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Post diagnosis diet quality and colorectal cancer survival in women.

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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  • Authors+Show Affiliations

    ,

    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.

    ,

    Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, United States of America.

    ,

    Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America.

    ,

    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; Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America.

    ,

    Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America.

    ,

    Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America.

    ,

    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.

    ,

    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.

    Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America.

    Source

    PloS one 9:12 2014 pg e115377

    MeSH

    Adult
    Aged
    Beverages
    Colorectal Neoplasms
    Diet, Mediterranean
    Feeding Behavior
    Female
    Fruit and Vegetable Juices
    Humans
    Middle Aged
    Prospective Studies
    Survival Rate

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    25506700

    Citation

    Fung, Teresa T., et al. "Post Diagnosis Diet Quality and Colorectal Cancer Survival in Women." PloS One, vol. 9, no. 12, 2014, pp. e115377.
    Fung TT, Kashambwa R, Sato K, et al. Post diagnosis diet quality and colorectal cancer survival in women. PLoS ONE. 2014;9(12):e115377.
    Fung, T. T., Kashambwa, R., Sato, K., Chiuve, S. E., Fuchs, C. S., Wu, K., ... Meyerhardt, J. A. (2014). Post diagnosis diet quality and colorectal cancer survival in women. PloS One, 9(12), pp. e115377. doi:10.1371/journal.pone.0115377.
    Fung TT, et al. Post Diagnosis Diet Quality and Colorectal Cancer Survival in Women. PLoS ONE. 2014;9(12):e115377. PubMed PMID: 25506700.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Post diagnosis diet quality and colorectal cancer survival in women. AU - Fung,Teresa T, AU - Kashambwa,Rutendo, AU - Sato,Kaori, AU - Chiuve,Stephanie E, AU - Fuchs,Charles S, AU - Wu,Kana, AU - Giovannucci,Edward, AU - Ogino,Shuji, AU - Hu,Frank B, AU - Meyerhardt,Jeffrey A, Y1 - 2014/12/15/ PY - 2014/06/24/received PY - 2014/11/21/accepted PY - 2014/12/16/entrez PY - 2014/12/17/pubmed PY - 2016/5/6/medline SP - e115377 EP - e115377 JF - PloS one JO - PLoS ONE VL - 9 IS - 12 N2 - 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. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/25506700/Post_diagnosis_diet_quality_and_colorectal_cancer_survival_in_women_ L2 - http://dx.plos.org/10.1371/journal.pone.0115377 DB - PRIME DP - Unbound Medicine ER -