Advertisement

European Journal of Nutrition

, Volume 54, Issue 4, pp 619–628 | Cite as

Higher intake of carotenoid is associated with a lower risk of colorectal cancer in Chinese adults: a case–control study

  • Min-Shan Lu
  • Yu-Jing Fang
  • Yu-Ming Chen
  • Wei-Ping Luo
  • Zhi-Zhong Pan
  • Xiao Zhong
  • Cai-Xia Zhang
Original Contribution

Abstract

Purpose

The associations between specific carotenoid intake and colorectal cancer risk remain inconsistent. The aim of this study was to examine the association between specific dietary carotenoid intake with colorectal cancer risk in Chinese adults.

Method

From July 2010 to October 2013, 845 eligible colorectal cancer cases and 845 frequency-matched controls (age and sex) completed in-person interviews. A validated food frequency questionnaire was used to estimate dietary intake. Multivariate logistical regression models were used to calculate the odds ratio (OR) and 95 % confidence intervals (95 % CIs) of colorectal cancer risk after adjusting for various confounders.

Results

A strong inverse association was found between β-cryptoxanthin intake and colorectal cancer risk. Compared with the lowest quartile, the highest quartile intake showed a risk reduction of 77 % (OR 0.23, 95 % CI 0.17–0.33, P trend < 0.01) after adjustment for various confounding variables. The inverse associations were also observed for α-carotene (OR 0.50, 95 % CI 0.37–0.68, P trend < 0.01), β-carotene (OR 0.67, 95 % CI 0.49–0.91, P trend < 0.01), and lycopene (OR 0.51, 95 % CI 0.37–0.70, P trend < 0.01). There was no statistically significant association between lutein/zeaxanthin intake and colorectal cancer risk. These findings were consistent across cancer site, sources of controls, and smoking status. The inverse associations between dietary α-carotene, β-cryptoxanthin, and lycopene intake and colorectal cancer risk were found in both males and females, while inverse associations between β-carotene intake and colorectal cancer risk were only observed in males.

Conclusions

Consumption of α-carotene, β-carotene, β-cryptoxanthin, and lycopene was inversely associated with colorectal cancer risk. No significant association was found between lutein/zeaxanthin intake and colorectal cancer risk.

Keywords

Carotenoid Colorectal cancer Case–control study China 

Notes

Acknowledgments

This study was jointly supported by the Sun Yat-sen University Hundred Talents Program (51000-3181301) and Danone Nutrition Research and Education Foundation (No: DIC2011-03). The funders had no role in the design, analysis, or writing of this article. We gratefully acknowledge the cooperation of the study participants; without them the study would not have been possible.

Conflict of interest

The authors declare no conflict of interest.

