Dietary intake of fiber, whole grains and risk of colorectal cancer: An updated analysis according to food sources, tumor location and molecular subtypes in two large US cohorts
He X, Wu K, Zhang X, Nishihara R, Cao Y, Fuchs CS, Giovannucci EL, Ogino S, Chan AT, Song M
International journal of cancer · 40 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Cohort study (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
- Intake measured by
- Food frequency questionnaire
Who paid for it
- Funding
- Independent funding
- Nonprofit
- American Cancer Society
- Nonprofit
- American Institute for Cancer Research
- Nonprofit
- National Comprehensive Cancer Network
- Nonprofit
- Gary Bennett Family Fund
- Government
- National Institutes of Health
- Government
- National Cancer Institute
- Government
- National Institute of Diabetes and Digestive and Kidney Diseases
- Government
- NIDDK NIH HHS
- Government
- NCI NIH HHS
- Government
- US National Institutes of Health (NIH)
- Grants
- National Cancer Institute (U01 CA167552); National Cancer Institute (P01 CA055075.); National Cancer Institute (R35CA253185); National Cancer Institute (P01 CA087969); National Institutes of Health (MRSG-17-220-01-NEC); National Cancer Institute (UM1 CA186107); American Cancer Society (MRSG-17-220-01-NEC); National Cancer Institute (R03 CA197879); National Cancer Institute (U01 CA176726); National Cancer Institute (UM1-CA-167552); National Cancer Institute (R35CA197735); National Cancer Institute (K99 CA215314); National Cancer Institute (R01-CA137178); National Cancer Institute (P50-CA127003); National Cancer Institute (R01 CA202704); National Cancer Institute (K07 CA218377); National Institute of Diabetes and Digestive and Kidney Diseases (K24 [DK]098311); National Cancer Institute (R21 CA222940); National Cancer Institute (R00 CA215314); National Cancer Institute (R21 CA230873); National Institutes of Health (P01 CA 87969); National Institutes of Health (K24 DK098311); National Institutes of Health (R01CA137178); National Institutes of Health (R01 CA 151993); National Institutes of Health (UM1 CA167552); National Institutes of Health (R03CA197879); National Institutes of Health (R35 CA197735); National Institutes of Health (R21CA222940); National Institutes of Health (P50-CA127003); National Institutes of Health (R01 CA202704); National Institutes of Health (R00 CA 215314); National Institutes of Health (UM1‐CA‐186107); National Institutes of Health (R01 CA176726); National Institutes of Health (K07 CA218377); National Institutes of Health (R21 CA230873); National Institutes of Health (K99CA215314); National Institutes of Health (CA186107); National Institutes of Health (P01 CA 55075); National Institutes of Health (CA 87969); National Institutes of Health (CA55075); National Cancer Institute (R01-CA151993)
Based on 10 listed funder(s).
Publication
- Published
- 2019-05-02 · Int J Cancer · vol. 145 · issue 11 · pp. 3040–3051
- Publisher
- Wiley
- Cited
- 61 citations · more than 95% of similar papers · 4.1× the field average
- Impact
- Top 10% most cited in its field
- References
- 57 works
- Access
- Free to read
- Research areas
- Nutrition and Health in Aging · Colorectal Cancer Screening and Detection · Nutritional Studies and Diet
- Keywords
- Medicine, Colorectal cancer, Hazard ratio, Internal medicine, Proportional hazards model, Incidence (geometry), KRAS, Rectum, Microsatellite instability, Oncology, Cancer, Genetics, Biology, Microsatellite, Confidence interval, Gene
- MeSH
- humans, colorectal neoplasms, proto-oncogene proteins b-raf, diet surveys, incidence, prospective studies, cpg islands, mutation, dietary fiber, adult, aged, middle aged, nurses, female, male, proto-oncogene proteins p21(ras), microsatellite instability, whole grains
10 authors
From US, CN
- Xiaosheng HeHarvard University; Sun Yat-sen University; Massachusetts General Hospital; Sixth Affiliated Hospital of Sun Yat-sen University
- Kana WuHarvard University
- Xuehong ZhangBrigham and Women's Hospital; Harvard University
- Reiko NishiharaBrigham and Women's Hospital; Harvard University; Cancer Research And Biostatistics; Dana-Farber Cancer Institute
- Yin CaoWashington University in St. Louis
- Charlie S. FuchsYale Cancer Center
Abstract
Epidemiologic evidence relating fiber intake to colorectal cancer (CRC) remains inconclusive and data are limited on different food sources of fiber and heterogeneity by tumor subsite and molecular profile. We prospectively followed for CRC incidence 90,869 women from the Nurses' Health Study (1980-2012) and 47,924 men from the Health Professionals Follow-up Study (1986-2012), who completed a validated food frequency questionnaire every 4 years. Cox proportional hazards regression was used to examine the associations with CRC risk for total, cereal, fruit and vegetable fiber and whole grains. We also assessed the associations according to tumor subsites (proximal colon, distal colon and rectum) and molecular markers (microsatellite instability, BRAF mutation, CpG island methylator phenotype and KRAS mutation). We documented 3,178 CRC cases during 3,685,903 person-years of follow-up in the NHS and HPFS. Intake of total dietary fiber was not associated with CRC risk after multivariable adjustment in either women (hazard ratio [HR] comparing extreme deciles, 1.17; 95% CI, 0.92-1.48, ptrend = 0.55) or men (HR, 0.90; 95% CI, 0.67-1.21, ptrend = 0.47). Higher intake of cereal fiber and whole grains was associated with lower CRC risk in men with an HR of 0.75 (95% CI, 0.57-1.00) and 0.72 (95% CI, 0.54-0.96), respectively. No heterogeneity was detected by tumor subsite or molecular markers (pheterogeneity > 0.05). Higher intake of total dietary fiber within the range of a typical American diet is unlikely to substantially reduce CRC risk. The potential benefit of cereal fiber and whole grains in men warrants further confirmation.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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