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Low adherence to the western and high adherence to the mediterranean dietary patterns could prevent colorectal cancer

European Journal of Nutrition volume 58, pages 1495–1505 (2019)Cite this article

Abstract

Purpose

To assess if the associations found between three previously identified dietary patterns with breast, prostate and gastric cancer are also observed for colorectal cancer (CRC).

Methods

MCC-Spain is a multicase-control study that collected information of 1629 incident cases of CRC and 3509 population-based controls from 11 Spanish provinces. Western, Prudent and Mediterranean data-driven dietary patterns—derived in another Spanish case-control study—were reconstructed in MCC-Spain. Their association with CRC was assessed using mixed multivariable logistic regression models considering a possible interaction with sex. Risk by tumor site (proximal colon, distal colon, and rectum) was evaluated using multinomial regression models.

Results

While no effect of the Prudent pattern on CRC risk was observed, a high adherence to the Western dietary pattern was associated with increased CRC risk for both males [ORfourth(Q4) vs. first(Q1)quartile (95% CI): 1.45 (1.11;1.91)] and females [ORQ4 vs. Q1 (95% CI): 1.50 (1.07;2.09)] but seem to be confined to distal colon [ORfourth(Q4) vs. first(Q1)quartile (95% CI): 2.02 (1.44;2.84)] and rectal [ORQ4 vs. Q1 (95% CI): 1.46 (1.05;2.01)] tumors. The protective effect of the Mediterranean dietary pattern against CRC was observed for both sexes [males: ORQ4 vs. Q1 (95% CI): 0.71 (0.55;0.92); females: ORQ4 vs. Q1 (95% CI): 0.56 (0.40;0.77)] and for all cancer sites: proximal colon [ORQ4 vs. Q1 (95% CI): 0.70 (0.51;0.97)], distal colon [ORQ4 vs. Q1 (95% CI): 0.65 (0.48;0.89)], and rectum (ORQ4 vs. Q1 (95% CI): 0.60 (0.45;0.81)].

Conclusion

Our results are consistent with most of the associations previously found between these patterns and breast, prostate and gastric cancer risk and indicate that consuming whole fruits, vegetables, legumes, olive oil, nuts, and fish and avoiding red and processed meat, refined grains, sweets, caloric drinks, juices, convenience food, and sauces might reduce CRC risk.

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Acknowledgements

This work was supported by Carlos III Institute of Health grants (PI12/00488, PI12/00265, PI12/00715, PI12/01270, PI11/01403, PI11/01889, PI11/00226, PI11/01810, PI11/02213, PI09/00773, PI09/01286, PI09/01903, PI09/02078, PI09/01662, PI08/1770, PI08/0533, PI08/1359), Spanish Ministry of Economy and Competitiveness (IJCI-2014-20900), Consejería de Salud de la Junta de Andalucía (PI-0306-2011; PI-0571-2009); Catalan Government DURSIgrant (2014SGR647);Instituto de Salud Carlos III, co-funded by FEDER funds—a way to build Europe—PI14-00613; Fundación Marqués de Valdecilla (API 10/09); Acción Transversal del Cancer, approved by the Spanish Ministry Council on October 11, 2007; Red Temática de Investigación del Cáncer del ISCIII (RD12/0036/0036); Junta de Castilla y León (LE22A10-2); Consejería de Salud de la Junta de Andalucía (2009-S0143); Conselleria de Sanitat de la Generalitat Valenciana (AP_061/10); Recercaixa (2010ACUP 00310); Regional Government of the Basque Country; Consejería de Sanidad de la Región de Murcia; European Commission grants (FOOD-CT-2006-036224-HIWATE); Spanish Association Against Cancer Scientific Foundation; Fundación Caja de Ahorros de Asturias; University of Oviedo. None of the sponsors intervened in any of the stages of the research.

