Korean J Gastroenterol.  2012 Aug;60(2):102-108. 10.4166/kjg.2012.60.2.102.

Dietary Risk Factors in Relation to Colorectal Adenoma

• Yang SY
• Kim YS
• Song JH
• Chung SJ
• Lee IH
• Hong KJ
• Lee EJ
• Kim D
• Yim JY
• Park MJ
• Lim SH
• Kim JS

• KMID: 1387338
• DOI: http://doi.org/10.4166/kjg.2012.60.2.102

Abstract

BACKGROUND/AIMS
The role of dietary risk factors in colorectal carcinogenesis remains unclear. We investigated the association between dietary intakes and colorectal adenomas who visited a health promotion center for a routine health check-up colonoscopy.
METHODS
We conducted a retrospective case-control study using data from individuals who had colonoscopy at Seoul National University Hospital Healthcare System Gangnam Center from October 2003 to December 2007. The subjects were 242 patients (162 males and 80 females) with histopathologically confirmed colorectal adenoma, and 464 (272 males and 192 females) controls. Dietary data were obtained via 24 hour dietary recall, assisted by a registered dietitian. The student's t-test and the chi-square test were performed for the statistical comparison of means and proportions among groups. Multivariate analyses using logistic regression were performed to assess the relation between dietary intake and colorectal adenoma.
RESULTS
The total average energy intake of the patients (male: 2,407.5+/-429.2 kcal, female: 1,901.3+/-316.9 kcal) was higher than the controls (male: 2,249.6+/-430.4 kcal, female: 1,752.4+/-275.0 kcal; p=0.001). High energy intake (male: OR=4.13, 95% CI=1.70-10.05, p=0.002; female: OR=4.00, 95% CI=1.51-10.61, p=0.005) and animal protein intake (male: OR=3.97, 95% CI=1.66-9.49, p=0.002; female: OR=5.76, 95% CI=1.99-16.169, p=0.001) were found to be associated with the risk of colorectal adenoma after adjusting for confounders such as age, BMI, waist circumference, metabolic syndrome and smoking.
CONCLUSIONS
In summary, high energy intake and animal protein were associated with colorectal adenoma.

Keyword

Colorectal neoplasms; Adenoma; Risk factors; Diet; Energy intake

MeSH Terms

Adenoma/complications/*diagnosis
Age Factors
Alcohol Drinking
Body Mass Index
Case-Control Studies
Colonoscopy
Colorectal Neoplasms/complications/*diagnosis
*Diet
Dietary Proteins
Energy Intake
Female
Humans
Male
Metabolic Syndrome X/complications
Middle Aged
Odds Ratio
Retrospective Studies
Risk Factors
Smoking
Waist Circumference

Reference

1. Fuchs CS, Giovannucci EL, Colditz GA, Hunter DJ, Speizer FE, Willett WC. A prospective study of family history and the risk of colorectal cancer. N Engl J Med. 1994. 331:1669–1674.

2. Sinha R, Peters U, Cross AJ, et al. Meat, meat cooking methods and preservation, and risk for colorectal adenoma. Cancer Res. 2005. 65:8034–8041.

3. Potter JD. Nutrition and colorectal cancer. Cancer Causes Control. 1996. 7:127–146.

4. Fearon ER, Jones PA. Progressing toward a molecular description of colorectal cancer development. FASEB J. 1992. 6:2783–2790.

5. Mathew A, Peters U, Chatterjee N, Kulldorff M, Sinha R. Fat, fiber, fruits, vegetables, and risk of colorectal adenomas. Int J Cancer. 2004. 108:287–292.

6. Probst-Hensch NM, Sinha R, Longnecker MP, et al. Meat preparation and colorectal adenomas in a large sigmoidoscopy-based case-control study in California (United States). Cancer Causes Control. 1997. 8:175–183.

7. Smith-Warner SA, Elmer PJ, Fosdick L, et al. Fruits, vegetables, and adenomatous polyps: the Minnesota Cancer Prevention Research Unit case-control study. Am J Epidemiol. 2002. 155:1104–1113.

8. Lee SY, Choi KY, Kim MK, et al. The relationship between intake of vegetables and fruits and colorectal adenoma-carcinoma sequence. Korean J Gastroenterol. 2005. 45:23–33.

9. Ministry of Health and Welfare. 2007 report of statistics of Korea National Health and Nutrition. 2007. Seoul: Ministry of Health and Welfare.

10. Grundy SM, Cleeman JI, Daniels SR, et al. American Heart Association. National Heart, Lung, and Blood Institute. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005. 112:2735–2752.

