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The effect of wheat bran fiber and calcium supplementation on rectal mucosal proliferation rates in patients with resected adenomatous colorectal polyps.
Cancer Epidemiol Biomarkers Prev. 1997 Mar; 6(3):161-9.CE

Abstract

Colorectal cancers continue as the second most common cause of death from cancer in the United States. Only a few prospective, randomized clinical trials have been performed to evaluate the potential preventive effects of dietary fiber or calcium in patients with an increased risk for the development or recurrence of colorectal cancer. We designed and conducted a double-blinded, placebo-controlled randomized trial involving supplementation of fiber and calcium intake and measurements of [3H]thymidine labeling index (LI) percentages in rectal mucosal biopsies obtained from patients with resected colorectal adenomas to examine the potential mechanisms by which dietary interventions might reduce colorectal cancer risk. We performed a randomized, double-blinded, Phase II study, using a factorial design to measure the effects of supplemental dietary wheat bran fiber (2.0 or 13.5 g/day) and calcium carbonate (250 or 1500 mg/day elemental calcium) supplementation on [3H]thymidine LI percentages in rectal mucosal crypts and 24-h in vitro outgrowth cultures. Measurements were made at baseline randomization (i.e., after a 3-month placebo run-in period using 2.0 g of wheat bran fiber plus 250 mg of calcium carbonate) and after 3 and 9 months on treatment in 100 randomized participants who had a history of colon adenoma resection. Neither the wheat bran fiber nor the calcium carbonate supplements significantly reduced [3H]thymidine LI percentages in rectal mucosal crypts (total or compartmental analysis) or 24-h in vitro outgrowth cultures at either 3 or 9 months of daily supplementation in the 93 evaluable participants. We conclude that 9 months of high-dose wheat bran fiber and calcium carbonate supplementation in study participants with a history of recently resected colorectal adenomas does not have a significant effect on cellular proliferation rates in rectal mucosal biopsies, comparing 3- and 9-month results to baseline results. Ultimately, there is great need for the evaluation of these two different nutrient interventions in the setting of Phase III studies wherein adenomatous polyp recurrence, rather than a rectal mucosal biomarker, serves as the primary end point.

Authors+Show Affiliations

Alberts DS
Department of Medicine, University of Arizona, Tucson 85724, USA.
Einspahr J
No affiliation info available
Ritenbaugh C
No affiliation info available
Aickin M
No affiliation info available
Rees-McGee S
No affiliation info available
Atwood J
No affiliation info available
Emerson S
No affiliation info available
Mason-Liddil N
No affiliation info available
Bettinger L
No affiliation info available
Patel J
No affiliation info available
Bellapravalu S
No affiliation info available
Ramanujam PS
No affiliation info available
Phelps J
No affiliation info available
Clark L
No affiliation info available

MeSH

Adenomatous PolypsAgedCalcium CarbonateCalcium, DietaryCell DivisionCells, CulturedColonic PolypsDietary FiberDouble-Blind MethodFemaleFollow-Up StudiesHumansIntestinal MucosaMaleMiddle AgedNeoplasm Recurrence, LocalPlacebosProspective StudiesRectal NeoplasmsRectumRisk FactorsThymidineTritium

Pub Type(s)

Clinical Trial
Clinical Trial, Phase II
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

9138658

Citation

Alberts, D S., et al. "The Effect of Wheat Bran Fiber and Calcium Supplementation On Rectal Mucosal Proliferation Rates in Patients With Resected Adenomatous Colorectal Polyps." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 6, no. 3, 1997, pp. 161-9.
Alberts DS, Einspahr J, Ritenbaugh C, et al. The effect of wheat bran fiber and calcium supplementation on rectal mucosal proliferation rates in patients with resected adenomatous colorectal polyps. Cancer Epidemiol Biomarkers Prev. 1997;6(3):161-9.
Alberts, D. S., Einspahr, J., Ritenbaugh, C., Aickin, M., Rees-McGee, S., Atwood, J., Emerson, S., Mason-Liddil, N., Bettinger, L., Patel, J., Bellapravalu, S., Ramanujam, P. S., Phelps, J., & Clark, L. (1997). The effect of wheat bran fiber and calcium supplementation on rectal mucosal proliferation rates in patients with resected adenomatous colorectal polyps. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 6(3), 161-9.
Alberts DS, et al. The Effect of Wheat Bran Fiber and Calcium Supplementation On Rectal Mucosal Proliferation Rates in Patients With Resected Adenomatous Colorectal Polyps. Cancer Epidemiol Biomarkers Prev. 1997;6(3):161-9. PubMed PMID: 9138658.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of wheat bran fiber and calcium supplementation on rectal mucosal proliferation rates in patients with resected adenomatous colorectal polyps. AU - Alberts,D S, AU - Einspahr,J, AU - Ritenbaugh,C, AU - Aickin,M, AU - Rees-McGee,S, AU - Atwood,J, AU - Emerson,S, AU - Mason-Liddil,N, AU - Bettinger,L, AU - Patel,J, AU - Bellapravalu,S, AU - Ramanujam,P S, AU - Phelps,J, AU - Clark,L, PY - 1997/3/1/pubmed PY - 1997/3/1/medline PY - 1997/3/1/entrez SP - 161 EP - 9 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol Biomarkers Prev VL - 6 IS - 3 N2 - Colorectal cancers continue as the second most common cause of death from cancer in the United States. Only a few prospective, randomized clinical trials have been performed to evaluate the potential preventive effects of dietary fiber or calcium in patients with an increased risk for the development or recurrence of colorectal cancer. We designed and conducted a double-blinded, placebo-controlled randomized trial involving supplementation of fiber and calcium intake and measurements of [3H]thymidine labeling index (LI) percentages in rectal mucosal biopsies obtained from patients with resected colorectal adenomas to examine the potential mechanisms by which dietary interventions might reduce colorectal cancer risk. We performed a randomized, double-blinded, Phase II study, using a factorial design to measure the effects of supplemental dietary wheat bran fiber (2.0 or 13.5 g/day) and calcium carbonate (250 or 1500 mg/day elemental calcium) supplementation on [3H]thymidine LI percentages in rectal mucosal crypts and 24-h in vitro outgrowth cultures. Measurements were made at baseline randomization (i.e., after a 3-month placebo run-in period using 2.0 g of wheat bran fiber plus 250 mg of calcium carbonate) and after 3 and 9 months on treatment in 100 randomized participants who had a history of colon adenoma resection. Neither the wheat bran fiber nor the calcium carbonate supplements significantly reduced [3H]thymidine LI percentages in rectal mucosal crypts (total or compartmental analysis) or 24-h in vitro outgrowth cultures at either 3 or 9 months of daily supplementation in the 93 evaluable participants. We conclude that 9 months of high-dose wheat bran fiber and calcium carbonate supplementation in study participants with a history of recently resected colorectal adenomas does not have a significant effect on cellular proliferation rates in rectal mucosal biopsies, comparing 3- and 9-month results to baseline results. Ultimately, there is great need for the evaluation of these two different nutrient interventions in the setting of Phase III studies wherein adenomatous polyp recurrence, rather than a rectal mucosal biomarker, serves as the primary end point. SN - 1055-9965 UR - https://www.unboundmedicine.com/medline/citation/9138658/The_effect_of_wheat_bran_fiber_and_calcium_supplementation_on_rectal_mucosal_proliferation_rates_in_patients_with_resected_adenomatous_colorectal_polyps_ DB - PRIME DP - Unbound Medicine ER -