Dietary patterns and the adenomacarcinoma sequence of colorectal cancer
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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.
The aim of this study was to determine dietary patterns associated with the colorectal adenoma–carcinoma pathway.
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.
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.
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 wordscolorectal neoplasms adenomatous polyps food habits diet case–control
- 1.World Cancer Research Fund (1997) Food, nutrition and the prevention of cancer: a global perspective. Banta book groups, Menasha, USAGoogle Scholar
- 10.Morson BC and Sobin LH (1976) Histopathological typing of colorectal tumours. Geneva, WHO 5:505–525Google Scholar
- 12.Lebart L, Morineau A, Piron M (1995) Statistique exploratoire multidimensionnelle. Dunod, 3rd edition, ParisGoogle Scholar
- 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
- 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.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.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
- 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