Food groups, diet quality and colorectal cancer risk in the Basque Country

Abstract

BACKGROUND The results obtained to date concerning food groups, diet quality and colorectal cancer (CRC) risk vary according to criteria used and the study populations. AIM To study the relationships between food groups, diet quality and CRC risk, in an adult population of the Basque Country (North of Spain). METHODS This observational study included 308 patients diagnosed with CRC and 308 age- and sex-matched subjects as controls. During recruitment, dietary, anthropometric, lifestyle, socioeconomic, demographic and health status information was collected. Adherence to the dietary recommendations was evaluated utilizing the Healthy Eating Index for the Spanish Diet and the MedDietScore. Conditional logistic regressions were used to evaluate the associations of food group intakes, diet quality scores, categorized in tertiles, with CRC risk. RESULTS The adjusted models for potential confounding factors showed a direct association between milk and dairy products consumption, in particular high-fat cheeses [odds ratio (OR) third tertile vs first tertile = 1.87, 95% confidence intervals (CI): 1.11-3.16], and CRC risk. While the consumption of fiber-containing foods, especially whole grains (OR third tertile vs first tertile = 0.62, 95%CI: 0.39-0.98), and fatty fish (OR third tertile vs first tertile = 0.53, 95%CI: 0.27-0.99) was associated with a lower risk for CRC. Moreover, higher MD adherence was associated with a reduced CRC risk in adjusted models (OR third tertile vs first tertile = 0.40, 95%CI: 0.20-0.80). CONCLUSION Direct associations were found for high-fat cheese, whereas an inverse relation was reported for fiber-containing foods and fatty fish, as well as adherence to a Mediterranean dietary pattern.

Gene–Diet Interactions in Colorectal Cancer: Survey Design, Instruments, Participants and Descriptive Data of a Case–Control Study in the Basque Country

“…The theoretical range of the HEISD is 0-100 and of the MDS 0-55; higher values of these scores indicate greater adherence to the dietary recommendations for the Spanish population and the Mediterranean diet pattern, respectively. These results were previously described [28].…”

“…The characteristics of the cases (pathological staging, location of the cancer, tumor grade and treatments) have been also described before [28]. Briefly, 72% were diagnosed with early-stage (I/II) CRC, 76% had distal location of the cancer, 80.5% of tumors were well-/moderately differentiated and 73.7% had undergone surgical resection.…”

Burden of colorectal cancer attributable to diet low in milk in China, 1990–2017: findings from the global burden of disease study 2017

“…However, the consumption level could be classified to a low intake according to the GBD study. A case–control study from the Basque Country indicated that a higher consumption of milk or dairy products was associated with an increased CRC risk, probably as a result of a small sample size ( n = 616) ( 16 ) . Meanwhile, the potential reasons for this were that cut‐offs for the highest milk or dairy product intake categories in different studies varied by geographical region, and also different studies had adjusted for different confounding factors, which biased the results and led to different estimates ( 50 ) .…”

“…Most systematic reviews and meta‐analysis of prospective studies consistently showed a decreased risk of CRC associated with a higher consumption of milk or total dairy products ( 9,12–14 ) . However, some studies showed contradictory results ( 15,16 ) . In view of this, the Global Burden of Disease (GBD) study 2017 established the convincing causality for a diet low in milk–CRC pairing by systematically evaluating all existing epidemiological evidence and summarising the important characteristics of the relationship ( 17 ) .…”

The Impact of Whole Grain Intake on Gastrointestinal Tumors: A Focus on Colorectal, Gastric, and Esophageal Cancers

“…Moreover, such association was observed in men, but not in women; this sex-disparity might depend on lower fiber intake registered for women (mean fiber intake of 14 g/day for women and 20.0 g/day for men) [ 118 ]. Alegria-Lertxundi and co-workers [ 115 ] investigated the relationships between food groups, diet quality and colorectal cancer risk and reported no significant differences of intake between control and patient groups for the majority of food classes, except for lower WG intake (and higher egg consumption) in tumor cases; coherently, the observed protective effects of fiber-containing foods appeared to be mainly ascribed to WGs. A recent, large US cohort analysis (with more than 10,000 incident colorectal cases and more than 15 years of follow-up) further confirmed that fiber from grains, but not from other sources, was associated with lower incidence, especially for distal colon and rectal cancers [ 116 ].…”