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B vitamin intakes and incidence of colorectal cancer: results from the Women's Health Initiative Observational Study cohort.
Am J Clin Nutr 2013; 97(2):332-43AJ

Abstract

BACKGROUND

The role of one-carbon metabolism nutrients in colorectal carcinogenesis is not fully understood. Associations might be modified by mandated folic acid (FA) fortification or alcohol intake.

OBJECTIVE

We investigated associations between intakes of folate, riboflavin, vitamin B-6, and vitamin B-12 and colorectal cancer (CRC) in the Women's Health Initiative Observational Study, stratified by time exposed to FA fortification and alcohol intake.

DESIGN

A total of 88,045 postmenopausal women were recruited during 1993-1998; 1003 incident CRC cases were ascertained as of 2009. Quartiles of dietary intakes were compared; HRs and 95% CIs were estimated by Cox proportional hazards models.

RESULTS

Dietary and total intakes of vitamin B-6 in quartile 4 compared with quartile 1 (HR: 0.80; 95% CI: 0.66, 0.97 and HR: 0.80; 95% CI: 0.66, 0.99, respectively) and total intakes of riboflavin (HR: 0.81; 95% CI: 0.66, 0.99) were associated with reduced risk of CRC overall and of regionally spread disease. In current drinkers who consumed <1 drink (13 g alcohol)/wk, B vitamin intakes were inversely associated with CRC risk (P-interaction < 0.05). Dietary folate intake was positively associated with CRC risk among women who had experienced the initiation of FA fortification for 3 to <9 y (P-interaction < 0.01).

CONCLUSIONS

Vitamin B-6 and riboflavin intakes from diet and supplements were associated with a decreased risk of CRC in postmenopausal women. Associations of B vitamin intake were particularly strong for regional disease and among women drinkers who consumed alcohol infrequently. Our study provides new evidence that the increased folate intake during the early postfortification period may have been associated with a transient increase in CRC risk.

Authors+Show Affiliations

Division of Preventive Oncology, National Center for Tumor Diseases, Heidelberg, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

23255571

Citation

Zschäbitz, Stefanie, et al. "B Vitamin Intakes and Incidence of Colorectal Cancer: Results From the Women's Health Initiative Observational Study Cohort." The American Journal of Clinical Nutrition, vol. 97, no. 2, 2013, pp. 332-43.
Zschäbitz S, Cheng TY, Neuhouser ML, et al. B vitamin intakes and incidence of colorectal cancer: results from the Women's Health Initiative Observational Study cohort. Am J Clin Nutr. 2013;97(2):332-43.
Zschäbitz, S., Cheng, T. Y., Neuhouser, M. L., Zheng, Y., Ray, R. M., Miller, J. W., ... Ulrich, C. M. (2013). B vitamin intakes and incidence of colorectal cancer: results from the Women's Health Initiative Observational Study cohort. The American Journal of Clinical Nutrition, 97(2), pp. 332-43. doi:10.3945/ajcn.112.034736.
Zschäbitz S, et al. B Vitamin Intakes and Incidence of Colorectal Cancer: Results From the Women's Health Initiative Observational Study Cohort. Am J Clin Nutr. 2013;97(2):332-43. PubMed PMID: 23255571.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - B vitamin intakes and incidence of colorectal cancer: results from the Women's Health Initiative Observational Study cohort. AU - Zschäbitz,Stefanie, AU - Cheng,Ting-Yuan David, AU - Neuhouser,Marian L, AU - Zheng,Yingye, AU - Ray,Roberta M, AU - Miller,Joshua W, AU - Song,Xiaoling, AU - Maneval,David R, AU - Beresford,Shirley A A, AU - Lane,Dorothy, AU - Shikany,James M, AU - Ulrich,Cornelia M, Y1 - 2012/12/19/ PY - 2012/12/21/entrez PY - 2012/12/21/pubmed PY - 2013/3/21/medline SP - 332 EP - 43 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 97 IS - 2 N2 - BACKGROUND: The role of one-carbon metabolism nutrients in colorectal carcinogenesis is not fully understood. Associations might be modified by mandated folic acid (FA) fortification or alcohol intake. OBJECTIVE: We investigated associations between intakes of folate, riboflavin, vitamin B-6, and vitamin B-12 and colorectal cancer (CRC) in the Women's Health Initiative Observational Study, stratified by time exposed to FA fortification and alcohol intake. DESIGN: A total of 88,045 postmenopausal women were recruited during 1993-1998; 1003 incident CRC cases were ascertained as of 2009. Quartiles of dietary intakes were compared; HRs and 95% CIs were estimated by Cox proportional hazards models. RESULTS: Dietary and total intakes of vitamin B-6 in quartile 4 compared with quartile 1 (HR: 0.80; 95% CI: 0.66, 0.97 and HR: 0.80; 95% CI: 0.66, 0.99, respectively) and total intakes of riboflavin (HR: 0.81; 95% CI: 0.66, 0.99) were associated with reduced risk of CRC overall and of regionally spread disease. In current drinkers who consumed <1 drink (13 g alcohol)/wk, B vitamin intakes were inversely associated with CRC risk (P-interaction < 0.05). Dietary folate intake was positively associated with CRC risk among women who had experienced the initiation of FA fortification for 3 to <9 y (P-interaction < 0.01). CONCLUSIONS: Vitamin B-6 and riboflavin intakes from diet and supplements were associated with a decreased risk of CRC in postmenopausal women. Associations of B vitamin intake were particularly strong for regional disease and among women drinkers who consumed alcohol infrequently. Our study provides new evidence that the increased folate intake during the early postfortification period may have been associated with a transient increase in CRC risk. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/23255571/full_citation L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.112.034736 DB - PRIME DP - Unbound Medicine ER -