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The relationship between nut intake and risk of colorectal cancer: a case control study.
Lee, J, Shin, A, Oh, JH, Kim, J
Nutrition journal. 2018;17(1):37
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Nut consumption has been shown to be associated with reduced risk of obesity, Type 2 diabetes and cardiovascular disease. This retrospective, case-controlled study aimed to examine the association between nut consumption and the risk of colo-rectal cancer in a cohort of Korean adults. 923 colorectal cancer patients and 1846 controls were included in the study. Each completed a validated food frequency questionnaire, including peanuts, pine nuts and almonds. A nut serving was considered to be 15g and was categorised as none, less than 1 serving per week, 1-3 servings per week and greater than 3 servings per week. Nut consumption was found to have a strong association with reduced colo-rectal cancer in both men and women, after adjusting for age, education level, alcohol consumption, BMI, regular exercise, red meat intake, fruit and vegetable intake and total energy intake. This association was found in all sub-sites of the colon for men and for the distal and rectum subsites for women.
Abstract
BACKGROUND Nut consumption is known to reduce the risk of obesity, diabetes mellitus, and cardiovascular disease. However, in previous studies, portion sizes and categories of nut consumption have varied, and few studies have assessed the association between colorectal cancer risk and nut consumption. In this study, we investigated the relationship between nut consumption and colorectal cancer risk. METHODS A case-control study was conducted among 923 colorectal cancer patients and 1846 controls recruited from the National Cancer Center in Korea. Information on dietary intake was collected using a semi-quantitative food frequency questionnaire with 106 items, including peanuts, pine nuts, and almonds (as 1 food item). Nut consumption was categorized as none, < 1 serving per week, 1-3 servings per week, and ≥3 servings per week. A binary logistic regression model was used to estimate odds ratios (OR) and their 95% confidence intervals (CI) for the association between nut consumption and colorectal cancer risk, and a polytomous logistic regression model was used for sub-site analyses. RESULTS High nut consumption was strongly associated with reduced risk of colorectal cancer among women (adjusted ORs: 0.30, 95%CI: 0.15-0.60 for the ≥3 servings per week group vs. none). A similar inverse association was observed for men (adjusted ORs: 0.28, 95% CI: 0.17-0.47). In sub-site analyses, adjusted ORs (95% CIs) comparing the ≥3 servings per week group vs none were 0.25 (0.09-0.70) for proximal colon cancer, 0.39 (0.19-0.80) for distal colon cancer, and 0.23 (0.12-0.46) for rectal cancer among men. An inverse association was also found among women for distal colon cancer (OR: 0.13, 95% CI: 0.04-0.48) and rectal cancer (OR: 0.40, 95% CI: 0.17-0.95). CONCLUSIONS We found a statistically significant association between high frequency of nut consumption and reduced risk of colorectal cancer. This association was observed for all sub-sites of the colon and rectum among both men and women, with the exception of proximal colon cancer for women.
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Dietary inflammatory index and risk of pancreatic cancer in an Italian case-control study.
Shivappa, N, Bosetti, C, Zucchetto, A, Serraino, D, La Vecchia, C, Hébert, JR
The British journal of nutrition. 2015;113(2):292-8
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Pancreatic cancer has the highest mortality rate amongst gastro-intestinal cancers and evidence suggests that diet plays a pivotal role in the aetiology of the disease. Chronic inflammation is often present with cancers however it is not known if inflammation has a causal role or is simply part of the body’s natural response mechanism. This 2015 case control study evaluated food frequency questionnaire (FFQ) data from 326 incident cases and 652 controls and indexed foods based on their inflammatory status using a global database derived from previous studies: the dietary inflammatory index (DII). The DII ranks foods against forty-five nutrient parameters to generate an overall score. The higher DII scores reflect a greater pro-inflammatory potential of the diet. Food parameters measured included: carbohydrate; protein; fat; alcohol; fibre; cholesterol; SFA; MUFA; PUFA; n -3; n -6; niacin; thiamin; riboflavin; vitamin B6; Fe; Zn; vitamin A; vitamin C; vitamin D; vitamin E; folic acid; β-carotene; anthocyanidins; flavan-3-ol; flavonol; flavonones; flavones; isoflavones; caffeine and tea. The DII is designed to consider all pro-inflammatory foods (such as red meat) and all anti-inflammatory foods (such as fruits and vegetables) to represent the potential inflammatory effect of diet as a whole. After adjustments for sex, age and other lifestyle factors the results showed that subjects with higher DII scores (i.e. representing a more pro-inflammatory diet) had a higher risk of developing pancreatic cancer.
Abstract
Previous studies have shown that various dietary components may be implicated in the aetiology of pancreatic cancer. However, the possible relationship between diet-related inflammation and the risk of pancreatic cancer has not yet been investigated. We examined the ability of a newly developed literature-derived dietary inflammatory index (DII) to predict the risk of pancreatic cancer in a case-control study conducted in Italy between 1991 and 2008. This included 326 incident cases and 652 controls admitted to the major teaching and general hospitals for non-neoplastic diseases, frequency-matched to cases by study centre, sex and age. The DII was computed based on dietary intake assessed using a validated and reproducible seventy-eight-item FFQ. Logistic regression models were used to estimate multivariable OR adjusted for age, sex, study centre, education, BMI, smoking status, alcohol drinking and history of diabetes. Energy adjustment was performed using the residual method. Subjects with higher DII scores (i.e., representing a more pro-inflammatory diet) had a higher risk of pancreatic cancer, with the DII being used as both a continuous variable (ORcontinuous 1.24, 95% CI 1.11, 1.38) and a categorical variable (i.e., compared with the subjects in the lowest quintile of the DII, those in the second, third, fourth and fifth quintiles had, respectively, OR(quintile2 v. 1) 1.70, 95% CI 1.02, 2.80; OR(quintile3 v. 1) 1.91, 95% CI 1.16, 3.16; OR(quintile4 v. 1) 1.98, 95% CI 1.20, 3.27; OR(quintile5 v. 1) 2.48, 95% CI 1.50, 4.10; P trend= 0.0015). These data suggest that a pro-inflammatory diet increases the risk of pancreatic cancer.