Diet Quality and Colorectal Cancer Risk in the Women's Health Initiative Observational Study.

Diet quality index scores on Healthy Eating Index 2010 (HEI-2010), Alternative HEI-2010, alternative Mediterranean Diet Index, and the Dietary Approaches to Stop Hypertension (DASH) index have been inversely associated with all-cause and cancer-specific death. This study assessed the association between these scores and colorectal cancer (CRC) incidence as well as CRC-specific mortality in the Women's Health Initiative Observational Study (1993-2012), a US study of postmenopausal women. During an average of 12.4 years of follow-up, there were 938 cases of CRC and 238 CRC-specific deaths. We estimated multivariate hazard ratios and 95% confidence intervals for relationships between quintiles of diet scores (from baseline food frequency questionnaires) and outcomes. HEI-2010 score (hazard ratios were 0.81, 0.77, and 0.73 with P values of 0.04, 0.01, and <0.01 for quintiles 3-5 vs. quintile 1, respectively) and DASH score (hazard ratios were 0.72, 0.74, and 0.78 with P values of <0.01, <0.01, and 0.03 for quintiles 3-5 vs. quintile 1, respectively), but not other diet scores, were associated with a lower risk of CRC in adjusted models. No diet scores were significantly associated with CRC-specific mortality. Closer adherence to HEI-2010 and DASH dietary recommendations was inversely associated with risk of CRC in this large cohort of postmenopausal women.

[1]  Carol J Boushey,et al.  The Dietary Patterns Methods Project: synthesis of findings across cohorts and relevance to dietary guidance. , 2015, The Journal of nutrition.

[2]  JoAnn E Manson,et al.  Comparing indices of diet quality with chronic disease mortality risk in postmenopausal women in the Women's Health Initiative Observational Study: evidence to inform national dietary guidance. , 2014, American journal of epidemiology.

[3]  D. Jacobs,et al.  Dietary Inflammatory Index and Risk of Colorectal Cancer in the Iowa Women's Health Study , 2014, Cancer Epidemiology, Biomarkers & Prevention.

[4]  J. Freudenheim,et al.  Better Postdiagnosis Diet Quality Is Associated with Reduced Risk of Death among Postmenopausal Women with Invasive Breast Cancer in the Women's Health Initiative , 2014, Cancer Epidemiology, Biomarkers & Prevention.

[5]  V. Moreno,et al.  Dietary inflammatory index and inflammatory gene interactions in relation to colorectal cancer risk in the Bellvitge colorectal cancer case–control study , 2014, Genes & Nutrition.

[6]  L. Hou,et al.  The association between dietary inflammatory index and risk of colorectal cancer among postmenopausal women: results from the Women’s Health Initiative , 2014, Cancer Causes & Control.

[7]  J. Manson,et al.  Mediterranean and DASH Diet Scores and Mortality in Women With Heart Failure: The Women’s Health Initiative , 2013, Circulation. Heart failure.

[8]  T. Powell-Wiley,et al.  Comparison of 4 established DASH diet indexes: examining associations of index scores and colorectal cancer. , 2013, The American journal of clinical nutrition.

[9]  S. Kirkpatrick,et al.  Update of the Healthy Eating Index: HEI-2010. , 2013, Journal of the Academy of Nutrition and Dietetics.

[10]  R. Sinha,et al.  Socioeconomic status and the risk of colorectal cancer , 2012, Cancer.

[11]  E. Rimm,et al.  Alternative dietary indices both strongly predict risk of chronic disease. , 2012, The Journal of nutrition.

[12]  B. Howard,et al.  Diet quality and the risk of cardiovascular disease: the Women's Health Initiative (WHI). , 2011, The American journal of clinical nutrition.

[13]  R. Chlebowski,et al.  Racial Differences in Colorectal Cancer Incidence and Mortality in the Women's Health Initiative , 2011, Cancer Epidemiology, Biomarkers & Prevention.

[14]  Robert B Wallace,et al.  Healthy lifestyles related to subsequent prevalence of age-related macular degeneration. , 2011, Archives of ophthalmology.

