm that physical activity lowers risk of mortality among colorectal cancer survivors; however, trials have shown that physical activity, including structured exercise, is safe for colorectal cancer survivors (localized to metastatic stage, during and after treatment) and improves cardiorespiratory fitness and physical function. In addition, prospective observational studies have suggested that a Western dietary pattern, high carbohydrate intake, and consuming sugar-sweetened beverages after diagnosis may increase risk of colorectal cancer recurrence and mortality, but these data are limited to single analyses from one of two US cohorts. Additional data from prospective studies and randomized controlled trials are needed. Nonetheless, on the basis of the available evidence, it is reasonable to counsel colorectal cancer survivors to engage in regular physical activity and limit consumption of refined carbohydrates, red and processed meats, and sugar-sweetened beverages.
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Affiliation(s)
- Erin L Van Blarigan
- Erin L. Van Blarigan, University of California San Francisco, San Francisco, CA; and Jeffrey A. Meyerhardt, Dana-Farber Cancer Institute, Boston, MA.
| | - Jeffrey A Meyerhardt
- Erin L. Van Blarigan, University of California San Francisco, San Francisco, CA; and Jeffrey A. Meyerhardt, Dana-Farber Cancer Institute, Boston, MA
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46
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Romaguera D, Ward H, Wark PA, Vergnaud AC, Peeters PH, van Gils CH, Ferrari P, Fedirko V, Jenab M, Boutron-Ruault MC, Dossus L, Dartois L, Hansen CP, Dahm CC, Buckland G, Sánchez MJ, Dorronsoro M, Navarro C, Barricarte A, Key TJ, Trichopoulou A, Tsironis C, Lagiou P, Masala G, Pala V, Tumino R, Vineis P, Panico S, Bueno-de-Mesquita HB, Siersema PD, Ohlsson B, Jirström K, Wennberg M, Nilsson LM, Weiderpass E, Kühn T, Katzke V, Khaw KT, Wareham NJ, Tjønneland A, Boeing H, Quirós JR, Gunter MJ, Riboli E, Norat T. Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients: a cohort study. BMC Med 2015; 13:107. [PMID: 25948112 PMCID: PMC4423114 DOI: 10.1186/s12916-015-0332-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 03/20/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Cancer survivors are advised to follow lifestyle recommendations on diet, physical activity, and body fatness proposed by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) for cancer prevention. Previous studies have demonstrated that higher concordance with these recommendations measured using an index score (the WCRF/AICR score) was associated with lower cancer incidence and mortality. The aim of this study was to evaluate the association between pre-diagnostic concordance with WCRF/AICR recommendations and mortality in colorectal cancer (CRC) patients. METHODS The association between the WCRF/AICR score (score range 0-6 in men and 0-7 in women; higher scores indicate greater concordance) assessed on average 6.4 years before diagnosis and CRC-specific (n = 872) and overall mortality (n = 1,113) was prospectively examined among 3,292 participants diagnosed with CRC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (mean follow-up time after diagnosis 4.2 years). Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. RESULTS The HRs (95% CIs) for CRC-specific mortality among participants in the second (score range in men/women: 2.25-2.75/3.25-3.75), third (3-3.75/4-4.75), and fourth (4-6/5-7) categories of the score were 0.87 (0.72-1.06), 0.74 (0.61-0.90), and 0.70 (0.56-0.89), respectively (P for trend <0.0001), compared to participants with the lowest concordance with the recommendations (category 1 of the score: 0-2/0-3). Similar HRs for overall mortality were observed (P for trend 0.004). Meeting the recommendations on body fatness and plant food consumption were associated with improved survival among CRC cases in mutually adjusted models. CONCLUSIONS Greater concordance with the WCRF/AICR recommendations on diet, physical activity, and body fatness prior to CRC diagnosis is associated with improved survival among CRC patients.
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Affiliation(s)
- Dora Romaguera
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, W2 1PG, London, UK.
- Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Universitario Son Espases, Research Unit I-1, Ctra. de Valldemossa 79, 07010, Palma de Mallorca, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0. 28029, Madrid, Spain.
| | - Heather Ward
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, W2 1PG, London, UK.
| | - Petra A Wark
- Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK.
| | - Anne-Claire Vergnaud
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, W2 1PG, London, UK.
| | - Petra H Peeters
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, W2 1PG, London, UK.
