Eating frequency and risk of colorectal cancer |
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Authors: | Martine M. Perrigue Elizabeth D. Kantor Theresa A. Hastert Ruth Patterson John D. Potter Marian L. Neuhouser Emily White |
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Affiliation: | 1. Cancer Prevention Program, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Mailbox M4-B402, Seattle, WA, 98109, USA 2. Nutritional Sciences Program, University of Washington, Seattle, WA, USA 3. Department of Epidemiology, University of Washington, Seattle, WA, USA 4. Moores Cancer Center, University of California San Diego, La Jolla, CA, USA 5. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA 6. Centre for Public Health Research, Massey University, Wellington, New Zealand
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Abstract: | Purpose Eating frequency is a modifiable aspect of dietary behavior that may affect risk of colorectal cancer (CRC). Although most previous case–control studies indicate a positive association, two prospective studies suggest an inverse association between eating frequency and CRC risk, with evidence of effect modification by diet composition. We examined the association between eating frequency and CRC in a large, prospective cohort study, and explored whether this relationship was modified by sex, coffee consumption, or dietary glycemic load. Methods Between 2000 and 2002, 67,912 western Washington residents aged 50–76 reported average daily meal and snack frequency using a mailed questionnaire as part of the vitamins and lifestyle study. Participants were followed for CRC through linkage with SEER through 2008, over which time 409 CRC cases developed. Hazard Ratios and 95 % Confidence Intervals were obtained using Cox regression. Results In age- and sex-adjusted models higher (5+ times/d) vs. lower (1–2 times/d) eating frequency was associated with a HR of 0.62 (95 % CI 0.43?0.88, Ptrend = 0.001). However, following further adjustment for BMI, race/ethnicity, alcohol, and other known CRC risk factors, the relationship was no longer statistically significant (HR: 0.76; 95 % CI 0.51, 1.14). No effect modification was observed by sex (Pinteraction = 0.45), coffee consumption (Pinteraction = 0.44), or dietary glycemic load (Pinteraction = 0.90). In subgroup analyses by tumor site, higher vs. lower eating frequency was associated with lower risk for colon (HR 0.65 95 % CI 0.39–1.07, Ptrend = 0.04), but not rectal cancers (HR = 1.08 95 % CI 0.54–2.18, Ptrend = 0.94). Conclusion The weak inverse association observed between eating frequency and CRC is consistent with findings from other prospective studies. Modification of this relationship by diet quality and participant characteristics should be considered in the future studies. |
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