Is Timing Important? The Role of Diet and Lifestyle During Early Life on Colorectal Neoplasia
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Purpose of the Review
To summarize the current evidence on the most important dietary and lifestyle factors in colorectal carcinogenesis during different stages of a lifetime with special emphasis on studies investigating exposure during childhood, adolescence, and young adulthood.
A number of studies showed that independent of adult obesity, higher body fatness during childhood, adolescence, and young adulthood is associated with risk of colorectal cancer later in life. In one large cohort study, the Nurses’ Health Study II, adherence to a western pattern diet was associated with higher risk of advanced adenoma. The current evidence relating consumption of individual foods and nutrients as well as physical activity during early life to colorectal cancer is sparse and less consistent, at least in part due to limitations in study design, such as sample size, limited data on potential confounders or lack of a validated dietary assessment instrument.
As colorectal carcinogenesis is a long process and can take up to several decades to develop, early life risk factors may also be etiologically relevant. The recent rise in early-onset colorectal cancer incidence and mortality in the USA, i.e., in individuals younger than 55 years at diagnosis, strongly supports that early life risk factors may influence colorectal carcinogenesis. Considering that the majority of colorectal cancers are preventable, there is an urgent need for well-designed investigations on the role of diet and lifestyle factors throughout the life course and risk of colorectal cancers.
KeywordsDiet Lifestyle Colorectal cancer Colorectal adenoma Life course Childhood Adolescence Young adulthood Overweight Obesity Red meat Processed meat Fiber Dairy Dietary pattern Physical activity
This article was supported in part by grants from the National Institutes of Health (R03CA197879) and the American Institute for Cancer Research to Dr. Kana Wu.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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- 1.Hughes LA, van den Brandt PA, Goldbohm RA, de Goeij AF, de Bruine AP, van Engeland M, et al. Childhood and adolescent energy restriction and subsequent colorectal cancer risk: results from the Netherlands Cohort Study. Int J Epidemiol. 2010;39(5):1333–44. https://doi.org/10.1093/ije/dyq062.CrossRefPubMedGoogle Scholar
- 3.Smith CP, Dunger DB, Williams AJ, et al. Relationship between insulin, insulin-like growth factor I, and dehydroepiandrosterone sulfate concentrations during childhood, puberty, and adult life. J Clin Endocrinol Metab. 1989;68(5):932–7. https://doi.org/10.1210/jcem-68-5-932.CrossRefPubMedGoogle Scholar
- 10.• Nimptsch K, Malik VS, Fung TT, Pischon T, Hu FB, Willett WC, et al. Dietary patterns during high school and risk of colorectal adenoma in a cohort of middle-aged women. Int J Cancer. 2014;134(10):2458–67. https://doi.org/10.1002/ijc.28578. Study showing that independent of dietary pattern during adulthood, overall dietary patterns during adolescence are related to later risk of colorectal adenoma. Estimates were adjusted for important potentially confounding factors. CrossRefPubMedGoogle Scholar
- 13.Song X, Gong X, Zhang T, Jiang W. Height and risk of colorectal cancer: a meta-analysis. Eur J Cancer Prev. 2017:1. https://doi.org/10.1097/cej.0000000000000390.
- 14.World Cancer Research Fund, American Institute for Cancer Research. Continuous Update Project Report: Diet, Nutrition, Physical Activity and Colorectal Cancer. 2017. World Cancer Research Fund/American Institute for Cancer Research. Available at http://www.wcrf.org/colorectal-cancer-2017; Last accessed 10/13/2017, Washington, D.C. 2017.
- 20.Aleksandrova K, Boeing H, Jenab M, Bueno-de-Mesquita HB, Jansen E, van Duijnhoven FJB, et al. Total and high-molecular weight adiponectin and risk of colorectal cancer: the European Prospective Investigation into Cancer and Nutrition Study. Carcinogenesis. 2012;33(6):1–8. https://doi.org/10.1093/carcin/bgs133.CrossRefGoogle Scholar
- 23.Harriss DJ, Atkinson G, George K, Tim Cable N, Reilly T, Haboubi N, et al. Lifestyle factors and colorectal cancer risk (1): systematic review and meta-analysis of associations with body mass index. Color Dis. 2009;11(6):547–63. https://doi.org/10.1111/j.1463-1318.2009.01766.x.CrossRefGoogle Scholar
- 24.Caprio S, Hyman LD, Limb C, et al. Central adiposity and its metabolic correlates in obese adolescent girls. Am J Phys. 1995;269(1 Pt 1):E118–26.Google Scholar
- 25.•• Kantor ED, Udumyan R, Signorello LB, Giovannucci EL, Montgomery S, Fall K. Adolescent body mass index and erythrocyte sedimentation rate in relation to colorectal cancer risk. Gut. 2016;65(8):1289–95. https://doi.org/10.1136/gutjnl-2014-309007. Recent comprehensive analysis on measured body mass index during adolescence and colorectal cancer risk in almost 240,000 Swedish men. Upper overweight and obesity during adolescence was associated with a more than twofold higher risk of colorectal cancer.
- 26.• Zhang X, Wu K, Giovannucci EL, Ma J, Colditz GA, Fuchs CS, et al. Early life body fatness and risk of colorectal cancer in US women and men—results from two large cohort studies. Cancer Epidemiol Biomark Prev. 2015;24(4):690–7. https://doi.org/10.1158/1055-9965.EPI-14-0909-T. Analysis from two large prospective cohorts relating recalled body shape during childhood and adolescence to later risk of colorectal cancer with the ability to adjust for important potentially confounding factors and adult body mass index. High body fatness during childhood or adolescence was associated with higher colorectal cancer risk independent of adult body mass index in women but not in men.CrossRefGoogle Scholar
- 37.Stunkard AJ, Sorensen T, Schulsinger F. Use of the Danish Adoption Register for the study of obesity and thinness. In: Kety SS, Rowland LP, Sidman SQ, Mathysee SW, editors. The genetics of neurological and psychiatric disorders. New York City: Raven Press; 1983. p. 115–20.Google Scholar
- 38.Must A, Willett WC, Dietz WH. Remote recall of childhood height, weight, and body build by elderly subjects. Am J Epidemiol. 1993;138(1):56–64. https://doi.org/10.1093/oxfordjournals.aje.a116777.CrossRefPubMedGoogle Scholar
- 51.Cross AJ, Ferrucci LM, Risch A, Graubard BI, Ward MH, Park Y, et al. A large prospective study of meat consumption and colorectal cancer risk: an investigation of potential mechanisms underlying this association. Cancer Res. 2010;70(6):2406–14. https://doi.org/10.1158/0008-5472.CAN-09-3929.CrossRefPubMedPubMedCentralGoogle Scholar
- 57.Maruti SS, Feskanich D, Rockett HR, Colditz GA, Sampson LA, Willett WC. Validation of adolescent diet recalled by adults. Epidemiology. 2006;17(2):226–9. https://doi.org/10.1097/01.ede.0000198181.86685.49.CrossRefPubMedGoogle Scholar
- 58.World Cancer Research Fund / American Institute for Cancer Research. Continuous Update Project Report. Food, nutrition, physical activity, and the prevention of colorectal cancer. Washington, DC. 2011.Google Scholar
- 65.Lamprecht SA, Lipkin M. Cellular mechanisms of calcium and vitamin D in the inhibition of colorectal carcinogenesis. Ann N Y Acad Sci. 2001;952(1):73–87. https://doi.org/10.1111/j.1749-6632.2001.tb02729.x.CrossRefPubMedGoogle Scholar