Cancer Causes & Control

, Volume 5, Issue 1, pp 38–52 | Cite as

Sugar, meat, and fat intake, and non-dietary risk factors for colon cancer incidence in Iowa women (United States)

  • Roberd M. Bostick
  • John D. Potter
  • Lawrence H. Kushi
  • Thomas A. Sellers
  • Kristi A. Steinmetz
  • David R. McKenzie
  • Susan M. Gapstur
  • Aaron R. Folsom
Research Papers

Abstract

To investigate the relation of dietary intakes of sucrose, meat, and fat, and anthropometric, lifestyle, hormonal, and reproductive factors to colon cancer incidence, data were analyzed from a prospective cohort study of 35,215 Iowa (United States) women, aged 55–69 years and without a history of cancer, who completed mailed dietary and other questionnaires in 1986. Through 1990, 212 incident cases of colon cancer were documented. Proportional hazards regression was used to adjust for age and other risk factors. Risk factors found to be associated significantly with colon cancer included: (i) sucrose-containing foods and beverages other than ice cream/milk; relative risks (RR) across the quintiles=1.00, 1.73, 1.56, 1.54, and 2.00 (95% confidence intervals [CI] for quintiles two and five exclude 1.0); (ii) sucrose; RR across the quintiles=1.00, 1.70, 1.81, 1.82, and 1.45 (CI for quintiles two through four exclude 1.0); (iii) height; RR=1.23 for highest to lowest quintile (P for trend-0.02); (iv) body mass index; RR=1.41 for highest to lowest quintile (P for trend=0.03); and (v) number of livebirths, RR=1.59 for having had one to two livebirths and 1.80 for having had three or more livebirths compared with having had none (P for trend=0.04). These data support hypotheses that sucrose intake or being tall or obese increases colon cancer risk; run contrary to the hypothesis that increased parity decreases risk; support previous findings of no association with demographic factors other than age, cigarette smoking, or use of oral contraceptives or estrogen replacement therapy; and raise questions regarding previous associations with meat, fat, protein, and physical activity.Cancer Causes and Control 1994, 5, 38–52.