References

  1. 1.
    Wu F, Lin G, Zhang J (2012) An overview of cancer incidence and trend in China. China Cancer 2:81–85Google Scholar
  2. 2.
    Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61:69–90CrossRefGoogle Scholar
  3. 3.
    Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM (2010) Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 127:2893–2917CrossRefGoogle Scholar
  4. 4.
    Wan D (2009) Epidemiologic trend of and strategies for colorectal cancer. Chin J Cancer 9:897–902CrossRefGoogle Scholar
  5. 5.
    Birt DF, Phillips GJ (2013) Diet, genes, and microbes: complexities of colon cancer prevention. Toxicol Pathol 42:182–188CrossRefGoogle Scholar
  6. 6.
    Britton G (1995) Structure and properties of carotenoids in relation to function. FASEB J 9:1551–1558Google Scholar
  7. 7.
    Lachance PA, Nakat Z, Jeong WS (2001) Antioxidants: an integrative approach. Nutrition 17:835–838CrossRefGoogle Scholar
  8. 8.
    Hughes DA (2001) Dietary carotenoids and human immune function. Nutrition 17:823–827CrossRefGoogle Scholar
  9. 9.
    Chew BP, Park JS (2004) Carotenoid action on the immune response. J Nutr 134:257S–261SGoogle Scholar
  10. 10.
    Zhang CX, Ho SC, Chen YM, Fu JH, Cheng SZ, Lin FY (2009) Greater vegetable and fruit intake is associated with a lower risk of breast cancer among Chinese women. Int J Cancer 125:181–188CrossRefGoogle Scholar
  11. 11.
    Donaldson MS (2004) Nutrition and cancer: a review of the evidence for an anti-cancer diet. Nutr J 3:19CrossRefGoogle Scholar
  12. 12.
    Freudenheim JL, Graham S, Marshall JR, Haughey BP, Wilkinson G (1990) A case–control study of diet and rectal cancer in western New York. Am J Epidemiol 131:612–624Google Scholar
  13. 13.
    Kune S, Kune GA, Watson LF (1987) Case–control study of dietary etiological factors: the Melbourne colorectal cancer study. Nutr Cancer 9:21–42CrossRefGoogle Scholar
  14. 14.
    McMichael AJ (2008) Food, nutrition, physical activity and cancer prevention. Authoritative report from World Cancer Research Fund provides global update. Public Health Nutr 11:762–763CrossRefGoogle Scholar
  15. 15.
    Levi F, Pasche C, Lucchini F, La Vecchia C (2000) Selected micronutrients and colorectal cancer. A case–control study from the canton of Vaud, Switzerland. Eur J Cancer 36:2115–2119CrossRefGoogle Scholar
  16. 16.
    Mannisto S, Yaun SS, Hunter DJ, Spiegelman D, Adami HO, Albanes D, van den Brandt PA, Buring JE et al (2007) Dietary carotenoids and risk of colorectal cancer in a pooled analysis of 11 cohort studies. Am J Epidemiol 165:246–255CrossRefGoogle Scholar
  17. 17.
    Roswall N, Olsen A, Christensen J, Dragsted LO, Overvad K, Tjonneland A (2010) Micronutrient intake and risk of colon and rectal cancer in a Danish cohort. Cancer Epidemiol 34:40–46CrossRefGoogle Scholar
  18. 18.
    Park SY, Nomura AM, Murphy SP, Wilkens LR, Henderson BE, Kolonel LN (2009) Carotenoid intake and colorectal cancer risk: the multiethnic cohort study. J Epidemiol 19:63–71CrossRefGoogle Scholar
  19. 19.
    Chen YM, Ho SC, Woo JL (2006) Greater fruit and vegetable intake is associated with increased bone mass among postmenopausal Chinese women. Br J Nutr 96:745–751CrossRefGoogle Scholar
  20. 20.
    Chiu BC, Ji BT, Dai Q, Gridley G, McLaughlin JK, Gao YT, Fraumeni JJ, Chow WH (2003) Dietary factors and risk of colon cancer in Shanghai, China. Cancer Epidemiol Biomark Prev 12:201–208Google Scholar
  21. 21.
    Hu JF, Liu YY, Yu YK, Zhao TZ, Liu SD, Wang QQ (1991) Diet and cancer of the colon and rectum: a case–control study in China. Int J Epidemiol 20:362–367CrossRefGoogle Scholar
