Ultra-Processed Food Intake and Smoking Interact in Relation with Colorectal Adenomas

Abstract

Smoking and ultra-processed foods (UPFs), a substantial part of the western diet, have been suggested to have a potential carcinogenic effect, though epidemiologic data are lacking. We aimed to examine the association between high UPF intake and colorectal adenomas, and to test the interaction with smoking. In a case-control study among consecutive subjects undergoing colonoscopy in a tertiary center during 2010–2015, UPF intake and smoking were compared between cases with colorectal adenomas and controls. Within 652 participants (cases, n = 294 and controls, n = 358), high UPF intake (defined as percent of kcal from UPF above the study sample upper tertile) was positively associated with adenomas (Odds ratio (OR) = 1.75, 95% Confidence interval (CI) 1.14–2.68), advanced and proximal adenomas (OR = 2.17, 1.29–3.65 and OR = 2.38, 1.37–4.11) among the whole study sample; and with adenomas (OR = 3.54, 1.90–6.61), non-advanced adenomas (OR = 2.60, 1.20–5.63), advanced adenomas (OR = 4.76, 2.20–10.30), proximal adenomas (OR = 6.23, 2.67–14.52), and distal adenomas (OR = 2.49, 1.21–5.13) among smokers. Additionally, a dose-dependent association was observed between tertiles of UPF intake and adenomas only among smokers (p for trend < 0.001). A significant interaction between smoking and high UPF intake was detected (p for interaction = 0.004). High intake of UPFs is strongly and independently associated with colorectal adenomas, especially advanced and proximal adenoma, and interacts with smoking. Results highlight smokers as more susceptible to the negative health effects of UPF consumption on colorectal neoplasia.

Association between maternal dietary intake classified according to its degree of processing and sex-specific birth weight for gestational age

“…Parity was also negatively associated with the healthy pattern (β=-0.1044, CI 95%: -0.1665; -0.0423) in a study by Castro et al [37] with 421 pregnant women in Rio de Janeiro, Brazil. Even though the association between smoking during pregnancy and SGA births is well established, only our study pointed out the possible association of smoking in pregnancy and the consumption of UPF [38]. Perhaps, this result is not related to the caloric consumption itself, because our results indicate that pregnant women in the second and third tertiles of the ultra-processed food group present a higher average total energetic consumption in relation to the first tertile.…”

Dietary Patterns and Associated Microbiome Changes that Promote Oncogenesis

“…A German population-based case-control study has established strong correlation between increased intake of not only processed meat but also red meat with increased risk of developing colorectal cancer (CRC) in mixed age groups ( Carr et al, 2017 ). A population-based case-control study in Israel, has also established the dose-dependent correlation between the concurrent intake of UPF and smoking on one hand and the severity of colorectal neoplasia on the other, with higher intake of UPF and smoking resulting in more advanced colorectal adenomas ( Fliss-Isakov et al, 2020 ).…”

The Diet as a Modulator of Tumor Microenvironment in Colorectal Cancer Patients

“…In contrast, it is widely accepted that the high consumption of meat and ultra-processed foods is associated with an increased risk of colorectal cancer [ 18 , 19 , 20 ]. In a similar way, a high intake of ultra-processed foods has been recently associated with colorectal adenomas, especially advanced and proximal adenomas [ 21 ]. Similarly, a higher prevalence of colorectal polyps is associated with the replacement of fresh food by canned food consumption [ 22 ].…”