Prospective study of dietary patterns and colorectal cancer among Singapore Chinese

Abstract

An influence of Western diet and lifestyle factors observed among Singapore Chinese may contribute to the population's marked rise in colorectal cancer incidence over the past two decades. Thus far, however, there is little evidence for individual nutrients and foods as major contributing factors in this population. We evaluated whether patterns of food intake were associated with colorectal cancer in a population-based cohort of 61,321 Singapore Chinese that was established in 1993 -98. Two dietary patterns, meat -dim sum and vegetable -fruit -soy, were previously identified by principal components analysis using baseline dietary data from a validated 165-item food frequency questionnaire. As of 31 December 2005, 961 incident colorectal cancer cases were diagnosed. Proportional hazards regression was used to calculate adjusted hazard ratios. Using nearly 10 years of follow-up data, we observed no association with either the meat -dim sum or vegetable -fruit -soy pattern for colorectal cancer. In conclusion, neither individual nutrients or foods nor dietary patterns appear to explain the rise in colorectal cancer among Singapore Chinese population. Trade and Industry, 2005). Along with the rise in industrialisation and urbanisation there was a shift in the major causes of death from infectious diseases to 'lifestyle' diseases common in Western societies, such as cancer, cardiovascular disease, and stroke (Ministry of Health, 2006). This shift was also evident with cancer trends, where cancers associated with infection, such as stomach, nasopharynx, liver, have been decreasing in incidence, whereas cancers of the prostate, breast, and colorectum have been on the rise (Seow et al, 2004). Colorectal cancer, in particular, has increased by over 120% among men and women in the past two decades (Wong and Eu, 2007), approaching the incidence rates seen among US Chinese (McCracken et al, 2007).Using data from a prospective cohort of 63 257 Singapore Chinese, we have investigated diet by analysing associations with individual nutrients and foods thought to be aetiologically relevant to colorectal cancer (World Cancer Research Fund/American Institute for Cancer Research, 2007). While valuable, this strategy probably did not capture the complex interactions between individual nutrients and their correlations with other dietary (Randall et al, 1990;Kant et al, 1991), lifestyle (Slattery et al, 1999;Maskarinec et al, 2000), and sociodemographic patterns (Gex-Fabry et al, 1988;Lv and Cason, 2004) that may confound associations with colorectal cancer. This is one plausible explanation for the more consistent epidemiologic findings with dietary patterns and colorectal cancer, compared to those with nutrients and foods. For example, several prospective studies support a positive association with dietary patterns characterised by red meat, potatoes, sweets, and fried foods (Fung et al, 2003;Dixon et al, 2004;Kesse et al, 2006;Flood et al, 2008). However, few data address dietary patterns among Chinese populations in relation to...

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Nutrient-derived Dietary Patterns and Risk of Colorectal Cancer: a Factor Analysis in Uruguay

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