  22. 22.
    Wang LD (2005) The dietary and nutritional status of Chinese population: 2002 National Nutrition Survey. People’s Medical Publishing House, BeijingGoogle Scholar
  23. 23.
    Zhong X, Fang YJ, Pan ZZ, Li B, Wang L, Zheng MC, Chen YM, Zhang CX (2013) Dietary fat, fatty acid intakes and colorectal cancer risk in Chinese adults: a case–control study. Eur J Cancer Prev 22:438–447CrossRefGoogle Scholar
  24. 24.
    Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, O’Brien WL, Bassett DJ, Schmitz KH, Emplaincourt PO, Jacobs DJ, Leon AS (2000) Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 32:S498–S504CrossRefGoogle Scholar
  25. 25.
    Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett DJ, Tudor-Locke C, Greer JL, Vezina J, Whitt-Glover MC, Leon AS (2011) 2011 Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc 43:1575–1581CrossRefGoogle Scholar
  26. 26.
    Chen C, Lu FC (2004) The guidelines for prevention and control of overweight and obesity in Chinese adults. Biomed Environ Sci 17(Suppl):1–36Google Scholar
  27. 27.
    Zhang CX, Ho SC (2009) Validity and reproducibility of a food frequency Questionnaire among Chinese women in Guangdong province. Asia Pac J Clin Nutr 18:240–250Google Scholar
  28. 28.
    Exler JKJ (2012) USDA national nutrient database for standard reference,release 25. http://www.ars.usda.gov/Services/docs.htm?docid=8964
  29. 29.
    Yang YX, Wang GY, Pan XC (2002) China food composition. Peking University Medical Press, BeijingGoogle Scholar
  30. 30.
    Wang L, Li B, Pan MX, Mo XF, Chen YM, Zhang CX (2014) Specific carotenoid intake is inversely associated with the risk of breast cancer among Chinese women. Br J Nutr 111:1686–1695CrossRefGoogle Scholar
  31. 31.
    Willett WC, Howe GR, Kushi LH (1997) Adjustment for total energy intake in epidemiologic studies. Am J Clin Nutr 65(4 Suppl): 1220S–1228S, 1229S–1231SGoogle Scholar
  32. 32.
    Lee HP, Gourley L, Duffy SW, Esteve J, Lee J, Day NE (1989) Colorectal cancer and diet in an Asian population—a case–control study among Singapore Chinese. Int J Cancer 43:1007–1016CrossRefGoogle Scholar
  33. 33.
    Chaiter Y, Gruber SB, Ben-Amotz A, Almog R, Rennert HS, Fischler R, Rozen G, Rennert G (2009) Smoking attenuates the negative association between carotenoids consumption and colorectal cancer risk. Cancer Causes Control 20:1327–1338CrossRefGoogle Scholar
  34. 34.
    Slattery ML, Benson J, Curtin K, Ma KN, Schaeffer D, Potter JD (2000) Carotenoids and colon cancer. Am J Clin Nutr 71:575–582Google Scholar
  35. 35.
    Williams CD, Satia JA, Adair LS, Stevens J, Galanko J, Keku TO, Sandler RS (2010) Antioxidant and DNA methylation-related nutrients and risk of distal colorectal cancer. Cancer Causes Control 21:1171–1181CrossRefGoogle Scholar
  36. 36.
    Nkondjock A, Ghadirian P (2004) Dietary carotenoids and risk of colon cancer: case–control study. Int J Cancer 110:110–116CrossRefGoogle Scholar
  37. 37.
    Murtaugh MA, Ma KN, Benson J, Curtin K, Caan B, Slattery ML (2004) Antioxidants, carotenoids, and risk of rectal cancer. Am J Epidemiol 159:32–41CrossRefGoogle Scholar
  38. 38.
    Jung S, Wu K, Giovannucci E, Spiegelman D, Willett WC, Smith-Warner SA (2013) Carotenoid intake and risk of colorectal adenomas in a cohort of male health professionals. Cancer Causes Control 24:705–717CrossRefGoogle Scholar
  39. 39.
    Wang Z, Joshi AM, Ohnaka K, Morita M, Toyomura K, Kono S, Ueki T, Tanaka M et al (2012) Dietary intakes of retinol, carotenes, vitamin C, and vitamin E and colorectal cancer risk: the Fukuoka colorectal cancer study. Nutr Cancer 64:798–805CrossRefGoogle Scholar