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85500 3508 GA, Utrecht, The Netherlands.
| | - Carla H van Gils
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85500 3508 GA, Utrecht, The Netherlands.
| | - Pietro Ferrari
- International Agency for Cancer Research (IARC), 150 Cours Albert Thomas, 69372, Lyon, CEDEX 08, France.
| | - Veronika Fedirko
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, USA.
- Winship Cancer Institute, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA.
| | - Mazda Jenab
- International Agency for Cancer Research (IARC), 150 Cours Albert Thomas, 69372, Lyon, CEDEX 08, France.
| | - Marie-Christine Boutron-Ruault
- Inserm (Institut National de la Santé et de la Recherche Médicale), Centre for Research in Epidemiology and Population Health (CESP), U1018, Team 9, 114 rue Édouard Vaillant, 94805, Villejuif, Cedex, France.
- Univ Paris Sud, UMRS 1018, 114 rue Édouard Vaillant 94805, Villejuif, France.
- Gustave Roussy, 114 rue Édouard Vaillant 94805, Villejuif, France.
| | - Laure Dossus
- Inserm (Institut National de la Santé et de la Recherche Médicale), Centre for Research in Epidemiology and Population Health (CESP), U1018, Team 9, 114 rue Édouard Vaillant, 94805, Villejuif, Cedex, France.
- Univ Paris Sud, UMRS 1018, 114 rue Édouard Vaillant 94805, Villejuif, France.
- Gustave Roussy, 114 rue Édouard Vaillant 94805, Villejuif, France.
| | - Laureen Dartois
- Inserm (Institut National de la Santé et de la Recherche Médicale), Centre for Research in Epidemiology and Population Health (CESP), U1018, Team 9, 114 rue Édouard Vaillant, 94805, Villejuif, Cedex, France.
- Univ Paris Sud, UMRS 1018, 114 rue Édouard Vaillant 94805, Villejuif, France.
- Gustave Roussy, 114 rue Édouard Vaillant 94805, Villejuif, France.
| | - Camilla Plambeck Hansen
- Section for Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, DK-8000, Aarhus C, Denmark.
| | - Christina Catherine Dahm
- Section for Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, DK-8000, Aarhus C, Denmark.
| | - Genevieve Buckland
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Avda. de la Granvia de l'Hospitalet, 199-203, 08908, Barcelona, Spain.
| | - María José Sánchez
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs. GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Campus Universitario de Cartuja, Cuesta del Observatorio, 4, 18011, Granada, Spain.
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0. 28029, Madrid, Spain.
| | - Miren Dorronsoro
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0. 28029, Madrid, Spain.
- Public Health Direction and Biodonostia Basque Regional Health Department, Avenida Navarra 4, 20013, San Sebastian, Spain.
| | - Carmen Navarro
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0. 28029, Madrid, Spain.
- Department of Epidemiology, Murcia Regional Health Council, Ronda de Levante, 11, 30008, Murcia, Spain.
- Department of Health and Social Sciences, Universidad de Murcia, Campus Universitario de Espinardo, s/n, 30100 Espinardo, Murcia, Spain.
| | - Aurelio Barricarte
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0. 28029, Madrid, Spain.
- Navarre Public Health Institute, C/ Leyre, 15 31003, Pamplona, Spain.
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK.
| | - Antonia Trichopoulou
- Hellenic Health Foundation, 13 Kaisareias Street, Athens, GR-115 27, Greece.
- Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens, GR-115 27, Greece.
| | - Christos Tsironis
- Hellenic Health Foundation, 13 Kaisareias Street, Athens, GR-115 27, Greece.
| | - Pagona Lagiou
- Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens, GR-115 27, Greece.
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, 75 M. Asias Street, Goudi, GR-115 27, Athens, Greece.
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Giovanna Masala
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Via delle Oblate 4, 50141, Florence, Italy.
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, Milan, Italy.
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, "Civic - M.P. Arezzo" Hospital, Via Dante Alighieri 109, I-97100, ASP, Ragusa, Italy.
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, W2 1PG, London, UK.
- HuGeF Foundation, via Nizza 52, Turin, Italy.
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, VIA PANSINI 5, 80131, Naples, Italy.
| | - H Bas Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, W2 1PG, London, UK.
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven / PO Box 1, 3720 BA, Bilthoven, The Netherlands.