Key words

Anthropometry colonic neoplasms dietary fats females lifestyle meat prospective studies reproduction sucrose United States 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Willett WC, MacMahon B. Diet and cancer—an overview.N Engl J Med 1984;310: 697–703.PubMedGoogle Scholar
  2. 2.
    Potter JD. Reconciling the epidemiology, physiology, and molecular biology of colon cancer.JAMA 1992;268: 1573–7.PubMedGoogle Scholar
  3. 3.
    Boring CC, Squires TS, Tong T. Cancer statistics.CA Cancer J Clin 1992;41: 19–38.Google Scholar
  4. 4.
    Eaton SB, Shostak M, Konner M.The Paleolithic Prescription. New York: Harper and Row, 1988: 69–87.Google Scholar
  5. 5.
    Trowell HC. Refined carbohydrate foods and fibre. In: Burkitt DP, Trowell HC, eds.Refined Carbohydrates: Food and Disease Oxford, UK: Academic Press, 1975; 23–41.Google Scholar
  6. 6.
    Food and Agricultural Organization. Food Balance Sheets 1975–1977 Average, Rome: FAO, 1980.Google Scholar
  7. 7.
    Stamp D, Zhang X-M, Medline A, Bruce WR, Archer MC. Sucrose enhancement of the early steps of colon carcinogenesis in mice.Carcinogenesis 1993;14: 777–9.PubMedGoogle Scholar
  8. 8.
    Stich HF, Rosin MP, Wu CH, Powrie WD. Clastogenicity of furans found in food.Cancer Lett 1981;13: 89–95.PubMedGoogle Scholar
  9. 9.
    Nishi Y, Miyakawa Y, Kato K. Chromosome aberations induced by pyrolysates of carbohydrates in Chinese hamster V79 cells.Mutat Res 1989;227: 117–23.PubMedGoogle Scholar
  10. 10.
    Corpet DE, Stamp D, Medline A, Minkin S, Archer MC, Bruce WR: Promotion of colonic microadenoma growth in mice and rats fed cooked sugar or cooked casein and fat.Cancer Res 1990;50: 6955–8.PubMedGoogle Scholar
  11. 11.
    Archer MC, Bruce WR, Chan CC, Medline A, Stamp D, Zhang X-M. Promotion of colonic microadenoma in rats by 5-hydroxymethyl-2-furaldehyde in thermolysed sugar.Proc Am Assoc Cancer Res 1992;33: 130.Google Scholar
  12. 12.
    Kruis W, Forstmaier G, Sheurlen C, Stellaard F. Effect of diets low and high in refined sugars on gut transit, bile acid metabolism, and bacterial fermentation.Gut 1991;32: 367–71.PubMedGoogle Scholar
  13. 13.
    Phillips R. Role of life-style and dectary habits in risk of cancer among Seventh-day Adventists.Cancer Res 1975;35; 3513–22.Google Scholar
  14. 14.
    Miller AB, Howe GR, Jain M, Craib KJP, Harrison L. Food iterms and food groups as risk factors in a case-control study of diet and colorectal cancer.Int J Cancer 1983;32: 155–61.PubMedGoogle Scholar
  15. 15.
    Manousos O, Day NE, Trichopoulos D, Gerovassilis G, Tzonou A. Diet and colorectal cancer: A case-control study in Greece.Int J Cancer 1983;32: 1–5.PubMedGoogle Scholar
  16. 16.
    Pickle LW, Greene MH, Ziegler RG, et al. Colorectal cancer in rural Nebraska.Cancer Res 1984;44: 363–9.PubMedGoogle Scholar
  17. 17.
    Macquart-Moulin G, Riboli E, Cornée J, Charnay B, Berthezene P, Day N. Case-control study on colorectal cancer and diet in Marseilles.Int J Cancer 1986;38: 183–91.PubMedGoogle Scholar
  18. 18.
    Tuyns AJ, Kaaks R, Haelterman M. Colorectal cancer and the consumption of foods: a case-control study in Belgium.Nutr Cancer 1988;11: 189–204.PubMedGoogle Scholar
  19. 19.
    La Vecchia C, Negri E, Decarli A, D'Avanzo B, Gallotti L, Gentile A, Franceschi S. A case-control study of diet and colo-rectal cancer in northern Italy.Int J Cancer 1988;41: 492–8.PubMedGoogle Scholar
  20. 20.
    Benito E, Obrador A, Stiggelbout A, Bosch FX, Mulet M, Munoz N, Kaldor J. A population-based case-control study of colorectal cancer in Majorca. I. Dietary factors.Int J Cancer 1990;45: 69–76.PubMedGoogle Scholar
  21. 21.
    Peters RK, Pike MC, Garabrant D, Mack TM. Diet and colon cancer in Los Angeles County, California.Cancer Causes Control 1992;3: 457–73.PubMedGoogle Scholar
  22. 22.
    Bristol JB, Emmett PM, Heaton KW, Williamson RCN. Sugar, fat, and the risk of colorectal cancer.Br Med J 1985;291: 1467–70.Google Scholar
  23. 23.
    Macquart-Moulin G, Riboli E, Cornée J, Kaaks R, Berthezene I. Colorectal polyps and diet: a case-control study in Marseilles.Int J Cancer 1987;40: 179–88.PubMedGoogle Scholar
  24. 24.
    Bidoli E, Franceschi S, Talamini R, Barra S, La Vecchia C. Food consumption and cancer of the colon and rectum in north-eastern Italy.Int J Cancer 1992;50: 223–9.PubMedGoogle Scholar
  25. 25.
    Sugimura T, Sato S. Mutagens-carcinogens in foods.Cancer Res 1983;43: 2415s-21s.PubMedGoogle Scholar
  26. 26.
    Potter JD, Slattery ML, Bostick RM, Gapstur SM. Colon cancer: a review of the epidemiology.Epidemiol Rev 1993;15: (in press).Google Scholar
  27. 27.
    Willett WC, Stampfer MJ, Colditz GA, et al. Relation of meat fat and fiber intake to the risk of colon cancer in a prospective study among women.N Engl J Med 1990;323: 1664–72.PubMedGoogle Scholar
  28. 28.
    Willett WC, Stampfer MJ. Total energy intake: Implications for epidemiologic analyses.Am J Epidemiol 1986;124: 17–27.PubMedGoogle Scholar
  29. 29.
