A randomized trial of a low fat high fibre diet in the recurrence of colorectal polyps

McKeown‐Eyssen, Gail; Bright‐See, Elizabeth; Bruce, W. R.; Jazmaji, V

doi:10.1016/0895-4356(94)90299-2

Cited by 174 publications

(109 citation statements)

References 29 publications

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“…For example, in the Netherlands Cohort Study, a weak inverse relation was found between energy restriction early in life and subsequent colon carcinoma risk for men and women (33). In addition to mostly null dietary adenoma interventions typically lasting 3 or 4 years (13)(14)(15), even the recently completed Women's Health Initiative study with 9 years of intervention found no effect of a low-fat eating plan on colon cancer (34).…”

Section: Discussionmentioning

confidence: 99%

“…Because adenomas are thought to be precursors of most colorectal cancers (6)(7)(8)(9), they have been used as an intermediate end point in a number of randomized trials to help clarify the diet -colorectal cancer relationship (10)(11)(12). However, adenoma recurrence trials on the effects of a low-fat, high-fiber diet (13,14), wheat bran supplementation (15), and low-fat, high-fiber, and highfruit and -vegetable diet (16) have shown no effect on adenoma recurrence rates.…”

Section: Introductionmentioning

confidence: 99%

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The Polyp Prevention Trial–Continued Follow-up Study: No Effect of a Low-Fat, High-Fiber, High-Fruit, and -Vegetable Diet on Adenoma Recurrence Eight Years after Randomization

Lanza

Murphy

et al. 2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

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The Polyp Prevention Trial (PPT) was a multicenter randomized clinical trial to evaluate the effects of a highfiber (18 g/1,000 kcal), high-fruit and -vegetable (3.5 servings/1,000 kcal), and low-fat (20% of total energy) diet on the recurrence of adenomatous polyps in the large bowel over a period of 4 years. Although intervention participants reported a significantly reduced intake of dietary fat, and increased fiber, fruit, and vegetable intakes, their risk of recurrent adenomas was not significantly different from that of the controls. Since the PPT intervention lasted only 4 years, it is possible that participants need to be followed for a longer period of time before treatment differences in adenoma recurrence emerge, particularly if diet affects early events in the neoplastic process. The PPTContinued Follow-up Study (PPT-CFS) was a postintervention observation of PPT participants for an additional 4 years from the completion of the trial. Of the 1,905 PPT participants, 1,192 consented to participate in the PPT-CFS and confirmed colonoscopy reports were obtained on 801 participants. The mean time between the main trial end point colonoscopy and the first colonoscopy in the PPT-CFS was 3.94 years (intervention group) and 3.87 years (control group). The baseline characteristics of 405 intervention participants and 396 control participants in the PPT-CFS were quite similar.Even though the intervention group participants increased their fat intake and decreased their intakes of fiber, fruits, and vegetables during the PPT-CFS, they did not go back to their prerandomization baseline diet (P < 0.001 from paired t tests) and intake for each of the three dietary goals was still significantly different from that in the controls during the PPT-CFS (P < 0.001 from t tests). As the CFS participants are a subset of the people in the PPT study, the nonparticipants might not be missing completely at random. Therefore, a multiple imputation method was used to adjust for potential selection bias. The relative risk (95% confidence intervals) of recurrent adenoma in the intervention group compared with the control group was 0.98 (0.88-1.09). There were no significant intervention-control group differences in the relative risk for recurrence of an advanced adenoma (1.06; 0.81-1.39) or multiple adenomas (0.92; 0.77-1.10). We also used a multiple imputation method to examine the cumulative recurrence of adenomas through the end of the PPT-CFS: the intervention-control relative risk (95% confidence intervals) for any adenoma recurrence was 1.04 (0.98-1.09). This study failed to show any effect of a low-fat, high-fiber, high-fruit and -vegetable eating pattern on adenoma recurrence even with 8 years of follow-up. (Cancer Epidemiol Biomarkers Prev 2007;16(9):1745 -52)

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Polyp Prevention Trial–Continued Follow-up Study: No Effect of a Low-Fat, High-Fiber, High-Fruit, and -Vegetable Diet on Adenoma Recurrence Eight Years after Randomization

Lanza

Murphy

et al. 2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…A recently published meta-analysis finds an RR= 0.80 (CI: 0.68, 0.93) for calcium supplement (33), which is close to the value estimated here, 0.79. Interventions with high wheat bran and/or low fat diet, beta-carotene or vitamin C and E had no effect at all on polyp recurrence (34)(35)(36)(37)(38)(39). The "weighted Table 1 shows the effect of other interventions: mixtures, complex dietary changes, or once only tested agents.…”

Section: Experimental Chemoprevention Of Intestinal Tumours In Humansmentioning

confidence: 99%

How good are rodent models of carcinogenesis in predicting efficacy in humans? A systematic review and meta-analysis of colon chemoprevention in rats, mice and men

Corpet

Pierre

2005

European Journal of Cancer

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To cite this version:Denis E Corpet, Fabrice Pierre. How good are rodent models of carcinogenesis in predicting efficacy in humans? A systematic review and meta-analysis of colon chemoprevention in rats, mice and men.. European Journal of Cancer, Elsevier, 2005, 41 (13), pp.1911-22. <10.1016/j.ejca.2005.06.006>. D.E. Corpet, F. Pierre / European Journal of Cancer 41 (2005) 1911-1922 AbstractTumours in rodent and human colon share many histological and genetic features. To know if rodent models of colon carcinogenesis are good predictors of chemopreventive efficacy in humans, we made a meta-analysis of aspirin, betacarotene, calcium, and wheat bran studies. Controlled intervention studies of adenoma recurrence in human volunteers were compared with chemoprevention studies of carcinogen-induced tumours in rats, and of polyps in Min (Apc(+/-)) mice: 6714 volunteers, 3911 rats and 458 mice were included in the meta-analyses. Difference between models was small since most global relative risks were between 0.76 and 1.00. A closer look showed that carcinogen-induced rat studies matched human trials for aspirin, calcium, carotene, and were compatible for wheat bran. Min mice results were compatible with human results for aspirin, but discordant for calcium and wheat bran (no carotene study). These few results suggest that rodent models roughly predict effect in humans, but the prediction is not accurate for all agents. Based on three cases only, the carcinogen-induced rat model seems better than the Min mouse model. However, rodent studies are useful to screen potential chemopreventive agents, and to study mechanisms of carcinogenesis and chemoprevention.

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“…[31][32][33] A recent prospective study of 16,448 U.S. men also did not find a significant association between the dietary intake of total, cereal, or vegetable fiber and colorectal adenomas, although a slight reduction in risk was observed with increasing intake of fruit fiber. 34 Many previous studies assessed a limited number of potential confounders.…”

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confidence: 95%

Dietary Fiber and the Risk of Colorectal Cancer and Adenoma in Women

et al. 1999

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A randomized trial of a low fat high fibre diet in the recurrence of colorectal polyps

Cited by 174 publications

References 29 publications

The Polyp Prevention Trial–Continued Follow-up Study: No Effect of a Low-Fat, High-Fiber, High-Fruit, and -Vegetable Diet on Adenoma Recurrence Eight Years after Randomization

The Polyp Prevention Trial–Continued Follow-up Study: No Effect of a Low-Fat, High-Fiber, High-Fruit, and -Vegetable Diet on Adenoma Recurrence Eight Years after Randomization

How good are rodent models of carcinogenesis in predicting efficacy in humans? A systematic review and meta-analysis of colon chemoprevention in rats, mice and men

Dietary Fiber and the Risk of Colorectal Cancer and Adenoma in Women

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