- Department of Gastroenterology and Hepatology, University Medical Centre, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.
| | - Peter D Siersema
- Department of Gastroenterology and Hepatology, University Medical Centre, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - Bodil Ohlsson
- Division of Internal Medicine, Department of Clinical Sciences, Skane University Hospital, Malmo, Lund University, Inga-Maria Nilssons gata 32, 205 02, Lund, Sweden.
| | - Karin Jirström
- Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Barngatan 2B, SE- 221 85, Lund, Sweden.
| | - Maria Wennberg
- Public Health and Clinical Medicine, Nutritional Research, Umeå University, S-901 87, Umeå, Sweden.
| | - Lena M Nilsson
- Arctic Research Centre, Umeå University, S-901 87, Umeå, Sweden.
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, ISM - Universitetet i Tromsø, 9037, Tromsø, Norway.
- Department of Research, Cancer Registry of Norway, P.B. 5313, Majorstuen, 0304, Oslo, Norway.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, 171 77, Stockholm, Sweden.
- Department of Genetic Epidemiology, Folkhälsan Research Center, Folkhälsan Research Center, Biomedicum 1, Haartmansgatan 8, PB 63 (B336b), FI-00014 University of Helsinki, Helsinki, Finland.
| | - Tilman Kühn
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology Im Neuenheimer Feld 581, D-69120, Heidelberg, Germany.
| | - Verena Katzke
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology Im Neuenheimer Feld 581, D-69120, Heidelberg, Germany.
| | - Kay-Tee Khaw
- University of Cambridge School of Clinical Medicine, Clinical Gerontology Unit Box 251, Addenbrooke's Hospital, Cambridge, CB2 2QQ, UK.
| | - Nick J Wareham
- MRC Epidemiology Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, CB2 2QQ, UK.
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, 69120, Germany.
| | - José R Quirós
- Public Health Directorate, Ciriaco Miguel Vigil 9, Oviedo, 33417, Asturias, Spain.
| | - Marc J Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, W2 1PG, London, UK.
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, W2 1PG, London, UK.
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, W2 1PG, London, UK.
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Chen Z, Wang PP, Woodrow J, Zhu Y, Roebothan B, Mclaughlin JR, Parfrey PS. Dietary patterns and colorectal cancer: results from a Canadian population-based study. Nutr J 2015; 14:8. [PMID: 25592002 PMCID: PMC4326290 DOI: 10.1186/1475-2891-14-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 01/08/2015] [Indexed: 11/29/2022] Open
Abstract
Background The relationship between major dietary patterns and colorectal cancer (CRC) in other populations largely remains consistent across studies. The objective of the present study is to assess if dietary patterns are associated with the risk of CRC in the population of Newfoundland and Labrador (NL). Methods Data from a population based case–control study in the province of NL were analyzed, including 506 CRC patients (306 men and 200 women) and 673 controls (400 men and 273 women), aged 20–74 years. Dietary habits were assessed by a 169-item food frequency questionnaire (FFQ). Logistic regression analyses were performed to investigate the association between dietary patterns and the CRC risk. Results Three major dietary patterns were derived using factor analysis, namely a Meat-diet pattern, a Plant-based diet pattern and a Sugary-diet pattern. In combination the three dietary patterns explained 74% of the total variance in food intake. Results suggest that the Meat-diet and the Sugary-diet increased the risk of CRC with corresponding odds ratios (ORs) of 1.84 (95% CI: 1.19-2.86) and 2.26 (95% CI: 1.39-3.66) for people in the highest intake quintile compared to those in the lowest. Whereas plant-based diet pattern decreases the risk of CRC with a corresponding OR of 0.55 (95% CI: 0.35-0.87). Even though odds ratios (ORs) were not always statistically significant, largely similar associations across three cancer sites were found: the proximal colon, the distal colon, and the rectum. Conclusion The finding that Meat-diet/Sugary-diet patterns increased and Plant-based diet pattern decreased the risk of CRC would guide the promotion of healthy eating for primary prevention of CRC in this population.
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Affiliation(s)
| | - Peizhong Peter Wang
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St, John's, Newfoundland and Labrador A1B 3V6, Canada.
