Christina C. Dahm

Main nutrient patterns and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition study

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  • Aurélie Moskal, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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  • Heinz Freisling, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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  • Graham Byrnes, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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  • Nada Assi, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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  • Michael T Fahey, Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Hawthorn, Melbourne, VIC 3122, Australia.
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  • Mazda Jenab, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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  • Pietro Ferrari, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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  • Anne Tjønneland, Danish Cancer Society Research Center, Unit of Diet, Genes and Environment, Strandboulevarden 49, Copenhagen DK-2100, Denmark.
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  • Kristina En Petersen, Danish Cancer Society Research Center, Unit of Diet, Genes and Environment, Strandboulevarden 49, Copenhagen DK-2100, Denmark.
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  • Christina C Dahm
  • Camilla Plambeck Hansen
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  • Aurélie Affret, Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM UMRS 1018, Villejuif F-94805, France.
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  • Marie-Christine Boutron-Ruault, Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM UMRS 1018, Villejuif F-94805, France.
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  • Claire Cadeau, Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM UMRS 1018, Villejuif F-94805, France.
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  • Tilman Kühn, Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
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  • Verena Katzke, Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
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  • Khalid Iqbal, Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114/116, Nuthetal 14558, Germany.
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  • Heiner Boeing, Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114/116, Nuthetal 14558, Germany.
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  • Antonia Trichopoulou, Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece; Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens GR-115 27, Greece.
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  • Christina Bamia, Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece; Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens GR-115 27, Greece.
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  • Androniki Naska, Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece; Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens GR-115 27, Greece.
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  • Giovanna Masala, Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Ponte Nuovo Palazzina 28A 'Mario Fiori', Via delle Oblate 4, Florence 50141, Italy.
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  • Maria Santucci de Magistris, Department of Clinical and Experimental Medicine, Federico II University, via Pansini 5, 80131 Naples, Italy.
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  • Sabina Sieri, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian, 1, 20133 Milano, Italy.
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  • Rosario Tumino, Cancer Registry and Histopathology Unit, "Civic-M.P.Arezzo" Hospital, ASP, Via Dante N° 109, 97100 Ragusa, Italy.
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  • Carlotta Sacerdote, Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza-University of Turin and Center for Cancer Prevention (CPO-Piemonte), Via Santena 7, 10126 Turin, Italy; Human Genetics Foundation (HuGeF), Via Nizza 52, 10126 Turin, Italy.
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  • Petra H Peeters, Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Huispost Str. 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands.
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  • Bas H Bueno-de-Mesquita, Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and The Environment (RIVM), PO Box 1, Bilthoven 3720 BA, The Netherlands.
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  • Dagrun Engeset, The Norwegian Food Safety Authority, Head Office, Postboks 383, 2381 Brumunddal, Norway.
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  • Idlir Licaj, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway.
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  • Guri Skeie, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway.
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  • Eva Ardanaz, Navarra Public Health Institute, c/Leyre 15, Pamplona 31003, Pamplona, Spain.
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  • Genevieve Buckland, Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), L'Hospitalet de Llobregat, Avda Gran Via 199-203, 08908 Barcelona, Spain.
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  • José M Huerta Castaño, CIBER Epidemiology and Public Health CIBERESP, Melchor Fernández Almagro 3-5, Madrid 28029, Spain.
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  • José R Quirós, Public Health Directorate, Asturias, Ciriaco Miguel Vigil St 9, Oviedo 33006, Spain.
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  • Pilar Amiano, CIBER Epidemiology and Public Health CIBERESP, Melchor Fernández Almagro 3-5, Madrid 28029, Spain.
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  • Elena Molina-Portillo, CIBER Epidemiology and Public Health CIBERESP, Melchor Fernández Almagro 3-5, Madrid 28029, Spain.
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  • Anna Winkvist, University of Gothenburg
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  • Robin Myte, Center for Cancer Prevention (CPO-Piemonte), Turin, Italy, Department of Radiation Sciences, Oncology Umeå University, 901 85 Umeå, Sweden.
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  • Ulrika Ericson, Department of Clinical Sciences Malmö, Lund University, Box 117, SE-221 00 Lund, Sweden.
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  • Emily Sonestedt, Department of Clinical Sciences Malmö, Lund University, Box 117, SE-221 00 Lund, Sweden.
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  • Aurora Perez-Cornago, Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Oxford OX3 7LF, United Kingdom.
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  • Nick Wareham, University of Cambridge
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  • Kay-Tee Khaw, Clinical Gerontology Unit, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 0SP, UK.
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  • Inge Huybrechts, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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  • Konstantinos K Tsilidis, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus, Ionnina 45110, Greece.
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  • Heather Ward, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, Cambridge.
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  • Marc J Gunter, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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  • Nadia Slimani, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.

BACKGROUND: Much of the current literature on diet-colorectal cancer (CRC) associations focused on studies of single foods/nutrients, whereas less is known about nutrient patterns. We investigated the association between major nutrient patterns and CRC risk in participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

METHODS: Among 477 312 participants, intakes of 23 nutrients were estimated from validated dietary questionnaires. Using results from a previous principal component (PC) analysis, four major nutrient patterns were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed for the association of each of the four patterns and CRC incidence using multivariate Cox proportional hazards models with adjustment for established CRC risk factors.

RESULTS: During an average of 11 years of follow-up, 4517 incident cases of CRC were documented. A nutrient pattern characterised by high intakes of vitamins and minerals was inversely associated with CRC (HR per 1 s.d.=0.94, 95% CI: 0.92-0.98) as was a pattern characterised by total protein, riboflavin, phosphorus and calcium (HR (1 s.d.)=0.96, 95% CI: 0.93-0.99). The remaining two patterns were not significantly associated with CRC risk.

CONCLUSIONS: Analysing nutrient patterns may improve our understanding of how groups of nutrients relate to CRC.British Journal of Cancer advance online publication 20 October 2016; doi:10.1038/bjc.2016.334 www.bjcancer.com.

Original languageEnglish
JournalB J C
Volume115
Issue11
Pages (from-to)1430–1440
Number of pages11
ISSN0007-0920
DOIs
Publication statusPublished - Nov 2016

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