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Recommendation-based dietary indexes and risk of colorectal cancer in the Nurses' Health Study and Health Professionals Follow-up Study.
Am J Clin Nutr. 2018 11 01; 108(5):1092-1103.AJ

Abstract

Background

Many dietary indexes exist for chronic disease prevention, but the optimal dietary pattern for colorectal cancer prevention is unknown.

Objective

We sought to determine associations between adherence to various dietary indexes and incident colorectal cancer in 2 prospective cohort studies.

Design

We followed 78,012 women in the Nurses' Health Study and 46,695 men in the Health Professionals Follow-up Study from 1986 and 1988, respectively, until 2012. We created dietary index scores for the Dietary Approaches to Stop Hypertension (DASH) diet, Alternative Mediterranean Diet (AMED), and Alternative Healthy Eating Index-2010 (AHEI-2010) and used Cox regression to estimate HRs and 95% CIs for risk of colorectal cancer (CRC) and by anatomic subsite. We also conducted latency analyses to examine associations between diet and CRC risk during different windows of exposure. We conducted analyses in men and women separately, and subsequently pooled these results in a random-effects meta-analysis.

Results

We documented 2690 colorectal cancer cases. Pooled multivariable HRs for colorectal cancer risk comparing the highest to lowest quintile of diet scores were 0.89 (95% CI: 0.74, 1.08; P-trend = 0.10) for DASH, 0.89 (95% CI: 0.73, 1.10; P-trend = 0.31) for AMED, and 0.95 (95% CI: 0.83, 1.09; P-trend = 0.56) for AHEI-2010 (P-heterogeneity ≥ 0.07 for all). In sex-specific analyses, we observed stronger associations in men for all dietary indexes (DASH: multivariable HR = 0.81, 95% CI: 0.66, 0.98; P-trend = 0.003; AMED: multivariable HR = 0.80, 95% CI: 0.65, 0.98; P-trend = 0.02; AHEI-2010: multivariable HR = 0.88, 95% CI: 0.72, 1.07; P-trend = 0.04) than in women (multivariable HRs range from 0.98 to 1.01).

Conclusions

Adherence to the DASH, AMED, and AHEI-2010 diets was inversely associated with colorectal cancer risk in men. These diets were not associated with colorectal cancer risk in women. This observational study was registered at http://www.clinicaltrials.gov as NCT03364582.

Authors+Show Affiliations

Departments of Nutrition, Harvard TH Chan School of Public Health, Boston, MA. Epidemiology, Harvard TH Chan School of Public Health, Boston, MA.Departments of Nutrition, Harvard TH Chan School of Public Health, Boston, MA. Epidemiology, Harvard TH Chan School of Public Health, Boston, MA.Departments of Nutrition, Harvard TH Chan School of Public Health, Boston, MA. Department of Nutrition, Simmons College, Boston, MA.Biostatistics, Harvard TH Chan School of Public Health, Boston, MA. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA.Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA. Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA. Division of Gastroenterology, Massachusetts General Hospital, Boston, MA.Departments of Nutrition, Harvard TH Chan School of Public Health, Boston, MA. Epidemiology, Harvard TH Chan School of Public Health, Boston, MA. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA.Departments of Nutrition, Harvard TH Chan School of Public Health, Boston, MA. Epidemiology, Harvard TH Chan School of Public Health, Boston, MA. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA.Departments of Nutrition, Harvard TH Chan School of Public Health, Boston, MA. Epidemiology, Harvard TH Chan School of Public Health, Boston, MA. Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH.

