Clin Nutr Res.  2015 Apr;4(2):110-123. 10.7762/cnr.2015.4.2.110.

Associations of Colorectal Cancer Incidence with Nutrient and Food Group Intakes in Korean Adults: A Case-Control Study

Affiliations
  • 1Department of Food and Nutrition, Sungshin Women's University, Seoul 142-732, Korea. smlee@sungshin.ac.kr
  • 2Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 135-720, Korea.
  • 3Colorectal Cancer Clinic/Division of Nursing, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 135-720, Korea.
  • 4Department of Nutrition Services, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 135-720, Korea.
  • 5Department of Gastroenterology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 135-720, Korea. hjpark21@yuhs.ac

Abstract

This study aimed to examine the associations between intakes of various nutrients and food groups and colorectal cancer risk in a case-control study among Koreans aged 20 to 80 years. A total of 150 new cases and 116 controls were recruited with subjects' informed consent. Dietary data were collected using the food frequency questionnaire developed and validated by the Korea Centers for Disease Control and Prevention. Multivariate logistic regression models were used to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for colorectal cancer incidence. High intakes of total lipid (OR(T3 vs T1) = 4.15, 95% CI: 1.33-12.96, p for trend = 0.034), saturated fatty acid (OR(T3 vs T1) = 2.96, 95% CI: 1.24-7.04, p for trend = 0.016) and monounsaturated fatty acid (OR(T3 vs T1) = 3.04, 95% CI: 1.23-7.54, p for trend = 0.018) were significantly associated with increased incidence of colorectal cancer. High dietary fiber (OR(T3 vs T1) = 0.22, 95% CI: 0.08-0.56, p for trend = 0.002) and vitamin C (OR(T3 vs T1) = 0.38, 95% CI: 0.14-1.05, p for trend = 0.021) intakes were significantly associated with reduced colorectal cancer incidence. From the food group analysis, bread (OR(T3 vs T1) = 2.26, 95% CI: 0.96-5.33, p for trend = 0.031), red meat (OR(T3 vs T1) = 7.33, 95% CI: 2.98-18.06, p for trend < 0.001), milk.dairy product (OR(T3 vs T1) = 2.42, 95% CI: 1.10-5.31, p for trend = 0.071) and beverage (OR(T3 vs T1) = 3.17, 95% CI: 1.35-7.48, p for trend = 0.002) intakes were positively associated with colorectal cancer risk. On the other hand, high intake of traditional rice cake (OR(T3 vs T1) = 0.35, 95% CI: 0.14-0.86, p for trend = 0.024) was linked with lower colorectal cancer incidence. In conclusion, eating a diet high in total lipid, saturated fatty acids and monounsaturated fatty acids is associated with higher incidence of colorectal cancer, whereas a diet high in dietary fiber and vitamin C was found to lower the incidence in Korean adults. Interestingly high traditional rice cake consumption is associated inversely with colorectal cancer incidence, warranting a future study.

Keyword

Colorectal cancer; Nutrient; Food group; Case-control study

MeSH Terms

Adult*
Ascorbic Acid
Beverages
Bread
Case-Control Studies*
Centers for Disease Control and Prevention (U.S.)
Colorectal Neoplasms*
Diet
Dietary Fiber
Eating
Fatty Acids
Fatty Acids, Monounsaturated
Hand
Humans
Incidence*
Informed Consent
Korea
Logistic Models
Meat
Odds Ratio
Surveys and Questionnaires
Ascorbic Acid
Fatty Acids
Fatty Acids, Monounsaturated

