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Diet and risk of colorectal adenomas: macronutrients, cholesterol, and fiber.
J Natl Cancer Inst. 1993 Jun 02; 85(11):884-91.JNCI

Abstract

BACKGROUND

Diet is thought to be important in the etiology of colorectal cancer. Studies suggest that a diet high in red meat and saturated fat and low in dietary fiber and vegetables may increase cancer risk. Diet may also be important in the development of colorectal adenomas that are precursors of most colorectal cancers, but this hypothesis has not been well studied.

PURPOSE

This case-control study was designed to examine the effects of dietary consumption of cholesterol, fiber (vegetables, fruits, beans, and grains), and macronutrients (protein, carbohydrate, and fat) on risk for colorectal adenomas.

METHODS

Analyses were based on data from 236 subjects (105 men and 131 women) with histologically confirmed adenomas (cases) and 409 adenoma-free control subjects (165 men and 244 women), all of whom had had colonoscopy. Case and control subjects were similar with respect to gender, body mass, race, marital status, education, and indications for colonoscopy. Using a validated quantitative food-frequency questionnaire, an experienced graduate nutritionist interviewed each subject by telephone. Sex-specific analyses were conducted because the ranges of nutrient intake were substantially different for men and women. Odds ratios (ORs) were calculated according to quintiles of nutrient intake.

RESULTS

Carbohydrate intake was inversely related to adenoma risk in women (P for trend = .002). Compared with women in the lowest quintile of carbohydrate consumption, those in the highest quintile were 60% less likely to develop adenomas (OR = 0.39; 95% confidence interval [CI] = 0.19-0.80). Intake of fruit (P for trend = .028) and intake of fiber derived from vegetables and fruits (P for trend = .012) were also inversely related to adenomas in women. Total fat showed a positive association in women (P for trend = .004), with an OR of 2.69 for the highest versus the lowest quintile (95% CI = 1.31-5.50). Results were comparable for saturated fat (P for trend = .027). The risks in men were generally similar in direction and magnitude but were not statistically significant.

CONCLUSIONS

These data support the hypothesis that a diet high in fat and low in carbohydrates, fruits, and fruit and vegetable fiber increases risk not only for colorectal cancer but also for precursor colorectal adenomas.

IMPLICATIONS

These results, which are consistent with findings of other investigators, suggest that environmental factors, influencing risk for colorectal cancer, such as a high-risk diet, may lead to development of the precursor adenomas.

Authors+Show Affiliations

Department of Medicine, University of North Carolina, Chapel Hill.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

8388061

Citation

Sandler, R S., et al. "Diet and Risk of Colorectal Adenomas: Macronutrients, Cholesterol, and Fiber." Journal of the National Cancer Institute, vol. 85, no. 11, 1993, pp. 884-91.
Sandler RS, Lyles CM, Peipins LA, et al. Diet and risk of colorectal adenomas: macronutrients, cholesterol, and fiber. J Natl Cancer Inst. 1993;85(11):884-91.
Sandler, R. S., Lyles, C. M., Peipins, L. A., McAuliffe, C. A., Woosley, J. T., & Kupper, L. L. (1993). Diet and risk of colorectal adenomas: macronutrients, cholesterol, and fiber. Journal of the National Cancer Institute, 85(11), 884-91.
Sandler RS, et al. Diet and Risk of Colorectal Adenomas: Macronutrients, Cholesterol, and Fiber. J Natl Cancer Inst. 1993 Jun 2;85(11):884-91. PubMed PMID: 8388061.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diet and risk of colorectal adenomas: macronutrients, cholesterol, and fiber. AU - Sandler,R S, AU - Lyles,C M, AU - Peipins,L A, AU - McAuliffe,C A, AU - Woosley,J T, AU - Kupper,L L, PY - 1993/6/2/pubmed PY - 1993/6/2/medline PY - 1993/6/2/entrez SP - 884 EP - 91 JF - Journal of the National Cancer Institute JO - J Natl Cancer Inst VL - 85 IS - 11 N2 - BACKGROUND: Diet is thought to be important in the etiology of colorectal cancer. Studies suggest that a diet high in red meat and saturated fat and low in dietary fiber and vegetables may increase cancer risk. Diet may also be important in the development of colorectal adenomas that are precursors of most colorectal cancers, but this hypothesis has not been well studied. PURPOSE: This case-control study was designed to examine the effects of dietary consumption of cholesterol, fiber (vegetables, fruits, beans, and grains), and macronutrients (protein, carbohydrate, and fat) on risk for colorectal adenomas. METHODS: Analyses were based on data from 236 subjects (105 men and 131 women) with histologically confirmed adenomas (cases) and 409 adenoma-free control subjects (165 men and 244 women), all of whom had had colonoscopy. Case and control subjects were similar with respect to gender, body mass, race, marital status, education, and indications for colonoscopy. Using a validated quantitative food-frequency questionnaire, an experienced graduate nutritionist interviewed each subject by telephone. Sex-specific analyses were conducted because the ranges of nutrient intake were substantially different for men and women. Odds ratios (ORs) were calculated according to quintiles of nutrient intake. RESULTS: Carbohydrate intake was inversely related to adenoma risk in women (P for trend = .002). Compared with women in the lowest quintile of carbohydrate consumption, those in the highest quintile were 60% less likely to develop adenomas (OR = 0.39; 95% confidence interval [CI] = 0.19-0.80). Intake of fruit (P for trend = .028) and intake of fiber derived from vegetables and fruits (P for trend = .012) were also inversely related to adenomas in women. Total fat showed a positive association in women (P for trend = .004), with an OR of 2.69 for the highest versus the lowest quintile (95% CI = 1.31-5.50). Results were comparable for saturated fat (P for trend = .027). The risks in men were generally similar in direction and magnitude but were not statistically significant. CONCLUSIONS: These data support the hypothesis that a diet high in fat and low in carbohydrates, fruits, and fruit and vegetable fiber increases risk not only for colorectal cancer but also for precursor colorectal adenomas. IMPLICATIONS: These results, which are consistent with findings of other investigators, suggest that environmental factors, influencing risk for colorectal cancer, such as a high-risk diet, may lead to development of the precursor adenomas. SN - 0027-8874 UR - https://www.unboundmedicine.com/medline/citation/8388061/Diet_and_risk_of_colorectal_adenomas:_macronutrients_cholesterol_and_fiber_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/85.11.884 DB - PRIME DP - Unbound Medicine ER -