Nutrient dietary patterns and the risk of colorectal cancer: a case–control study from Italy

ObjectiveThe role of diet on colorectal cancer has been considered in terms of single foods and nutrients, but less frequently in terms of dietary patterns.MethodsData were derived from an Italian case–control study, including 1,225 subjects with cancer of the colon, 728 subjects with rectal cancer, and 4,154 hospital controls. We identified dietary patterns on a selected set of nutrients through principal component factor analysis. Odds ratios (OR) and 95% confidence intervals for both cancers were estimated using unconditional multiple logistic regression.ResultsWe identified 5 major dietary patterns. Direct associations were observed between the Starch-rich pattern and both cancer of the colon (OR = 1.68) and of the rectum (OR = 1.74). Inverse relationships were found between the Vitamins and fiber pattern and rectal cancer (OR = 0.61), between the Unsaturated fats (animal source) and the Unsaturated fats (vegetable source) and cancer of the colon (OR = 0.80 and OR = 0.79, respectively). No other significant association was found.ConclusionsThe Starch-rich pattern is potentially an unfavorable indicator of risk for both colon and rectal cancer, whereas the Vitamins and fiber pattern is associated with a reduced risk of rectal cancer and the Unsaturated fats patterns with a reduced risk of colon cancer.

[1]  C. la Vecchia,et al.  Intake of selected micronutrients and risk of colorectal cancer , 1997, International journal of cancer.

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

[3]  W. Willett,et al.  Major dietary patterns and the risk of colorectal cancer in women. , 2003, Archives of internal medicine.

[4]  N. Lackey,et al.  Making Sense of Factor Analysis: The Use of Factor Analysis for Instrument Development in Health Care Research , 2003 .

[5]  F B Hu,et al.  Prospective study of major dietary patterns and colorectal cancer risk in women. , 2001, American journal of epidemiology.

[6]  P Gnagnarella,et al.  Validation of a food-frequency questionnaire to assess dietary intakes in cancer studies in Italy. Results for specific nutrients. , 1996, Annals of epidemiology.

[7]  S. Franceschi,et al.  Nutrient dietary patterns and the risk of breast and ovarian cancers , 2008, International journal of cancer.

[8]  N. Lackey,et al.  Making Sense of Factor Analysis , 2003 .

[9]  F. Clavel-Chapelon,et al.  Dietary Patterns and Risk of Colorectal Tumors : A Cohort of French Women of the National Education System ( E 3 N ) , 2006 .

[10]  C. la Vecchia,et al.  An assessment, and reproducibility of food frequency data provided by hospital controls. , 1997, European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation.

[11]  E. Giovannucci,et al.  Cancers of the Colon and Rectum , 2006 .

[12]  O. Nanni,et al.  Reproducibility of an Italian food frequency questionnaire for cancer studies: results for specific food items. , 1993, European journal of cancer.

[13]  H. Kaiser.  An index of factorial simplicity , 1974 .

[14]  F. Clavel-Chapelon,et al.  Dietary patterns and risk of colorectal tumors: a cohort of French women of the National Education System (E3N). , 2006, American journal of epidemiology.

[15]  S. Salvini,et al.  Banca Dati di Composizione degli Alimenti per Studi Epidemiologici in Italia , 1998 .

[16]  N. Breslow,et al.  The analysis of case-control studies , 1980 .

[17]  Richard A. Johnson,et al.  Applied Multivariate Statistical Analysis , 1983 .

[18]  E. Rimm,et al.  Dietary patterns and risk of colon cancer and adenoma in a cohort of men (United States) , 2004, Cancer Causes & Control.

[19]  M. Leppert,et al.  Western diet, family history of colorectal cancer, NAT2, GSTM-1 and risk of colon cancer , 2004, Cancer Causes & Control.

[20]  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.

[21]  J. Potter,et al.  Eating patterns and risk of colon cancer. , 1998, American journal of epidemiology.

[22]  Victor Kipnis,et al.  Dietary patterns as identified by factor analysis and colorectal cancer among middle-aged Americans. , 2008, The American journal of clinical nutrition.

[23]  W. Koh,et al.  Prospective study of dietary patterns and colorectal cancer among Singapore Chinese , 2008, British Journal of Cancer.

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

[25]  S. Graham,et al.  Dietary patterns and colon cancer in western New York. , 1992, Nutrition and cancer.

[26]  S. Tsugane,et al.  Dietary patterns and subsequent colorectal cancer risk by subsite: A prospective cohort study , 2005, International journal of cancer.

[27]  N. E. Breslow.  Statistical Methods in Cancer Research , 1986 .

[28]  N. Breslow,et al.  Statistical methods in cancer research: volume 1- The analysis of case-control studies , 1980 .

[29]  J. Fraumeni,et al.  Cancer epidemiology and prevention. , 2006 .

[30]  Denis Muller,et al.  Associations of empirically derived eating patterns with plasma lipid biomarkers: a comparison of factor and cluster analysis methods. , 2004, The American journal of clinical nutrition.

[31]  Howard B. Lee,et al.  A first course in factor analysis , 1973 .

[32]  O. Nanni,et al.  Food groups and risk of colorectal cancer in Italy , 1997, International journal of cancer.

[33]  S. Franceschi,et al.  The Update of the Italian Food Composition Database of Gluten-Free Products and Its Application in Food-Based Dietary Guidelines Menus , 2004, Nutrients.

[34]  L. Cronbach.  Coefficient alpha and the internal structure of tests , 1951 .

[35]  D. Amadori,et al.  Macronutrient intake and risk of colorectal cancer in Italy , 1998, International journal of cancer.

[36]  S. Kono,et al.  Dietary patterns and colorectal adenomas in Japanese men: the Self-Defense Forces Health Study. , 2005, American journal of epidemiology.

[37]  Christopher F. Martin,et al.  Dietary Patterns and Colon Cancer Risk in Whites and African Americans in the North Carolina Colon Cancer Study , 2009, Nutrition and cancer.