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Grain and dietary fiber intake and bladder cancer risk: a pooled analysis of prospective cohort studies.
Am J Clin Nutr. 2020 11 11; 112(5):1252-1266.AJ

Abstract

BACKGROUND

Higher intakes of whole grains and dietary fiber have been associated with lower risk of insulin resistance, hyperinsulinemia, and inflammation, which are known predisposing factors for cancer.

OBJECTIVES

Because the evidence of association with bladder cancer (BC) is limited, we aimed to assess associations with BC risk for intakes of whole grains, refined grains, and dietary fiber.

METHODS

We pooled individual data from 574,726 participants in 13 cohort studies, 3214 of whom developed incident BC. HRs, with corresponding 95% CIs, were estimated using Cox regression models stratified on cohort. Dose-response relations were examined using fractional polynomial regression models.

RESULTS

We found that higher intake of total whole grain was associated with lower risk of BC (comparing highest with lowest intake tertile: HR: 0.87; 95% CI: 0.77, 0.98; HR per 1-SD increment: 0.95; 95% CI: 0.91, 0.99; P for trend: 0.023). No association was observed for intake of total refined grain. Intake of total dietary fiber was also inversely associated with BC risk (comparing highest with lowest intake tertile: HR: 0.86; 95% CI: 0.76, 0.98; HR per 1-SD increment: 0.91; 95% CI: 0.82, 0.98; P for trend: 0.021). In addition, dose-response analyses gave estimated HRs of 0.97 (95% CI: 0.95, 0.99) for intake of total whole grain and 0.96 (95% CI: 0.94, 0.98) for intake of total dietary fiber per 5-g daily increment. When considered jointly, highest intake of whole grains with the highest intake of dietary fiber showed 28% reduced risk (95% CI: 0.54, 0.93; P for trend: 0.031) of BC compared with the lowest intakes, suggesting potential synergism.

CONCLUSIONS

Higher intakes of total whole grain and total dietary fiber are associated with reduced risk of BC individually and jointly. Further studies are needed to clarify the underlying mechanisms for these findings.

Authors+Show Affiliations

Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands.Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands.Department of Data Science and Knowledge Engineering, Maastricht University, Maastricht, Netherlands.Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands. Department of Clinical Studies and Nutritional Epidemiology, Nutrition Biomed Research Institute, Melbourne, Victoria, Australia. Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.Department of Epidemiology, School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, Netherlands. Department of Epidemiology, School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, Netherlands.Fred Hutchinson Cancer Research Center, Seattle, WA, USA.International Agency for Research on Cancer/WHO, Lyon, France.International Agency for Research on Cancer/WHO, Lyon, France.International Agency for Research on Cancer/WHO, Lyon, France.International Agency for Research on Cancer/WHO, Lyon, France.Department of Urology, Skåne University Hospital, Malmö, Sweden. Institution of Translational Medicine, Lund University, Malmö, Sweden.Department of Community Medicine, UIT The Arctic University of Norway, Tromsø, Norway.Danish Cancer Society Research Center, Copenhagen, Denmark. Department of Public Health, University of Copenhagen, Copenhagen, Denmark.Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia. Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia. Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands. CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands. School of Cancer Sciences, University of Birmingham, Birmingham, United Kingdom.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

32778880

Citation

Yu, Evan Y W., et al. "Grain and Dietary Fiber Intake and Bladder Cancer Risk: a Pooled Analysis of Prospective Cohort Studies." The American Journal of Clinical Nutrition, vol. 112, no. 5, 2020, pp. 1252-1266.
Yu EYW, Wesselius A, Mehrkanoon S, et al. Grain and dietary fiber intake and bladder cancer risk: a pooled analysis of prospective cohort studies. Am J Clin Nutr. 2020;112(5):1252-1266.
Yu, E. Y. W., Wesselius, A., Mehrkanoon, S., Brinkman, M., van den Brandt, P., White, E., Weiderpass, E., Le Calvez-Kelm, F., Gunter, M., Huybrechts, I., Liedberg, F., Skeie, G., Tjonneland, A., Riboli, E., Giles, G. G., Milne, R. L., & Zeegers, M. P. (2020). Grain and dietary fiber intake and bladder cancer risk: a pooled analysis of prospective cohort studies. The American Journal of Clinical Nutrition, 112(5), 1252-1266. https://doi.org/10.1093/ajcn/nqaa215
Yu EYW, et al. Grain and Dietary Fiber Intake and Bladder Cancer Risk: a Pooled Analysis of Prospective Cohort Studies. Am J Clin Nutr. 2020 11 11;112(5):1252-1266. PubMed PMID: 32778880.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Grain and dietary fiber intake and bladder cancer risk: a pooled analysis of prospective cohort studies. AU - Yu,Evan Y W, AU - Wesselius,Anke, AU - Mehrkanoon,Siamak, AU - Brinkman,Maree, AU - van den Brandt,Piet, AU - White,Emily, AU - Weiderpass,Elisabete, AU - Le Calvez-Kelm,Florence, AU - Gunter,Marc, AU - Huybrechts,Inge, AU - Liedberg,Fredrik, AU - Skeie,Guri, AU - Tjonneland,Anne, AU - Riboli,Elio, AU - Giles,Graham G, AU - Milne,Roger L, AU - Zeegers,Maurice P, PY - 2020/03/11/received PY - 2020/07/08/accepted PY - 2020/8/12/pubmed PY - 2020/12/17/medline PY - 2020/8/12/entrez KW - bladder cancer KW - cohort study KW - dietary fiber KW - dose-response analysis KW - grain SP - 1252 EP - 1266 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 112 IS - 5 N2 - BACKGROUND: Higher intakes of whole grains and dietary fiber have been associated with lower risk of insulin resistance, hyperinsulinemia, and inflammation, which are known predisposing factors for cancer. OBJECTIVES: Because the evidence of association with bladder cancer (BC) is limited, we aimed to assess associations with BC risk for intakes of whole grains, refined grains, and dietary fiber. METHODS: We pooled individual data from 574,726 participants in 13 cohort studies, 3214 of whom developed incident BC. HRs, with corresponding 95% CIs, were estimated using Cox regression models stratified on cohort. Dose-response relations were examined using fractional polynomial regression models. RESULTS: We found that higher intake of total whole grain was associated with lower risk of BC (comparing highest with lowest intake tertile: HR: 0.87; 95% CI: 0.77, 0.98; HR per 1-SD increment: 0.95; 95% CI: 0.91, 0.99; P for trend: 0.023). No association was observed for intake of total refined grain. Intake of total dietary fiber was also inversely associated with BC risk (comparing highest with lowest intake tertile: HR: 0.86; 95% CI: 0.76, 0.98; HR per 1-SD increment: 0.91; 95% CI: 0.82, 0.98; P for trend: 0.021). In addition, dose-response analyses gave estimated HRs of 0.97 (95% CI: 0.95, 0.99) for intake of total whole grain and 0.96 (95% CI: 0.94, 0.98) for intake of total dietary fiber per 5-g daily increment. When considered jointly, highest intake of whole grains with the highest intake of dietary fiber showed 28% reduced risk (95% CI: 0.54, 0.93; P for trend: 0.031) of BC compared with the lowest intakes, suggesting potential synergism. CONCLUSIONS: Higher intakes of total whole grain and total dietary fiber are associated with reduced risk of BC individually and jointly. Further studies are needed to clarify the underlying mechanisms for these findings. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/32778880/Grain_and_dietary_fiber_intake_and_bladder_cancer_risk:_a_pooled_analysis_of_prospective_cohort_studies_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/nqaa215 DB - PRIME DP - Unbound Medicine ER -