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Br J Cancer. 2016 Nov 22;115(11):1430-1440. doi: 10.1038/bjc.2016.334. Epub 2016 Oct 20.

Main nutrient patterns and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition study.

Author information

1
International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
2
Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Hawthorn, Melbourne, VIC 3122, Australia.
3
Danish Cancer Society Research Center, Unit of Diet, Genes and Environment, Strandboulevarden 49, Copenhagen DK-2100, Denmark.
4
Section for Epidemiology, Department of Public Health, Aarhus University, Bartholins Alle 2, Aarhus C DK-8000, Denmark.
5
Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM UMRS 1018, Villejuif F-94805, France.
6
Institut Gustave Roussy, Villejuif F-94805, France.
7
Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany.
8
Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, Nuthetal 14558, Germany.
9
Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece.
10
WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Mikras Asias 75, Goudi, Athens GR-115 27, Greece.
11
Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Ponte Nuovo Palazzina 28A 'Mario Fiori', Via delle Oblate 4, Florence 50141, Italy.
12
Department of Clinical and Experimental Medicine, Federico II University, via Pansini 5, 80131 Naples, Italy.
13
Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian, 1, Milano 20133, Italy.
14
Cancer Registry and Histopathology Unit, 'Civic-M.P.Arezzo' Hospital, ASP, Via Dante No. 109, Ragusa 97100, Italy.
15
Unit of Cancer Epidemiology, University of Turin, Via Santena 7, Turin 10126, Italy.
16
Centre for Cancer Epidemiology and Prevention (CPO Piemonte), Via Santena 7, Turin 10126, Italy.
17
Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost Str. 6.131, PO Box 85500, Utrecht 3508 GA The Netherlands.
18
MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK.
19
Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and The Environment (RIVM), PO Box 1, Bilthoven 3720 BA, The Netherlands.
20
Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Heidelberglann 100, Utrecht 3584 CX, The Netherlands.
21
Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK.
22
Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
23
The Norwegian Food Safety Authority, Head Office, Postboks 383, 2381 Brumunddal, Norway.
24
Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø N-9037, Norway.
25
Navarra Public Health Institute, c/Leyre 15, Pamplona 31003, Pamplona, Spain.
26
IdiSNA, Navarra Institute for Health Research, Recinto de Complejo Hospitalario de Navarra c/Irunlarrea 3, Pamplona, 31008, Spain.
27
CIBER, Epidemiology and Public Health (CIBERESP), Melchor Fernández Almagro, 3-5, Madrid 28029, Spain.
28
Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), L'Hospitalet de Llobregat, Avda Gran Via 199-203, 08908 Barcelona, Spain.
29
Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Ronda de Levante 11, Murcia 30008, Spain.
30
Public Health Directorate, Asturias, Ciriaco Miguel Vigil St 9, Oviedo 33006, Spain.
31
Public Health Division of Gipuzkoa-BIODonostia Research Institute, Basque Regional Health Department, 20013 San Sebastian, Spain.
32
Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs, Hospitales Universitarios de Granada/Universidad de Granada, Cuesta del Observatorio, 4, Campus Universitario de Cartuja, Granada 18080, Spain.
33
Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, PO Box 459, 40530 Gothenburg, Sweden.
34
Department of Public Health and Clinical Medicine, Nutrition Research, Umeå University, SE-901 87 Umeå, Sweden.
35
Department of Radiation Sciences, Oncology, Umeå University, SE-901 87 Umeå, Sweden.
36
Department of Clinical Sciences Malmö, Lund University, Box 117, SE-221 00 Lund, Sweden.
37
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Oxford OX3 7LF, UK.
38
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Box 285, CB2 0QQ Cambridge, UK.
39
Clinical Gerontology Unit, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 0SP, UK.
40
Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus, Ionnina 45110, Greece.
41
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, Cambridge.

Abstract

BACKGROUND:

Much of the current literature on diet-colorectal cancer (CRC) associations focused on studies of single foods/nutrients, whereas less is known about nutrient patterns. We investigated the association between major nutrient patterns and CRC risk in participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

METHODS:

Among 477 312 participants, intakes of 23 nutrients were estimated from validated dietary questionnaires. Using results from a previous principal component (PC) analysis, four major nutrient patterns were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed for the association of each of the four patterns and CRC incidence using multivariate Cox proportional hazards models with adjustment for established CRC risk factors.

RESULTS:

During an average of 11 years of follow-up, 4517 incident cases of CRC were documented. A nutrient pattern characterised by high intakes of vitamins and minerals was inversely associated with CRC (HR per 1 s.d.=0.94, 95% CI: 0.92-0.98) as was a pattern characterised by total protein, riboflavin, phosphorus and calcium (HR (1 s.d.)=0.96, 95% CI: 0.93-0.99). The remaining two patterns were not significantly associated with CRC risk.

CONCLUSIONS:

Analysing nutrient patterns may improve our understanding of how groups of nutrients relate to CRC.

PMID:
27764841
PMCID:
PMC5129834
DOI:
10.1038/bjc.2016.334
[Indexed for MEDLINE]
Free PMC Article

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