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Whole grain and dietary fiber intake and risk of colorectal cancer in the NIH-AARP Diet and Health Study cohort.
Am J Clin Nutr. 2020 09 01; 112(3):603-612.AJ

Abstract

BACKGROUND

Whole grains and other foods containing fiber are thought to be inversely related to colorectal cancer (CRC). However, whether these associations reflect fiber or fiber source remains unclear.

OBJECTIVES

We evaluated associations of whole grain and dietary fiber intake with CRC risk in the large NIH-AARP Diet and Health Study.

METHODS

We used Cox proportional hazard models to estimate HRs and 95% CIs for whole grain and dietary fiber intake and risk of CRC among 478,994 US adults, aged 50-71 y. Diet was assessed using a self-administered FFQ at baseline in 1995-1996, and 10,200 incident CRC cases occurred over 16 y and 6,464,527 person-years of follow-up. We used 24-h dietary recall data, collected on a subset of participants, to evaluate the impact of measurement error on risk estimates.

RESULTS

After multivariable adjustment for potential confounders, including folate, we observed an inverse association for intake of whole grains (HRQ5 vs.Q1 : 0.84; 95% CI: 0.79, 0.90; P-trend < 0.001), but not dietary fiber (HRQ5 vs. Q1: 0.96; 95% CI: 0.88, 1.04; P-trend = 0.40), with CRC incidence. Intake of whole grains was inversely associated with all CRC cancer subsites, particularly rectal cancer (HRQ5 vs. Q1: 0.76; 95% CI: 0.67, 0.87; P-trend < 0.001). Fiber from grains, but not other sources, was associated with lower incidence of CRC (HRQ5 vs. Q1: 0.89; 95% CI: 0.83, 0.96; P-trend < 0.001), particularly distal colon (HRQ5 vs. Q1: 0.84; 95% CI: 0.73, 0.96; P-trend = 0.005) and rectal cancer (HRQ5 vs. Q1: 0.77; 95% CI: 0.66, 0.88; P-trend < 0.001).

CONCLUSIONS

Dietary guidance for CRC prevention should focus on intake of whole grains as a source of fiber.

Authors+Show Affiliations

Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH, Bethesda, MD, USA.Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH, Bethesda, MD, USA.Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH, Bethesda, MD, USA.Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH, Bethesda, MD, USA.Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH, Bethesda, MD, USA.Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH, Bethesda, MD, USA.

Pub Type(s)

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

Language

eng

PubMed ID

32619213

Citation

Hullings, Autumn G., et al. "Whole Grain and Dietary Fiber Intake and Risk of Colorectal Cancer in the NIH-AARP Diet and Health Study Cohort." The American Journal of Clinical Nutrition, vol. 112, no. 3, 2020, pp. 603-612.
Hullings AG, Sinha R, Liao LM, et al. Whole grain and dietary fiber intake and risk of colorectal cancer in the NIH-AARP Diet and Health Study cohort. Am J Clin Nutr. 2020;112(3):603-612.
Hullings, A. G., Sinha, R., Liao, L. M., Freedman, N. D., Graubard, B. I., & Loftfield, E. (2020). Whole grain and dietary fiber intake and risk of colorectal cancer in the NIH-AARP Diet and Health Study cohort. The American Journal of Clinical Nutrition, 112(3), 603-612. https://doi.org/10.1093/ajcn/nqaa161
Hullings AG, et al. Whole Grain and Dietary Fiber Intake and Risk of Colorectal Cancer in the NIH-AARP Diet and Health Study Cohort. Am J Clin Nutr. 2020 09 1;112(3):603-612. PubMed PMID: 32619213.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Whole grain and dietary fiber intake and risk of colorectal cancer in the NIH-AARP Diet and Health Study cohort. AU - Hullings,Autumn G, AU - Sinha,Rashmi, AU - Liao,Linda M, AU - Freedman,Neal D, AU - Graubard,Barry I, AU - Loftfield,Erikka, PY - 2019/12/19/received PY - 2020/06/01/accepted PY - 2020/7/4/pubmed PY - 2020/9/26/medline PY - 2020/7/4/entrez KW - colon cancer KW - colorectal cancer KW - diet KW - dietary fiber KW - epidemiology KW - rectal cancer KW - whole grains SP - 603 EP - 612 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 112 IS - 3 N2 - BACKGROUND: Whole grains and other foods containing fiber are thought to be inversely related to colorectal cancer (CRC). However, whether these associations reflect fiber or fiber source remains unclear. OBJECTIVES: We evaluated associations of whole grain and dietary fiber intake with CRC risk in the large NIH-AARP Diet and Health Study. METHODS: We used Cox proportional hazard models to estimate HRs and 95% CIs for whole grain and dietary fiber intake and risk of CRC among 478,994 US adults, aged 50-71 y. Diet was assessed using a self-administered FFQ at baseline in 1995-1996, and 10,200 incident CRC cases occurred over 16 y and 6,464,527 person-years of follow-up. We used 24-h dietary recall data, collected on a subset of participants, to evaluate the impact of measurement error on risk estimates. RESULTS: After multivariable adjustment for potential confounders, including folate, we observed an inverse association for intake of whole grains (HRQ5 vs.Q1 : 0.84; 95% CI: 0.79, 0.90; P-trend < 0.001), but not dietary fiber (HRQ5 vs. Q1: 0.96; 95% CI: 0.88, 1.04; P-trend = 0.40), with CRC incidence. Intake of whole grains was inversely associated with all CRC cancer subsites, particularly rectal cancer (HRQ5 vs. Q1: 0.76; 95% CI: 0.67, 0.87; P-trend < 0.001). Fiber from grains, but not other sources, was associated with lower incidence of CRC (HRQ5 vs. Q1: 0.89; 95% CI: 0.83, 0.96; P-trend < 0.001), particularly distal colon (HRQ5 vs. Q1: 0.84; 95% CI: 0.73, 0.96; P-trend = 0.005) and rectal cancer (HRQ5 vs. Q1: 0.77; 95% CI: 0.66, 0.88; P-trend < 0.001). CONCLUSIONS: Dietary guidance for CRC prevention should focus on intake of whole grains as a source of fiber. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/32619213/Whole_grain_and_dietary_fiber_intake_and_risk_of_colorectal_cancer_in_the_NIH_AARP_Diet_and_Health_Study_cohort_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/nqaa161 DB - PRIME DP - Unbound Medicine ER -