Association between habitual dietary flavonoid and lignan intake and colorectal cancer in a Spanish case–control study (the Bellvitge Colorectal Cancer Study)
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Flavonoid-rich foods, such as fruits, vegetables, and tea, may have a protective effect upon colorectal cancer. However, current epidemiological evidence for a protective effect of flavonoid intake upon colorectal cancer is promising but not conclusive.
To examine the relation between dietary flavonoid and lignan intakes and the risk of colorectal cancer within a Spanish population.
Data from the Bellvitge Colorectal Cancer Study, a case–control study (424 cases with incident colorectal cancer and 401 hospital-based controls), were used. A reproducible and validated food frequency questionnaire was administered in personal interviews. An ad hoc food composition database on flavonoids and lignans was compiled, mainly using data from the US Department of Agriculture and Phenol-Explorer databases. Adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) were estimated using unconditional logistic regression models.
An inverse association was found between intake of total flavonoids (OR, 0.59; 95 % CI, 0.35–0.99 for the highest vs. the lowest quartile; p for trend = 0.04), lignans (OR, 0.59; 95 % CI, 0.34–0.99; p for trend = 0.03), and some individual flavonoid subgroups (flavones, proanthocyanidins) and the risk of colorectal cancer. Separate analyses by cancer site showed similar results.
Intake of total dietary flavonoids (particularly certain flavonoid subgroups) and lignans was inversely associated with colorectal cancer risk in a Spanish population.
KeywordsFlavonoids Lignans Colorectal cancer Case–control study
European Prospective Investigation into Cancer and Nutrition
Food composition database
US Department of Agriculture
This study has received financial support from the Spanish Instituto de Salud Carlos III RTICCC RD06/0020, CIBERESP CB07/02/2005 and grants PI08-1359, PI08-1635, PS09-1037) and also from the Spanish Association Against Cancer (AECC) Scientific Foundation, the Catalan Government DURSI grant 2009SGR1489, and the European Commission grants FOOD-CT-2006-036224-HIWATE and FP7-COOP-Health-2007-B HiPerDART. R. Z. R. is thankful for a postdoctoral “Sara Borrell” program (CD09/00133) from the MEC and Instituto de Salud Carlos III.
Conflict of interest
The authors are not aware of any conflict of interest.
- 1.World Research Cancer Fund, American Institute for Cancer Research (2007) Food, nutrition, physical activity and the prevention of cancer: a global perspective. American Institute for Cancer Research, WashingtonGoogle Scholar
- 6.Curtis PJ, Sampson M, Potter J, Dhatariya K, Kroon PA, Cassidy A (2012) Chronic ingestion of flavan-3-ols and isoflavones improves insulin sensitivity and lipoprotein status and attenuates estimated 10-year CVD risk in medicated postmenopausal women with type 2 diabetes: a 1-year, double-blind, randomized, controlled trial. Diabetes Care 35:226–232PubMedCrossRefGoogle Scholar
- 24.Ward HA, Kuhnle GG, Mulligan AA, Lentjes MA, Luben RN, Khaw KT (2010) Breast, colorectal, and prostate cancer risk in the European Prospective Investigation into Cancer and Nutrition-Norfolk in relation to phytoestrogen intake derived from an improved database. Am J Clin Nutr 91:440–448PubMedCrossRefGoogle Scholar
- 25.Ward H, Chapelais G, Kuhnle GG, Luben R, Khaw KT, Bingham S (2008) Lack of prospective associations between plasma and urinary phytoestrogens and risk of prostate or colorectal cancer in the European Prospective into Cancer-Norfolk study. Cancer Epidemiol Biomarkers Prev 17:2891–2894PubMedCrossRefGoogle Scholar
- 28.EPIC Group of Spain (1997) Relative validity and reproducibility of a diet history questionnaire in Spain. I. Foods. Int J Epidemiol 26(Suppl 1):S91–S99Google Scholar
- 29.EPIC Group of Spain (1997) Relative validity and reproducibility of a diet history questionnaire in Spain. II. Nutrients. Int J Epidemiol 26(Suppl 1):S100–S109Google Scholar
- 31.Knaze V, Zamora-Ros R, Luján-Barroso L et al. (2011) Intake estimation of total and individual flavan-3-ols, proanthocyanidins and theaflavins, their food sources and determinants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Br J Nutr. doi: 10.1017/S0007114511006386
- 34.Zamora-Ros R, Knaze V, Luján-Barroso L et al. (2012) Dietary intakes and food sources of phytoestrogens in the European Prospective Investigation into Cancer and Nutrition (EPIC) 24-hour dietary recall cohort. Eur J Clin Nutr. doi: 10.1038/ejcn.2012.36
- 35.U.S. Department of Agriculture (2007) USDA database for the flavonoid content of selected foods. Release 2.1 ed. U.S. Department of Agriculture, BeltsvilleGoogle Scholar
- 36.U.S. Department of Agriculture (2008) USDA database for the isoflavone content of selected foods. Release 2.0 ed. U.S. Department of Agriculture, BeltsvilleGoogle Scholar
- 37.U.S. Department of Agriculture (2004) USDA database for the proanthocyanidin content of selected foods. U.S. Department of Agriculture, BeltsvilleGoogle Scholar
- 47.EPIC Group of Spain (1997) Relative validity and reproducibility of a diet history questionnaire in Spain. III. Biochemical markers. Int J Epidemiol 26(Suppl 1):S110–S117Google Scholar