  40. 40.
    Ghadirian P, Lacroix A, Maisonneuve P, Perret C, Potvin C, Gravel D, Bernard D, Boyle P (1997) Nutritional factors and colon carcinoma: a case–control study involving French Canadians in Montreal, Quebec, Canada. Cancer 80:858–864CrossRefGoogle Scholar
  41. 41.
    Kune G, Watson L (2006) Colorectal cancer protective effects and the dietary micronutrients folate, methionine, vitamins B6, B12, C, E, selenium, and lycopene. Nutr Cancer 56:11–21CrossRefGoogle Scholar
  42. 42.
    Terry P, Jain M, Miller AB, Howe GR, Rohan TE (2002) Dietary carotenoid intake and colorectal cancer risk. Nutr Cancer 42:167–172CrossRefGoogle Scholar
  43. 43.
    Hwang ES, Kim GH (2013) Effects of various heating methods on glucosinolate, carotenoid and tocopherol concentrations in broccoli. Int J Food Sci Nutr 64:103–111CrossRefGoogle Scholar
  44. 44.
    Gomes S, Torres AG, Godoy R, Pacheco S, Carvalho J, Nutti M (2013) Effects of boiling and frying on the bioaccessibility of beta-carotene in yellow-fleshed cassava roots (Manihot esculenta Crantz cv. BRS Jari). Food Nutr Bull 34:65–74Google Scholar
  45. 45.
    van Het HK, West CE, Weststrate JA, Hautvast JG (2000) Dietary factors that affect the bioavailability of carotenoids. J Nutr 130:503–506Google Scholar
  46. 46.
    Ferraroni M, La Vecchia C, D’Avanzo B, Negri E, Franceschi S, Decarli A (1994) Selected micronutrient intake and the risk of colorectal cancer. Br J Cancer 70:1150–1155CrossRefGoogle Scholar
  47. 47.
    Potter JD, McMichael AJ (1986) Diet and cancer of the colon and rectum: a case–control study. J Natl Cancer Inst 76:557–569Google Scholar
  48. 48.
    Bohl JL (2012) Hereditary colon and rectal cancer. Clin Colon Rectal Surg 25:61–62CrossRefGoogle Scholar
  49. 49.
    Wei EK, Giovannucci E, Wu K, Rosner B, Fuchs CS, Willett WC, Colditz GA (2004) Comparison of risk factors for colon and rectal cancer. Int J Cancer 108:433–442CrossRefGoogle Scholar
  50. 50.
    Macfarlane GT, Macfarlane S (1997) Human colonic microbiota: ecology, physiology and metabolic potential of intestinal bacteria. Scand J Gastroenterol Suppl 222:3–9Google Scholar
  51. 51.
    Koushik A, Hunter DJ, Spiegelman D, Beeson WL, van den Brandt PA, Buring JE, Calle EE, Cho E et al (2007) Fruits, vegetables, and colon cancer risk in a pooled analysis of 14 cohort studies. J Natl Cancer Inst 99:1471–1483CrossRefGoogle Scholar
  52. 52.
    Alberg A (2002) The influence of cigarette smoking on circulating concentrations of antioxidant micronutrients. Toxicology 180:121–137CrossRefGoogle Scholar
  53. 53.
    Wan D, Chen G, Pan Z (2001) Dynamic analysis of hospitalized colorectal cancer patients in 35 years (1964–1999). Guangdong Med J 07:557–558Google Scholar
  54. 54.
    Xu A, Jiang B (2006) The trend of clinical characteristics of colorectal cancer during the past 20 years in Guangdong province. Natl Med J China 04:272–275Google Scholar
  55. 55.
    Dai Z, Zheng RS, Zou XN, Zhang SW, Zeng HM, Li N, Chen WQ (2012) Analysis and prediction of colorectal cancer incidence trend in China. China J Prev Med 46:598–603Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Min-Shan Lu
    • 1
  • Yu-Jing Fang
    • 2
  • Yu-Ming Chen
    • 1
  • Wei-Ping Luo
    • 1
  • Zhi-Zhong Pan
    • 2
  • Xiao Zhong
    • 1
  • Cai-Xia Zhang
    • 1
  1. 1.Department of Medical Statistics and Epidemiology, School of Public HealthSun Yat-sen UniversityGuangzhouChina
  2. 2.Department of Colorectal Surgery, State Key Laboratory of Oncology in South ChinaSun Yat-sen University Cancer CenterGuangzhouChina

Personalised recommendations