European Journal of Nutrition

, Volume 44, Issue 5, pp 318–318

Dietary patterns and the adenomacarcinoma sequence of colorectal cancer

  • P. Rouillier
  • P. Senesse
  • V. Cottet
  • A. Valléau
  • J. Faivre
  • M.-C. Boutron-Ruault
ERRATUM

Summary

Background

Food components of a diet are highly related, so that building up dietary patterns may help understand the relationship between chronic diseases and diet, and identify high risk groups that need preventive advice.

Aim

The aim of this study was to determine dietary patterns associated with the colorectal adenoma–carcinoma pathway.

Methods

We performed a two–step analysis using first principal component analysis to select the most appropriate food groups, then a hierarchical agglomerative clustering method, in order to determine dietary patterns in 1372 subjects included in a case–control study. Patients with hyperplastic polyps (n = 103), adenomas < 10mm, (n = 154) or larger adenomas (n = 208) were then compared with polyp–free controls (n = 426), and colorectal cancer cases (n = 171) compared with population controls (n = 309) using unconditional logistic regression adjusted on age and gender.

Results

Cluster analysis determined five food patterns. Cluster 1 identified a low-energy diet; cluster 2 a high–starch, highfat, and low–fruit diet; cluster 3 a high–processed meat, –energy, –alcohol, and –starchy foods diet; cluster 4 a high–fish, –cereals, –honey, –olive oil, –fruit and –vegetables diet; and cluster 5 a high–flour, –sugar, –chocolate, –animal fats, and –eggs diet. Logistic regression identified cluster 2 as significantly associated with risk of small adenomas (OR = 1.7; 95% confidence interval 1.0–2.7), large adenomas (OR = 1.9; 1.2–3.0) and cancers (OR = 1.7; 1.1–2.8) compared with cluster 1. Cluster 4 diet was inversely associated with risk of small adenomas (OR = 0.4; 0.2–1.0). There was no relationship between patterns and risk of hyperplastic polyps. Multiple adjustment decreased the strength of the relationships with cluster 2, which remained significantly associated with adenomas, but not cancer.

Conclusion

A lowenergy diet appeared as protective all along the adenoma–carcinoma sequence, contrary to a high–energy, high–processed meat and –animal fat diet.