[15]  C. Ulrich,et al.  Postdiagnosis diet quality, the combination of diet quality and recreational physical activity, and prognosis after early-stage breast cancer , 2011, Cancer Causes & Control.

[16]  R. Sinha,et al.  Diet index-based and empirically derived dietary patterns are associated with colorectal cancer risk. , 2010, The Journal of nutrition.

[17]  Mark Woodward,et al.  The impact of dietary and lifestyle risk factors on risk of colorectal cancer: A quantitative overview of the epidemiological evidence , 2009, International journal of cancer.

[18]  J. Manson,et al.  Mediterranean diet and incidence and mortality of coronary heart disease and stroke in women , 2009, Circulation.

[19]  P. Maisonneuve,et al.  Smoking and colorectal cancer: a meta-analysis. , 2008, JAMA.

[20]  S. Kirkpatrick,et al.  Development of the Healthy Eating Index‐2010 , 2008, Journal of the American Dietetic Association.

[21]  J. Stanford,et al.  Conjugated Equine Estrogens and Colorectal Cancer Incidence and Survival: The Women's Health Initiative Randomized Clinical Trial , 2008, Cancer Epidemiology Biomarkers & Prevention.

[22]  Pamela A Shaw,et al.  Use of recovery biomarkers to calibrate nutrient consumption self-reports in the Women's Health Initiative. , 2008, American journal of epidemiology.

[23]  M. Vitolins,et al.  Deteriorating dietary habits among adults with hypertension: DASH dietary accordance, NHANES 1988-1994 and 1999-2004. , 2008, Archives of internal medicine.

[24]  A F Subar,et al.  Index-based dietary patterns and risk of colorectal cancer: the NIH-AARP Diet and Health Study. , 2007, American journal of epidemiology.

[25]  F. Hu,et al.  Adherence to a DASH-style diet and risk of coronary heart disease and stroke in women. , 2007, Archives of internal medicine.

[26]  T. Rohan,et al.  Association between cigarette smoking and colorectal cancer in the Women's Health Initiative. , 2007, Journal of the National Cancer Institute.

[27]  E. Riboli,et al.  The second expert report, Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective , 2007 .

[28]  Vittorio Krogh,et al.  Dietary patterns associated with colon and rectal cancer: results from the Dietary Patterns and Cancer (DIETSCAN) Project. , 2004, The American journal of clinical nutrition.

[29]  Garnet L Anderson,et al.  The Women's Health Initiative recruitment methods and results. , 2003, Annals of epidemiology.

[30]  R. Langer,et al.  The Women's Health Initiative Observational Study: baseline characteristics of participants and reliability of baseline measures. , 2003, Annals of epidemiology.

[31]  C. Kooperberg,et al.  Outcomes ascertainment and adjudication methods in the Women's Health Initiative. , 2003, Annals of epidemiology.

[32]  Frank B. Hu,et al.  Dietary pattern analysis: a new direction in nutritional epidemiology , 2002, Current opinion in lipidology.

[33]  G. Bray,et al.  Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. , 2001, The New England journal of medicine.

[34]  Orton,et al.  EFFECTS ON BLOOD PRESSURE OF REDUCED DIETARY SODIUM AND THE DIETARY APPROACHES TO STOP HYPERTENSION ( DASH ) DIET , 2000 .

[35]  B. Graubard,et al.  A prospective study of diet quality and mortality in women. , 2000, JAMA.

[36]  C. Sempos,et al.  Food and nutrient exposures: what to consider when evaluating epidemiologic evidence. , 1999, The American journal of clinical nutrition.

[37]  A. Kristal,et al.  Measurement characteristics of the Women's Health Initiative food frequency questionnaire. , 1999, Annals of epidemiology.

[38]  JoAnn E. Manson,et al.  Design of the Women's Health Initiative clinical trial and observational study. The Women's Health Initiative Study Group. , 1998, Controlled clinical trials.

[39]  G. Bray,et al.  A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. , 1997, The New England journal of medicine.

[40]  I M Buzzard,et al.  Sources of data for developing and maintaining a nutrient database. , 1988, Journal of the American Dietetic Association.

[41]  G Block,et al.  A data-based approach to diet questionnaire design and testing. , 1986, American journal of epidemiology.