Association of total energy intake and macronutrient consumption with colorectal cancer risk: results from a large population-based case-control study in Newfoundland and Labrador and Ontario, Canada

• Published in: Nutrition Journal
• Main Authors: Sun Zhuoyu, Liu Lin, Wang Peizhong, Roebothan Barbara, Zhao Jin, Dicks Elizabeth, Cotterchio Michelle, Buehler Sharon, Campbell Peter T, Mclaughlin John R, Parfrey Patrick S
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2012
• Subjects: Colorectal cancer; Total energy; Macronutrient; Case-control study; Nutrition. Foods and food supply; TX341-641; Nutritional diseases. Deficiency diseases; RC620-627; Newfoundland; Canada
• Online Access: https://doi.org/10.1186/1475-2891-11-18; https://doaj.org/article/c8c764e97ee647e79958065557afdd63

Abstract Background Diet is regarded as one of the most important environmental factors associated with colorectal cancer (CRC) risk. A recent report comprehensively concluded that total energy intake does not have a simple relationship with CRC risk, and that the data were inconsistent for carbohydrate, cholesterol and protein. The objective of this study was to identify the associations of CRC risk with dietary intakes of total energy, protein, fat, carbohydrate, fiber, and alcohol using data from a large case-control study conducted in Newfoundland and Labrador (NL) and Ontario (ON), Canada. Methods Incident colorectal cancer cases (n = 1760) were identified from population-based cancer registries in the provinces of ON (1997-2000) and NL (1999-2003). Controls (n = 2481) were a random sample of residents in each province, aged 20-74 years. Family history questionnaire (FHQ), personal history questionnaire (PHQ), and food frequency questionnaire (FFQ) were used to collect study data. Logistic regression was used to evaluate the association of intakes of total energy, macronutrients and alcohol with CRC risk. Results Total energy intake was associated with higher risk of CRC (OR: 1.56; 95% CI: 1.21-2.01, p -trend = 0.02, 5 th versus 1 st quintile), whereas inverse associations emerged for intakes of protein (OR: 0.85, 95%CI: 0.69-1.00, p -trend = 0.06, 5 th versus 1 st quintile), carbohydrate (OR: 0.81, 95%CI: 0.63-1.00, p -trend = 0.05, 5 th versus 1 st quintile) and total dietary fiber (OR: 0.84, 95% CI:0.67-0.99, p -trend = 0.04, 5 th versus 1 st quintile). Total fat, alcohol, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, and cholesterol were not associated with CRC risk. Conclusion This study provides further evidence that high energy intake may increase risk of incident CRC, whereas diets high in protein, fiber, and carbohydrate may reduce the risk of the disease.