Key words

colorectal neoplasms adenomatous polyps food habits diet case–control 

References

  1. 1.
    World Cancer Research Fund (1997) Food, nutrition and the prevention of cancer: a global perspective. Banta book groups, Menasha, USAGoogle Scholar
  2. 2.
    Slattery ML, Boucher KM, Caan BJ, Potter JD, Ma KN (1998) Eating patterns and risk of colon cancer. Am J Epidemiol 148:4–16PubMedGoogle Scholar
  3. 3.
    Terry P, Hu FB, Hansen H, Wolk A (2001) Prospective study of major dietary patterns and colorectal cancer risk in women. Am J Epidemiol 154:1143–1149CrossRefPubMedGoogle Scholar
  4. 4.
    Van Dam RM, Grievink L, Ocke MC, Feskens EJ (2003) Patterns of food consumption and risk factors for cardiovascular disease in the general Dutch population. Am J Clin Nutr 77:1156–1163PubMedGoogle Scholar
  5. 5.
    Trichopoulou A, Costacou T, Bamia C, Trichopoulos D (2003) Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 348:2599–2608CrossRefPubMedGoogle Scholar
  6. 6.
    Hoffman K, Schulze MB, Boeing H, Altenburg HP (2002) Dietary patterns: report of an international workshop. Public Health Nutr 5:89–90PubMedGoogle Scholar
  7. 7.
    Fung T, Hu FB, Fuchs C, et al. (2003) Major dietary patterns and the risk of colorectal cancer in women. Arch Intern Med 163:309–314PubMedGoogle Scholar
  8. 8.
    Fung TT, Rimm EB, Spiegelman D, et al. (2001) Association between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk. Am J Clin Nutr 73:61–67PubMedGoogle Scholar
  9. 9.
    Boutron-Ruault MC, Senesse P, Meance S, Belghiti C, Faivre J (2001) Energy intake, body mass index, physical activity, and the colorectal adenoma-carcinoma sequence. Nutr Cancer 39:50–57CrossRefPubMedGoogle Scholar
  10. 10.
    Morson BC and Sobin LH (1976) Histopathological typing of colorectal tumours. Geneva, WHO 5:505–525Google Scholar
  11. 11.
    Boutron MC, Faivre J, Milan C, Lorcerie B, Esteve J (1989) A comparison of two diet history questionnaires that measure usual food intake. Nutr Cancer 12:83–91PubMedGoogle Scholar
  12. 12.
    Lebart L, Morineau A, Piron M (1995) Statistique exploratoire multidimensionnelle. Dunod, 3rd edition, ParisGoogle Scholar
  13. 13.
    Pryer JA, Cook A, Shetty P (2001) Identification of groups who report similar patterns of diet among a representative national sample of British adults aged 65 years of age or more. Public Health Nutr 4:787–795PubMedGoogle Scholar
  14. 14.
    Morineau A (1984) Note sur la caractérisation statistique d’une classe et les valeurs-tests. Bull Techn du Centre de Statist et d’Infor Appl 2:20–27Google Scholar
  15. 15.
    Senesse P, Boutron-Ruault MC, Faivre J et al. (2002) Foods as risk factors for colorectal adenomas: a case-control study in Burgundy (France). Nutr Cancer 44:7–15CrossRefPubMedGoogle Scholar
  16. 16.
    Levi F, Pasche C, La Vecchia C, Lucchini F, Franceschi S (1999) Food groups and colorectal cancer risk. Br J Cancer 79:1283–1287CrossRefPubMedGoogle Scholar
  17. 17.
    Norat T, Lukanova A, Ferrari P, Riboli E (2002) Meat consumption and colorectal cancer risk: dose-response metaanalysis of epidemiological studies. Int J Cancer 98:241–256PubMedGoogle Scholar
  18. 18.
    Terry P, Giovannucci E, Michels KB, et al. (2001) Fruit, vegetables, dietary fiber, and risk of colorectal cancer. J Natl Cancer Inst 93:525–533PubMedGoogle Scholar
  19. 19.
    Norat T and Riboli E (2003) Dairy products and colorectal cancer. A review of possible mechanisms and epidemiological evidence. Eur J Clin Nutr 57:1–17CrossRefPubMedGoogle Scholar
  20. 20.
    Fuchs CS, Giovannucci EL, Colditz GA, et al. (1999) Dietary fiber and the risk of colorectal cancer and adenoma in women. N Engl J Med 340:169–176CrossRefPubMedGoogle Scholar
  21. 21.
    Michels KB, Edward G, Joshipura KJ, et al. (2000) Prospective study of fruit and vegetable consumption and incidence of colon and rectal cancers. J Natl Cancer Inst 92:1740–1752PubMedGoogle Scholar
  22. 22.
    Tavani A, La Vecchia C (2000) Coffee and cancer: a review of epidemiological studies, 1990–1999. Eur J Cancer Prev 9:241–256Google Scholar
  23. 23.
    Terry P, Bergkvist L, Holmberg L,Wolk A (2001) Coffee consumption and risk of colorectal cancer in a population based prospective cohort of Swedish women. Gut 49:87–90Google Scholar
  24. 24.
    Bartoli R, Fernandez-Banares F, Navarro E, et al. (2000) Effect of olive oil on early and late events of colon carcinogenesis in rats: modulation of arachidonic acid metabolism and local prostaglandin E(2) synthesis. Gut 46:191–199Google Scholar
  25. 25.
    Giovannucci E (2001) Insulin, insulinlike growth factors and colon cancer: a review of the evidence. J Nutr 131:3109S–3120SPubMedGoogle Scholar
  26. 26.
    Palmqvist R, Hallmans G, Rinaldi S, et al. (2002) Plasma insulin-like growth factor 1, insulin-like growth factor binding protein 3, and risk of colorectal cancer: a prospective study in northern Sweden. Gut 50:642–646Google Scholar

Copyright information

© Steinkopff-Verlag 2004

Authors and Affiliations

  • P. Rouillier
    • 1
  • P. Senesse
    • 2
  • V. Cottet
    • 2
  • A. Valléau
    • 1
  • J. Faivre
    • 2
  • M.-C. Boutron-Ruault
    • 1
    • 3
  1. 1.Institut Scientifique et Techniquede l’Alimentation et de la Nutrition INSERM U557,CNAMParisFrance
  2. 2.Registre des cancers digestifsFaculté de MédecineDijon cedexFrance
  3. 3.ISTNA, CNAMParisFrance

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