Association of nut and seed intake with colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition.
A link between unsaturated fatty acids or phytonutrients and reduced risk of colorectal cancer has been suggested. However, the effects of higher intake of dietary sources of these nutrients, such as the nuts and seeds food group, are less clear. The objective of this study was to determine the effects of nut and seed intake on colorectal cancer risk within the European Prospective Investigation into Cancer and Nutrition study, a large prospective cohort study involving 10 European countries. Total nut and seed intake was determined from country-specific dietary questionnaires. The data set included 478,040 subjects (141,988 men, 336,052 women) with a total of 855 (327 men, 528 women) colon and 474 (215 men, 259 women) rectal cancer cases. A multivariate Cox proportional hazards model, stratified by center and controlled for fruit intake, dietary fiber, energy, height, weight, sex, age, physical activity, and smoking, was used. The data show no association between higher intake of nuts and seeds and risk of colorectal, colon, and rectal cancers in men and women combined, but a significant inverse association was observed in subgroup analyses for colon cancer in women at the highest (>6.2 g/d) versus the lowest (nonconsumers; hazard ratio, 0.69; 95% confidence interval, 0.50-0.95) category of intake and for the linear effect of log-transformed intake (hazard ratio, 0.89; 95% confidence interval, 0.80-0.98), with no associations in men. It is not evident from this data why there may be a stronger association in women or why it may be limited to the colon, suggesting that much further research is necessary.
Jenab
Mazda
M
Nutrition and Hormones Group, IARC-WHO, 150 cours Albert-Thomas, 69372 Lyon Cedex 08, France. jenab@iarc.fr
Ferrari
Pietro
P
Slimani
Nadia
N
Norat
Teresa
T
Casagrande
Corinne
C
Overad
Kim
K
Olsen
Anja
A
Stripp
Connie
C
Tjønneland
Anne
A
Boutron-Ruault
Marie-Christine
MC
Clavel-Chapelon
Françoise
F
Kesse
Emmanuelle
E
Nieters
Alexandra
A
Bergmann
Manuela
M
Boeing
Heiner
H
Naska
Androniki
A
Trichopoulou
Antonia
A
Palli
Domenico
D
Krogh
Vittorio
V
Celentano
Egidio
E
Tumino
Rosario
R
Sacerdote
Carlotta
C
Bueno-de-Mesquita
Hendrik B
HB
Ocké
Marga C
MC
Peeters
Petra H M
PH
Engeset
Dagrun
D
Quirós
José R
JR
González
Carlos A
CA
Martínez
Carmen
C
Chirlaque
Maria D
MD
Ardanaz
Eva
E
Dorronsoro
Miren
M
Wallström
Peter
P
Palmqvist
Richard
R
Van Guelpen
Bethany
B
Bingham
Sheila
S
San Joaquin
Miguel A
MA
Saracci
Rodolfo
R
Kaaks
Rudolf
R
Riboli
Elio
E
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000209:etiology* / Q000517:prevention & control*; D004032:Diet; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009754:Nuts; D011446:Prospective Studies; D012307:Risk Factors; D012639:Seeds; D012737:Sex Factors