    Hirayama T. A large-scale cohort study on the relationship between diet and selected cancers of digestive organs. In: Bruce WR, Correa P, Lipkin M, Tannenbaum SR, Wilkins TD, eds.Gastrointestinal Cancer: Endogenous Factors; Banbury Report 7. New York: Cold Spring Harbor Laboratory, 1981; 409–26.Google Scholar
  30. 30.
    Stemmermann GN, Nomura AMY, Heilbrun LK. Dietary fat and the risk of colorectal cancer.Cancer Res 1984;44: 4633–7.PubMedGoogle Scholar
  31. 31.
    Phillips RI, Snowdon DA. Dietary relationships with fatal colorectal cancer among Seventh-Day Adventists.JNCI 1985;74: 307–17.PubMedGoogle Scholar
  32. 32.
    Lipkin M. Biomarkers of increased susceptibility to gastrointestinal cancer.Gastroenterology 1987;92: 1083–6.Google Scholar
  33. 33.
    Folsom AR, Kaye SA, Sellers TA, et al. Body fat distribution and 5-year risk of death in older women.JAMA 1993;269: 483–7.PubMedGoogle Scholar
  34. 34.
    Kaye SA, Folsom AR, Sprafka JM, Prineas RJ, Wallace RB. Increased incidence of diabetes mellitus in relation to abdominal adiposity in older women.J Clin Epidemiol 1991;44: 329–34.PubMedGoogle Scholar
  35. 35.
    Prineas RJ, Folsom AR, Kaye SA. Central adiposity and increased risk of coronary heart disease mortality in older women.Ann Epidemiol 1993;3: 35–41.PubMedGoogle Scholar
  36. 36.
    Sellers TA, Kushi LH, Potter JD, et al. Effect of family history, body fat distribution, and reproductive factors on risk of postmenopausal breast cancer.N Engl J Med 1992;326: 1323–9.PubMedGoogle Scholar
  37. 37.
    Steinmetz KA, Kushi LH, Bostick RM, Folsom AR, Potter JD. Vegetables, fruit, and colon cancer in the Iowa Women's Health Study.Am J Epidemiol 1994;139 (in press).Google Scholar
  38. 38.
    Bostick RM, Potter JD, Sellers TA, McKenzie DR, Kushi LH, Folsom AR. Relation of calcium, vitamin D, and dairy food intake to incidence of colon cancer among older women: the Iowa Women's Health Study.Am J Epidemiol 1993;137: 1302–17.PubMedGoogle Scholar
  39. 39.
    Bostick RM, Potter JD, McKenzie DR, et al. Reduced risk of colon cancer with high intake of vitamin E: the Iowa Women's Health Study.Cancer Res 1993;53: 4230–7.PubMedGoogle Scholar
  40. 40.
    Gapstur SM, Potter JD, Folsom AR. Alcohol consumption and colon and rectal cancer in postmenopausal women.Int J Epidemiol 1993;22 (in press).Google Scholar
  41. 41.
    Willett WC, Sampson L, Browne ML, et al. The use of a self-administered questionnaire to assess diet four years in the past.Am J Epidemiol 1988;127: 188–99.PubMedGoogle Scholar
  42. 42.
    Willett WC, Sampson L, Stampfer MJ, et al. Reproductibility and validity of a semiquantitative food frequency questionnaire.Am J Epidemiol 1985;122: 51–65.PubMedGoogle Scholar
  43. 43.
    Block G, Hartman AM, Dresser CM, Carroll MD, Gannon J, Gardner L. A data-based approach to diet questionnaire design and testing.Am J Epidemiol 1986;124: 453–469.PubMedGoogle Scholar
  44. 44.
    Rimm EB, Giovannucci EL, Stampfer MJ, Colditz GA, Litin LB, Willett WC. Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals.Am J Epidemiol 1992;135: 1114–26.PubMedGoogle Scholar
  45. 45.
    Munger RG, Folsom AR, Kushi LH, Kaye SA, Sellers TA. Dietary assessment of older Iowa women with a food frequency questionnaire: Nutrient intake, reproducibility and comparison to 24-hour dietary recall interviews.Am J Epidemiol 1992;136: 192–200.PubMedGoogle Scholar
  46. 46.
    Kushi LH, Kaye SA, Folsom AR, Soler JT, Prineas RJ. Accuracy and reliability of self-measurement of body girth.Am J Epidemiol 1988;128: 740–8.PubMedGoogle Scholar
  47. 47.
    US Department of Health and Human Services, US Public Health Service.SEER Program: Cancer Incidence and Mortality in the United States, 1973–81 Bethesda, MD: National Cancer Institute, 1984; NIH Pub. No. 85-1837.Google Scholar
  48. 48.
    Whittemore AS, Wu-Williams AH, Lee M, et al. Diet, physical activity, and colorectal cancer among Chinese in North America and China.JNCI 1990;82: 915–26.PubMedGoogle Scholar
  49. 49.
    Peltomäki P, Aaltonen LA, Sistonen P, et al. Genetic mapping of a locus predisposing to human colorectal cancers.Science 1993;260: 810–2.PubMedGoogle Scholar
  50. 50.
    Kadlubar FF, Butler MA, Kaderlik KR, Chou HC, Lang NP. Polymorphisms for aromatic amine metabolism in humans: relevance for human carcinogenesis.Environ Health Persp 1992;98: 69–74.Google Scholar
  51. 51.
    Anti M, Marra G, Armelao F, et al. Effect of ω-3 fatty acids on rectal mucosal cell proliferation in subjects at risk for colon cancer.Gastroenterology 1992;102: 883–91.Google Scholar

Copyright information

© Rapid Communications of Oxford Ltd 1994

Authors and Affiliations

  • Roberd M. Bostick
    • 1
    • 2
  • John D. Potter
    • 2
  • Lawrence H. Kushi
    • 2
  • Thomas A. Sellers
    • 2
  • Kristi A. Steinmetz
    • 2
  • David R. McKenzie
    • 2
  • Susan M. Gapstur
    • 2
  • Aaron R. Folsom
    • 2
  1. 1.Department of Family Practice and Community Health, Medical SchoolUniversity of MinnesotaMinneapolisUSA
  2. 2.Division of Epidemiology, School of Public HealthUniversity of MinnesotaMinneapolisUSA

Personalised recommendations