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Fung TT, Kashambwa R, Sato K, Chiuve SE, Fuchs CS, Wu K, Giovannucci E, Ogino S, Hu FB, Meyerhardt JA. Post diagnosis diet quality and colorectal cancer survival in women. PLoS One 2014; 9:e115377. [PMID: 25506700 PMCID: PMC4266679 DOI: 10.1371/journal.pone.0115377] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 11/21/2014] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Dietary factors are known to influence colorectal cancer (CRC) risk, however, their association with CRC survival is unclear. Therefore, we prospectively examined the association between diet quality scores, dietary patterns and colorectal cancer (CRC) survival. METHODS 1201 women diagnosed with stage I-III CRC between 1986 and 2008, were followed through 2010. Diet was assessed via a food frequency questionnaire administered at least 6 months after diagnosis. We computed the Alternate Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean Diet score (aMED) and Dietary Approaches to Stop Hypertension score (DASH) and derived two dietary patterns, Western (unhealthy) and prudent (healthy), by principal component analysis for each woman. RESULTS During follow-up, we documented 435 deaths, including 162 from CRC. After adjusting for potential confounders, only a higher AHEI-2010 score was significantly associated with lower overall mortality (HR comparing extreme quintiles = 0.71, 95% CI 0.52-0.98, p trend = 0.01) as well as borderline significantly with lower risk of CRC mortality by the trend test (HR Q5 vs Q1 = 0.72, 95% CI = 0.43-1.21, p trend = 0.07). When AHEI-2010 components were examined separately, inverse associations for overall mortality were primarily accounted for by moderate alcohol intake (HR comparing abstainers vs 5-15 g/d = 1.30, 95%CI = 1.05-1.61) and lower intake of sugar sweetened beverages and fruit juices combined (HR for each additional serving = 1.11, 95% CI = 1.01-1.23). No other diet quality score or dietary pattern was associated with overall or CRC-specific mortality. CONCLUSION Higher AHEI-2010 score may be associated with lower overall mortality, moderate alcohol consumption and lower consumption of sugar sweetened beverages and juices combined appeared to account for most of the observed associations.
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Affiliation(s)
- Teresa T. Fung
- Department of Nutrition, Simmons College, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
| | - Rutendo Kashambwa
- Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
| | - Kaori Sato
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America
| | - Stephanie E. Chiuve
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Charles S. Fuchs
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America
| | - Kana Wu
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Edward Giovannucci
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Shuji Ogino
- Channing Division of Network Medicine, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America
| | - Frank B. Hu
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jeffrey A. Meyerhardt
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America
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Chen YS, Xu SX, Ding YB, Huang XE, Deng B. Helicobacter pylori Infection and the Risk of Colorectal Adenoma and Adenocarcinoma: an Updated Meta-analysis of Different Testing Methods. Asian Pac J Cancer Prev 2013; 14:7613-9. [PMID: 24460342 DOI: 10.7314/apjcp.2013.14.12.7613] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Yao-Sheng Chen
- Department of Gastroenterology, Yangzhou NO.1 People's Hospital, Yangzhou, China E-mail :
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McCullough ML, Gapstur SM, Shah R, Jacobs EJ, Campbell PT. Association between red and processed meat intake and mortality among colorectal cancer survivors. J Clin Oncol 2013; 31:2773-82. [PMID: 23816965 DOI: 10.1200/jco.2013.49.1126] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Red and processed meat intake is convincingly associated with colorectal cancer (CRC) incidence, but its impact on prognosis after CRC diagnosis is unknown. We examined associations of red and processed meat consumption, self-reported before and after cancer diagnosis, with all-cause and cause-specific mortality among men and women with invasive, nonmetastatic CRC. PATIENTS AND METHODS Participants in the Cancer Prevention Study II Nutrition Cohort reported information on diet and other factors at baseline in 1992-1993, 1999, and 2003. Participants with a verified CRC diagnosis after baseline and up to June 30, 2009, were observed for mortality through December 31, 2010. RESULTS Among 2,315 participants diagnosed with CRC, 966 died during follow-up (413 from CRC and 176 from cardiovascular disease [CVD]). In multivariable-adjusted Cox proportional hazards regression models, red and processed meat intake before CRC diagnosis was associated with higher risks of death as a result of all causes (top v bottom quartile, relative risk [RR], 1.29; 95% CI, 1.05 to 1.59; Ptrend = .03) and from CVD (RR, 1.63; 95% CI, 1.00 to 2.67; Ptrend = .08) but not CRC (RR, 1.09; 95% CI, 0.79 to 1.51; Ptrend = 0.54). Although red and processed meat consumption after CRC diagnosis was not associated with mortality, survivors with consistently high (median or higher) intakes before and after diagnosis had a higher risk of CRC-specific mortality (RR, 1.79; 95% CI, 1.11 to 2.89) compared with those with consistently low intakes. CONCLUSION This study suggests that greater red and processed meat intake before diagnosis is associated with higher risk of death among patients with nonmetastatic CRC.
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Affiliation(s)
- Marjorie L McCullough
- Epidemiology Research Program, American Cancer Society, Atlanta, GA 30303-1002, USA.
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