Pub Type(s)

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

Language

eng

PubMed ID

30289433

Citation

Petimar, Joshua, et al. "Recommendation-based Dietary Indexes and Risk of Colorectal Cancer in the Nurses' Health Study and Health Professionals Follow-up Study." The American Journal of Clinical Nutrition, vol. 108, no. 5, 2018, pp. 1092-1103.
Petimar J, Smith-Warner SA, Fung TT, et al. Recommendation-based dietary indexes and risk of colorectal cancer in the Nurses' Health Study and Health Professionals Follow-up Study. Am J Clin Nutr. 2018;108(5):1092-1103.
Petimar, J., Smith-Warner, S. A., Fung, T. T., Rosner, B., Chan, A. T., Hu, F. B., Giovannucci, E. L., & Tabung, F. K. (2018). Recommendation-based dietary indexes and risk of colorectal cancer in the Nurses' Health Study and Health Professionals Follow-up Study. The American Journal of Clinical Nutrition, 108(5), 1092-1103. https://doi.org/10.1093/ajcn/nqy171
Petimar J, et al. Recommendation-based Dietary Indexes and Risk of Colorectal Cancer in the Nurses' Health Study and Health Professionals Follow-up Study. Am J Clin Nutr. 2018 11 1;108(5):1092-1103. PubMed PMID: 30289433.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recommendation-based dietary indexes and risk of colorectal cancer in the Nurses' Health Study and Health Professionals Follow-up Study. AU - Petimar,Joshua, AU - Smith-Warner,Stephanie A, AU - Fung,Teresa T, AU - Rosner,Bernard, AU - Chan,Andrew T, AU - Hu,Frank B, AU - Giovannucci,Edward L, AU - Tabung,Fred K, PY - 2018/02/16/received PY - 2018/06/29/accepted PY - 2018/10/6/pubmed PY - 2019/9/10/medline PY - 2018/10/6/entrez SP - 1092 EP - 1103 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 108 IS - 5 N2 - Background: Many dietary indexes exist for chronic disease prevention, but the optimal dietary pattern for colorectal cancer prevention is unknown. Objective: We sought to determine associations between adherence to various dietary indexes and incident colorectal cancer in 2 prospective cohort studies. Design: We followed 78,012 women in the Nurses' Health Study and 46,695 men in the Health Professionals Follow-up Study from 1986 and 1988, respectively, until 2012. We created dietary index scores for the Dietary Approaches to Stop Hypertension (DASH) diet, Alternative Mediterranean Diet (AMED), and Alternative Healthy Eating Index-2010 (AHEI-2010) and used Cox regression to estimate HRs and 95% CIs for risk of colorectal cancer (CRC) and by anatomic subsite. We also conducted latency analyses to examine associations between diet and CRC risk during different windows of exposure. We conducted analyses in men and women separately, and subsequently pooled these results in a random-effects meta-analysis. Results: We documented 2690 colorectal cancer cases. Pooled multivariable HRs for colorectal cancer risk comparing the highest to lowest quintile of diet scores were 0.89 (95% CI: 0.74, 1.08; P-trend = 0.10) for DASH, 0.89 (95% CI: 0.73, 1.10; P-trend = 0.31) for AMED, and 0.95 (95% CI: 0.83, 1.09; P-trend = 0.56) for AHEI-2010 (P-heterogeneity ≥ 0.07 for all). In sex-specific analyses, we observed stronger associations in men for all dietary indexes (DASH: multivariable HR = 0.81, 95% CI: 0.66, 0.98; P-trend = 0.003; AMED: multivariable HR = 0.80, 95% CI: 0.65, 0.98; P-trend = 0.02; AHEI-2010: multivariable HR = 0.88, 95% CI: 0.72, 1.07; P-trend = 0.04) than in women (multivariable HRs range from 0.98 to 1.01). Conclusions: Adherence to the DASH, AMED, and AHEI-2010 diets was inversely associated with colorectal cancer risk in men. These diets were not associated with colorectal cancer risk in women. This observational study was registered at http://www.clinicaltrials.gov as NCT03364582. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/30289433/Recommendation_based_dietary_indexes_and_risk_of_colorectal_cancer_in_the_Nurses'_Health_Study_and_Health_Professionals_Follow_up_Study_ DB - PRIME DP - Unbound Medicine ER -