Dietary inflammatory index and odds of colorectal cancer in a case-control study from Jordan

Dietary components that promote inflammation of the colon have been suggested to be risk factors in the development of colorectal cancer (CRC). The possible link between inflammatory potential of diet and CRC has been investigated in several developed or Western countries. Despite the fact that dietary choices in the Middle East differ markedly from those in the West, results have not been reported from any study conducted in a Middle-Eastern population. We examined the association between dietary inflammatory index (DII) scores and CRC in a case-control study conducted in Jordan. This study included 153 histopathologically confirmed CRC cases and 202 disease-free control subjects' frequency matched on age, sex, and occupation. Data were collected between January 2010 and December 2012, using interviewer-administered questionnaires. DII scores were computed from dietary data reported using a food frequency questionnaire. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for age, sex, education, physical activity, body mass index, smoking, and family history of CRC. Subjects with higher DII scores were at increased odds of CRC, with the DII being used both as a continuous variable (OR_continuous = 1.45, 95% CI: 1.13-1.85; 1-unit increase corresponding to ≈20% of its range in the current study) and as a categorical variable (OR_{tertile 3 vs tertile 1} = 2.13, 95%CI: 1.23-3.72). Our results, based on a Jordanian population, add to the growing literature indicating that a pro-inflammatory diet is associated with increased odds of CRC.

Meats, milk and fat consumption in colorectal cancer

BACKGROUND

Data from several studies suggest that a diet high in meat, including processed meat and fat, may have an association with the development of colorectal cancer (CRC).

METHODS

The present study aimed to investigate the relationship between meats, dairy products, fat consumption and the risk of CRC in Jordanians. A case-control study was performed at the five largest hospitals in Jordan. Dietary data were collected from 220 diagnosed cases of CRC and 281 healthy disease-free controls. The CRC cases were matched as closely as possible to controls using age, sex, occupation and marital status.

RESULTS

The consumption of different levels and frequencies of several food types, including meats, chicken, milk and fish, was found to be associated with the risk of developing CRC. Added fats and oils were inversely associated with CRC risk with odds ratio = 0.33 (95% confidence interval = 0.13-0.83, P_trend = 0.005). The predominant fat added by cases and controls was olive oil, followed by corn oil.

CONCLUSIONS

The results of the study suggest that the consumption of some types of meat, processed meats and Labaneh (strained yogurt) may be associated with the risk of developing CRC.

Dietary patterns and colorectal cancer

BACKGROUND & AIMS

Dietary pattern and lifestyle have been reported to be important risk factors in the development of colorectal cancer (CRC). However, the mechanism of action of dietary factors in CRC disease is unclear. The aim of this study is the examination of several dietary choices and their potential association with the risk of developing CRC.

METHODS

Dietary data was collected from 220 subjects who were previously diagnosed with CRC, and 281 control subjects (matched by age, gender, occupation and marital status). The data was collected between January 2010 and December 2012, using interview-based questionnaires. Multivariate logistic regression was used to estimate the relationship between dietary choices and risk of developing colorectal cancer.

RESULTS

Factor analysis revealed three major dietary patterns. The first pattern we identified as the "Healthy Pattern", the second was identified as "High Sugar/High Tea Pattern" and the third as "Western Pattern". In the Healthy Pattern group we found a 10.54% variation in food intake, while the intake variation was 11.64% in the Western Pattern. After adjusting for confounding factors, the Western Pattern food choice was found to be significantly associated with an increased risk of developing CRC (OR = 1.88; 95% CI = 1.12-3.16). The results for the Healthy and High-Sugar/High Tea Patterns showed a decrease, but the statistic was not significant for the risk of CRC development.

CONCLUSION

The Western Pattern of dietary choice was directly associated with CRC. The association between the dietary food choice in the Healthy and High-Sugar/High Tea Patterns and colorectal cancer needs further study in our Jordanian population.

Fruit and vegetable intake among Jordanians: results from a case-control study of colorectal cancer

BACKGROUND

Diets that include fruits and vegetables have been suggested as one way to reduce the risk of developing colorectal cancer (CRC); however, the association between consuming fruits and vegetables and CRC risk is not clear. The objective of the present study is to compare fruit and vegetable intake between 2 groups of Jordanians and further investigate this possible relationship.

METHODS

A history of fruit and vegetable consumption was obtained from 220 people with CRC and 281 healthy controls, all of whom were from Jordan. Both groups were matched for age, sex, occupation, and marital status. Fruit and vegetable consumption was quantified for the previous 12 months in both groups.

RESULTS

Total vegetable intake was associated with the risk of developing CRC. Consuming 5 servings of vegetables a day decreased the risk of developing CRC when compared with no more than 1 serving a day (odds ratio [OR] = 0.23; 95% confidence interval [CI]: 0.55-0.97). A significant direct relationship between CRC risk and consuming cauliflower and cabbage was found; however, no association was found for raw or cooked leafy vegetable and other vegetable types. Consuming several types of fruits also revealed no association with risk of CRC, although an increased intake of dates and figs was associated with a reduced risk of developing CRC. The ORs for the highest intake of servings compared with the lowest intake were 0.48 (95% CI: 0.27-0.87; P = .004) for dates and 0.604 (95% CI: 0.35-1.06; P = .003) for figs.

CONCLUSIONS

Consuming fruits and vegetables did not significantly correlate with a lowered incidence of CRC. However, a trend of protection was detected for several types of fruits and vegetables.

Macro- and micronutrients consumption and the risk for colorectal cancer among Jordanians

OBJECTIVE

Diet and lifestyle have been reported to be important risk factors for the development of colorectal cancer (CRC). However, the association between total energy and nutrient intake and the risk of developing CRC has not been clearly explained. The aim of our study is to examine the relationship between total energy intake and other nutrients and the development of CRC in the Jordanian population.

RESEARCH METHODS AND PROCEDURES

Dietary data was collected from 169 subjects who were previously diagnosed with CRC, and 248 control subjects (matched by age, gender, occupation and marital status). These control subjects were healthy and disease free. Data was collected between January 2010 and December 2012, using interview-based questionnaires. Logistic regression was used to evaluate the association between quartiles of total energy, macro- and micronutrient intakes with the risk of developing CRC in our study population.

RESULTS

Total energy intake was associated with a higher risk of developing CRC (OR = 2.60 for the highest versus lowest quartile of intake; 95% CI: 1.21-5.56, p-trend = 0.03). Intakes of protein (OR = 3.62, 95% CI: 1.63-8.05, p-trend = 0.002), carbohydrates (OR = 1.41, 95% CI: 0.67-2.99, p-trend = 0.043), and percentage of energy from fat (OR = 2.10, 95% CI: 0.38-11.70, p-trend = 0.009) significantly increased the risk for the development of CRC. Saturated fat, dietary cholesterol and sodium intake showed a significant association with the risk of developing CRC (OR = 5.23, 95% CI: 2.33-11.76; OR = 2.48, 95% CI: 1.18-5.21; and OR = 3.42, 95% CI: 1.59-7.38, respectively), while vitamin E and caffeine intake were indicative of a protective effect against the development of CRC, OR = 0.002 (95% CI: 0.0003-0.011) and 0.023 (95%CI: 0.008-0.067), respectively.

CONCLUSION

Our results suggest an increased risk for the development of CRC in subjects with high dietary intake of energy, protein, saturated fat, cholesterol, and sodium, and diets high in vitamin E and caffeine were suggestive of a protective effect against the risk of developing CRC.

IMPACT

This is the first study in Jordan to suggest that it may be possible to reduce CRC risk by adjusting the intake of some macro-and micronutrients.