Association of total energy intake and macronutrient consumption with colorectal cancer risk: results from a large population-based case-control study in Newfoundland and Labrador and Ontario, Canada

Abstract

Background Diet is regarded as one of the most important environmental factors associated with colorectal cancer (CRC) risk. A recent report comprehensively concluded that total energy intake does not have a simple relationship with CRC risk, and that the data were inconsistent for carbohydrate, cholesterol and protein. The objective of this study was to identify the associations of CRC risk with dietary intakes of total energy, protein, fat, carbohydrate, fiber, and alcohol using data from a large case-control study conducted in Newfoundland and Labrador (NL) and Ontario (ON), Canada. Methods Incident colorectal cancer cases (n = 1760) were identified from population-based cancer registries in the provinces of ON (1997-2000) and NL (1999-2003). Controls (n = 2481) were a random sample of residents in each province, aged 20-74 years. Family history questionnaire (FHQ), personal history questionnaire (PHQ), and food frequency questionnaire (FFQ) were used to collect study data. Logistic regression was used to evaluate the association of intakes of total energy, macronutrients and alcohol with CRC risk. Results Total energy intake was associated with higher risk of CRC (OR: 1.56; 95% CI: 1.21-2.01, p -trend = 0.02, 5 th versus 1 st quintile), whereas inverse associations emerged for intakes of protein (OR: 0.85, 95%CI: 0.69-1.00, p -trend = 0.06, 5 th versus 1 st quintile), carbohydrate (OR: 0.81, 95%CI: 0.63-1.00, p -trend = 0.05, 5 th versus 1 st quintile) and total dietary fiber (OR: 0.84, 95% CI:0.67-0.99, p -trend = 0.04, 5 th versus 1 st quintile). Total fat, alcohol, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, and cholesterol were not associated with CRC risk. Conclusion This study provides further evidence that high energy intake may increase risk of incident CRC, whereas diets high in protein, fiber, and carbohydrate may reduce the risk of the disease.

The Association between Postdiagnosis Dietary Supplement Use and Total Mortality Differs by Diet Quality among Older Female Cancer Survivors

“…One prospective cohort study reported a non-significant increase in the risk of death among U.S. adults who took iron at a dosage above the RDA (18 mg/day for premenopausal women) compared with non-users (41). Population-based case-control studies have shown 34% to 56% higher odds of iron supplement use among colorectal cancer cases than control subjects (42, 43). Recent systematic review and meta-analysis of epidemiologic studies have concluded that higher heme iron intake was associated with a trend towards higher risk of cancer (44).…”

No Effect of Energy Intake Overall on Risk of Endometrial Cancers: a Meta-analysis

“…Also, published epidemiologic findings has indicated that higher energy intake was associated with increased risk of specific type of cancer, e.g. prostate (Hsieh et al, 2003), breast (Sue et al, 2009), and colorectal cancer (Sun et al, 2012). However, the association between energy and endometrial cancer were ambiguous.…”

Dietary patterns and colorectal cancer recurrence and survival: a cohort study

“…Nutrient and total energy intakes were calculated by multiplying the frequency of consumption of each food by the nutrient content of the portion size based on the composition values from the 2005 Canadian Nutrient file. 12 Taking a similar grouping scheme to that used elsewhere, 3 we collapsed individual food items on the FFQ into 39 predefined food groups based on the roles of food in diet and cancer aetiology. Distinct food items were reserved as individual categories if it was deemed inappropriate to combine them (eg, jam, pies, beer and wine).…”

“…1 Geographically isolated in the Atlantic Ocean, NL has long maintained its traditional foods, a Western-style diet consisting of a large proportion of processed meat, red meat and insufficient vegetables. 11 Several studies have partially attributed the high CRC incidence rate in NL to its unique diet, [11][12][13] but no study has explored the association between the NL diet and its impact on survival among CRC patients.…”