 |
Relationship
of Diet to Risk of Colorectal Adenoma in Men  |
|
Relationship
of Diet to Risk of Colorectal Adenoma in Men |
Giovannucci E; Stampfer MJ; Colditz G; Rimm EB;
Willett WC
Journal of the National Cancer Institute, 1992 Jan 15, 84(2):91-8
Abstract:
BACKGROUND:
Rates
of colorectal cancer in various countries are strongly correlated
with per-capita consumption of red meat and animal fat and
inversely associated with fiber consumption. There have been few
studies, however, of dietary risk factors for colorectal
adenomas, which are precursors of cancer.
PURPOSE:
Our
purpose was to determine prospectively the relationship between
dietary factors and risk of colorectal adenomas.
METHODS:
Using
data from the Health Professionals Follow-up Study, we documented
170 cases of adenomas of the left colon or rectum in 7284 male
health professionals who completed a food-frequency questionnaire
in 1986 and who had a colonoscopy or sigmoidoscopy between 1986
and 1988. Relative risk (RR) of adenoma was determined according
to quintiles of nutrient intakes.
RESULTS:
After
adjustment for total energy intake, saturated fat was positively
associated with risk of colorectal adenoma (P for trend = .006);
RR for the highest versus the lowest quintile of intake was 2.0
(95% confidence interval [CI] = 1.2-3.2). Dietary fiber was
inversely associated with risk of adenoma (P for trend less than
.0001); RR for men in the highest versus the lowest quintile was
0.36 (95% CI = 0.22-0.60). All sources of fiber (vegetables,
fruits, and grains) were associated with decreased risk of
adenoma. For subjects on a high-saturated fat, low-fiber diet,
the RR was 3.7 (95% CI = 1.5-8.8) compared with those on a
low-saturated fat, high-fiber diet. The ratio of the intake of
red meat to the intake of chicken and fish was positively
associated with risk of adenoma (P for trend = .02).
CONCLUSIONS:
These
prospective data provide evidence for the hypothesis that a diet
high in saturated fat and low in fiber increases the risk of
colorectal adenoma. They also support existing recommendations to
substitute chicken and fish for red meat in the diet and to
increase intake of vegetables, fruits, and grains to reduce risk
of colorectal cancer.