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Authors and Affiliations

  1. Cancer Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain

    Adela Castelló, Nerea Fernández de Larrea, Beatriz Pérez-Gómez, Nuria Aragonés & Marina Pollán

  2. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain

    Adela Castelló, Pilar Amiano, Nerea Fernández de Larrea, Gemma Castaño-Vinyals, Beatriz Pérez-Gómez, Rocío Olmedo-Requena, Marcela Guevara, Guillermo Fernandez-Tardon, Jose María Huerta, Jesús Castilla, Jose Juan Jiménez-Moleón, Manolis Kogevinas, Nuria Aragonés & Marina Pollán

  3. Faculty of Medicine, University of Alcalá, Campus Universitario-C/ 19, Av. de Madrid, Km 33,600, 28871, Alcalá de Henares, Madrid, Spain

    Adela Castelló

  4. Public Health Department of Gipuzkoa, Government of the Basque Country, Avenida Navarra, 4, 20013, San Sebastián, Spain

    Pilar Amiano

  5. Biodonostia Research Institute, Paseo Dr Beguiristain s/n, 20014, San Sebastián, Spain

    Pilar Amiano & Carmen Urtiaga

  6. The Research Group in Gene-Environment and Health Interactions, Vegazana Campus, University of León, Campus Vegazana, s/n, 24071, León, Spain

    Vicente Martín, Tania Fernández-Villa & Verónica Dávila-Batista

  7. Unit of Biomarkers and Susceptibility, Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO) and IDIBELL, Gran Via km 2.7, 08907, L’Hospitalet de Llobregat, Spain

    Maria Henar Alonso, Anna Díez-Villanueva & Víctor Moreno

  8. Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Campus de Bellvitge, Pavelló de Govern, Feixa Llarga s/n, 08907, L’Hospitalet de Llobregat, Spain

    Maria Henar Alonso & Víctor Moreno

  9. ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain

    Gemma Castaño-Vinyals & Manolis Kogevinas

  10. Universitat Pompeu Fabra (UPF), Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain

    Gemma Castaño-Vinyals & Manolis Kogevinas

  11. IMIM (Hospital del Mar Medical Research Institute), Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain

    Gemma Castaño-Vinyals & Manolis Kogevinas

  12. Department of Preventive Medicine and Public Health, University of Granada, Av, de la Investigación, 11, 18016, Granada, Spain

    Rocío Olmedo-Requena & Jose Juan Jiménez-Moleón

  13. Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de Granada, Edificio Licinio de la Fuente, Calle Dr. Azpitarte, 4, 18012, Granada, Spain

    Rocío Olmedo-Requena & Jose Juan Jiménez-Moleón

  14. Public Health Institute of Navarra, Calle Leyre 15, 31003, Pamplona, Spain

    Marcela Guevara & Jesús Castilla

  15. IUOPA, University of Oviedo, Facultad de Medicina, Planta 7, Campus de El Cristo B, 33006, Oviedo, Spain

    Guillermo Fernandez-Tardon

  16. Universidad de Cantabria, IDIVAL, Avenida Cardenal Herrera Oria s/n, 39011, Santander, Spain

    Trinidad Dierssen-Sotos

  17. Centro de Salud Pública de Dénia, Consellería de Sanidad Universal y Salud Pública, Plaza Jaime I, 5, 03700, Denia, Spain

    Cristobal Llorens-Ivorra

  18. Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, C/ Luis Fontes Pagán nº 9-1ª planta, C.P.-30003, Murcia, Spain

    Jose María Huerta

  19. Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Campus Universitario de El Carmen, 21071, Huelva, Spain

    Rocío Capelo

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  1. Adela Castelló
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On behalf of MCC-Spain researchers

Corresponding author

Correspondence to Adela Castelló.

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The MCC-Spain study protocol was approved by the Ethics Committee of each the participating institutions and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments. All participants were informed about the study objectives and signed an informed consent.

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The authors declare that they have no conflict of interest.

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Castelló, A., Amiano, P., Fernández de Larrea, N. et al. Low adherence to the western and high adherence to the mediterranean dietary patterns could prevent colorectal cancer. Eur J Nutr 58, 1495–1505 (2019). https://doi.org/10.1007/s00394-018-1674-5

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  • DOI: https://doi.org/10.1007/s00394-018-1674-5

Keywords

  • Colonic neoplasms
  • Rectal neoplasms
  • Prevention and control
  • Principal component analysis
  • Dietary patterns
  • Diet
  • Diet, Western
  • Diet, Mediterranean