Fruit, vegetables, dietary fiber, and risk of colorectal cancer.
By Paul Terry, Edward L. Giovannucci, Karin B. Michels, L. Bergkvist, Holger Hansen, L. Holmberg, A. Wolk. Journal of the National Cancer Institute, 2001
620 citations recorded by the source corpus.
BACKGROUND Several recent large prospective cohort studies have failed to demonstrate the presumed protective effect of fruit, vegetable, and dietary fiber consumption on colorectal cancer risk. To further explore this issue, we have examined these associations in a population that consumes relatively low amounts of fruit and vegetables and high amounts of cereals. METHODS We examined data obtained from a food-frequency questionnaire used in a population-based prospective mammography screening study of women in central Sweden. Women with colorectal cancer diagnosed through December 31, 1998, were identified by linkage to regional cancer registries. Cox proportional hazards models were used to estimate relative risks. All statistical tests were two-sided. RESULTS During an average 9.6 years of follow-up of 61 463 women, we observed 460 incident cases of colorectal cancer (291 colon cancers, 159 rectal cancers, and 10 cancers at both sites). In the entire study population, total fruit and vegetable consumption was inversely associated with colorectal cancer risk. Subanalyses showed that this association was due largely to fruit consumption. The association was stronger, however, and the dose-response effect was more evident among individuals who consumed the lowest amounts of fruit and vegetables. Individuals who consumed less than 1.5 servings of fruit and vegetables per day had a relative risk for developing colorectal cancer of 1.65 (95% confidence interval = 1.23 to 2.20; P(trend) =.001) compared with individuals who consumed more than 2.5 servings. We observed no association between colorectal cancer risk and the consumption of cereal fiber, even at amounts substantially greater than previously examined, or of non-cereal fiber. CONCLUSIONS Individuals who consume very low amounts of fruit and vegetables have the greatest risk of colorectal cancer. Relatively high consumption of cereal fiber does not appear to lower the risk of colorectal cancer.
Subfields: Oncology, Public Health, Environmental and Occupational Health
View Paper: https://www.semanticscholar.org/paper/1b1a26433caa8bad0cd5b5131085a3ab65b65258
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Citations in the corpus
- Obesity and Risk of Colorectal Cancer: A Systematic Review of Prospective Studies (2013, background): “Several studies have demonstrated that lifestyle factors, such as smoking, obesity, physical inactivity, or a high-fat/low-fiber diet, might contribute to the aetiology of CRC [3,4,5].”
- Epidemiologic evidence of the protective effect of fruit and vegetables on cancer risk. (2003, neutral): “For colorectal cancer, while recent case-control studies have reported a protective effect of vegetables and to a lesser extent of fruit (3–9), cohort studies have almost unanimously reported null associations (10–14), with one exception (15).”
- Effects of Dietary Fiber and Its Components on Metabolic Health (2010, background): “behind dietary fibers beneficial effects on the treatment and prevention of obesity and diabetes [1,26], reduced CVD [27] and decreased incidence of certain types of cancer [28,29].”
- Obesity and Risk of Colorectal Cancer: A Meta-analysis of 31 Studies with 70,000 Events (2007, background): “The wide geographic variation in incidence rates for colorectal cancer, together with observations from migrant studies, suggest that lifestyle risk factors, including diet (3, 4), physical activity (5), obesity (6), and diabetes (7), play a pivotal role in the etiology of the disease (8).”