11. Alberti KG, Zimmet P, Shaw J. IDF Epidemiology Task Force Consensus Group. The metabolic syndrome--a new worldwide definition. Lancet. 2005. 366:1059–1062.

12. Levi F, Pasche C, Lucchini F, La Vecchia C. Macronutrients and colorectal cancer: a Swiss case-control study. Ann Oncol. 2002. 13:369–373.

13. Giovannucci E, Goldin B. The role of fat, fatty acids, and total energy intake in the etiology of human colon cancer. Am J Clin Nutr. 1997. 66:6 Suppl. 1564S–1571S.

14. Slattery ML, Caan BJ, Potter JD, et al. Dietary energy sources and colon cancer risk. Am J Epidemiol. 1997. 145:199–210.

15. Kritchevsky D. Colorectal cancer: the role of dietary fat and caloric restriction. Mutat Res. 1993. 290:63–70.

16. Steinbach G, Heymsfield S, Olansen NE, Tighe A, Holt PR. Effect of caloric restriction on colonic proliferation in obese persons: implications for colon cancer prevention. Cancer Res. 1994. 54:1194–1197.

17. Satia-Abouta J, Galanko JA, Potter JD, Ammerman A, Martin CF, Sandler RS. North Carolina Colon Cancer Study. Associations of total energy and macronutrients with colon cancer risk in African Americans and Whites: results from the North Carolina colon cancer study. Am J Epidemiol. 2003. 158:951–962.

18. Jacobs ET, Thompson PA, Martínez ME. Diet, gender, and colorectal neoplasia. J Clin Gastroenterol. 2007. 41:731–746.

19. Kaaks R, Lukanova A. Energy balance and cancer: the role of insulin and insulin-like growth factor-I. Proc Nutr Soc. 2001. 60:91–106.

20. Kang HW, Kim D, Kim HJ, et al. Visceral obesity and insulin resistance as risk factors for colorectal adenoma: a cross-sectional, case-control study. Am J Gastroenterol. 2010. 105:178–187.

21. Breuer-Katschinski B, Nemes K, Marr A, et al. Colorectal Adenoma Study Group. Colorectal adenomas and diet: a case-control study. Colorectal Adenoma Study Group. Dig Dis Sci. 2001. 46:86–95.

22. Chao A, Thun MJ, Connell CJ, et al. Meat consumption and risk of colorectal cancer. JAMA. 2005. 293:172–182.

23. Willett WC, Stampfer MJ, Colditz GA, Rosner BA, Speizer FE. Relation of meat, fat, and fiber intake to the risk of colon cancer in a prospective study among women. N Engl J Med. 1990. 323:1664–1672.

24. Ferrucci LM, Sinha R, Graubard BI, et al. Dietary meat intake in relation to colorectal adenoma in asymptomatic women. Am J Gastroenterol. 2009. 104:1231–1240.

25. Gonzalez CA, Riboli E. Diet and cancer prevention: Contributions from the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Eur J Cancer. 2010. 46:2555–2562.

26. Reddy BS, Narisawa T, Vukusich D, Weisburger JH, Wynder EL. Effect of quality and quantity of dietary fat and dimethylhydrazine in colon carcinogenesis in rats. Proc Soc Exp Biol Med. 1976. 151:237–239.

27. Sesink AL, Termont DS, Kleibeuker JH, Van der Meer R. Red meat and colon cancer: the cytotoxic and hyperproliferative effects of dietary heme. Cancer Res. 1999. 59:5704–5709.

28. Giovannucci E, Stampfer MJ, Colditz G, Rimm EB, Willett WC. Relationship of diet to risk of colorectal adenoma in men. J Natl Cancer Inst. 1992. 84:91–98.

29. Rohrmann S, Hermann S, Linseisen J. Heterocyclic aromatic amine intake increases colorectal adenoma risk: findings from a prospective European cohort study. Am J Clin Nutr. 2009. 89:1418–1424.

30. Oh SY, Lee JH, Kim HJ. Analyses on the associations of dietary patterns with colon cancer risk. Korean J Nutr. 2004. 37:550–556.

31. Oh SY, Lee JH, Kim HJ. Analyses on the factors associated with dietary behavior regarding colon cancer risk. Korean J Nutr. 2004. 37:202–209.

32. Kim KW, Lee JW, Oh SW, et al. Fruit and vegetables consumption and distal colorectal adenomatous polyps in Korean adults. Korean J Health Promot Dis Prev. 2006. 6:186–193.