Reference

1. Ministry of Health and Welfare (KR). Korea Central Cancer Registry. National Cancer Center (KR). Annual report of cancer statistics in Korea in 2012 [Internet]. 2015. cited 2015 April 1. Available fromhttp://ncc.re.kr/manage/manage03_033_list.jsp.
2. World Cancer Research Fund (GB). American Institute for Cancer Research. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Washington, D.C.: American Institute for Cancer Research;2007.
3. Kim J, Kim DH, Lee BH, Kang SH, Lee HJ, Lim SY, Suh YK, Ahn YO. Folate intake and the risk of colorectal cancer in a Korean population. Eur J Clin Nutr. 2009; 63:1057–1064.
Article
4. Kim J, Cho YA, Kim DH, Lee BH, Hwang DY, Jeong J, Lee HJ, Matsuo K, Tajima K, Ahn YO. Dietary intake of folate and alcohol, MTHFR C677T polymorphism, and colorectal cancer risk in Korea. Am J Clin Nutr. 2012; 95:405–412.
Article
5. Oh SY, Lee JH, Kim HJ. Analyses on the associations of dietary patterns with colon cancer risk. Korean J Nutr. 2004; 37:550–556.
6. Ministry of Health and Welfare. Korea Centers for Disease Control and Prevention. Korea National Health and Nutrition Examination Survey form [Internet]. 2013. cited 2014 April 20. Available fromhttps://knhanes.cdc.go.kr/knhanes/index.do.
7. Ahn Y, Lee JE, Paik HY, Lee HK, Jo I, Kimm K. Development of a semiquantitative food frequency questionnaire based on dietary data from the Korea national health and nutrition examination survey. Nutr Sci. 2003; 6:173–184.
8. Ahn Y, Lee JE, Cho NH, Shin C, Park C, Oh BS, Kimm K. Validation and calibration of semi-quantitative food frequency questionnaire: with participants of the Korean health and genome study. Korean J Community Nutr. 2004; 9:173–182.
9. Norat T, Aune D, Chan D, Romaguera D. Fruits and vegetables: updating the epidemiologic evidence for the WCRF/AICR lifestyle recommendations for cancer prevention. Cancer Treat Res. 2014; 159:35–50.
Article
10. Armstrong B, Doll R. Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices. Int J Cancer. 1975; 15:617–631.
Article
11. Levi F, Pasche C, Lucchini F, La Vecchia C. Macronutrients and colorectal cancer: a Swiss case-control study. Ann Oncol. 2002; 13:369–373.
Article
12. Beresford SA, Johnson KC, Ritenbaugh C, Lasser NL, Snetselaar LG, Black HR, Anderson GL, Assaf AR, Bassford T, Bowen D, Brunner RL, Brzyski RG, Caan B, Chlebowski RT, Gass M, Harrigan RC, Hays J, Heber D, Heiss G, Hendrix SL, Howard BV, Hsia J, Hubbell FA, Jackson RD, Kotchen JM, Kuller LH, LaCroix AZ, Lane DS, Langer RD, Lewis CE, Manson JE, Margolis KL, Mossavar-Rahmani Y, Ockene JK, Parker LM, Perri MG, Phillips L, Prentice RL, Robbins J, Rossouw JE, Sarto GE, Stefanick ML, Van Horn L, Vitolins MZ, Wactawski-Wende J, Wallace RB, Whitlock E. Low-fat dietary pattern and risk of colorectal cancer: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006; 295:643–654.
Article
13. Key TJ, Appleby PN, Masset G, Brunner EJ, Cade JE, Greenwood DC, Stephen AM, Kuh D, Bhaniani A, Powell N, Khaw KT. Vitamins, minerals, essential fatty acids and colorectal cancer risk in the United Kingdom Dietary Cohort Consortium. Int J Cancer. 2012; 131:E320–E325.
Article
14. Ministry of Health and Welfare. Korea Centers for Disease Control and Prevention. Korea Health Statistics 2008: Korea National Health and Nutrition Examination Survey (KNHANES IV-2) [Internet]. 2009. cited 2014 April 20. Available fromhttps://knhanes.cdc.go.kr/knhanes/index.do.
15. Burkitt DP. Epidemiology of cancer of the colon and rectum. 1971. Dis Colon Rectum. 1993; 36:1071–1082.
16. Dahm CC, Keogh RH, Spencer EA, Greenwood DC, Key TJ, Fentiman IS, Shipley MJ, Brunner EJ, Cade JE, Burley VJ, Mishra G, Stephen AM, Kuh D, White IR, Luben R, Lentjes MA, Khaw KT, Rodwell Bingham SA. Dietary fiber and colorectal cancer risk: a nested case-control study using food diaries. J Natl Cancer Inst. 2010; 102:614–626.
Article
17. Egeberg R, Olsen A, Loft S, Christensen J, Johnsen NF, Overvad K, Tjønneland A. Intake of wholegrain products and risk of colorectal cancers in the Diet, Cancer and Health cohort study. Br J Cancer. 2010; 103:730–734.
Article
18. Lupton JR, Turner ND. Potential protective mechanisms of wheat bran fiber. Am J Med. 1999; 106:24S–27S.
Article
19. Lee HJ, Kim YA, Lee HS. Annual changes in the estimated dietary fiber intake of Korean during 1991~2001. Korean J Nutr. 2006; 39:549–559.
20. Austin GL, Adair LS, Galanko JA, Martin CF, Satia JA, Sandler RS. A diet high in fruits and low in meats reduces the risk of colorectal adenomas. J Nutr. 2007; 137:999–1004.
Article
21. Cotterchio M, Boucher BA, Manno M, Gallinger S, Okey AB, Harper PA. Red meat intake, doneness, polymorphisms in genes that encode carcinogen-metabolizing enzymes, and colorectal cancer risk. Cancer Epidemiol Biomarkers Prev. 2008; 17:3098–3107.
Article
22. Magalhães B, Bastos J, Lunet N. Dietary patterns and colorectal cancer: a case-control study from Portugal. Eur J Cancer Prev. 2011; 20:389–395.
23. Oh SY, Lee JH, Kim HJ. Analyses on the associations of dietary patterns with colon cancer risk. Korean J Nutr. 2004; 37:550–556.
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