title: Is the association with fiber from foods in colorectal cancer confounded by folate intake?
abstract: The effect of multivariate adjustment including folate on the strong protective effect of fiber in foods on colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition was investigated in 1,721 cases identified in the latest follow-up. The inclusion of an additional 656 cases confirmed our previously published results, with a strong and significant reduction in colorectal cancer risk of approximately 9% for each uncalibrated quintile increase in fiber (P(linear trend) < 0.001) compared with an 8% reduction in our previous report, which had not been adjusted for folate. Inclusion of the other covariates (physical activity, alcohol, smoking, and red and processed meat) confirmed this significant inverse association for colon cancer and strengthened the association with left-sided colon cancer (P < 0.001). After maximum adjustment, the association between fiber and rectal cancer was not significant, as in our previous analysis. The association with fiber from different food sources was analyzed, but again, there were no significance trends after maximum adjustment.
authors.affiliation: Medical Research Council Dunn Human Nutrition Unit, Cambridge, United Kingdom.
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Bingham
authors.forename: Teresa
authors.initials: T
authors.lastname: Norat
authors.forename: Aurelie
authors.initials: A
authors.lastname: Moskal
authors.forename: Pietro
authors.initials: P
authors.lastname: Ferrari
authors.forename: Nadia
authors.initials: N
authors.lastname: Slimani
authors.forename: Françoise
authors.initials: F
authors.lastname: Clavel-Chapelon
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Kesse
authors.forename: Alexandra
authors.initials: A
authors.lastname: Nieters
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.forename: Carmen
authors.initials: C
authors.lastname: Martinez
authors.forename: Miren
authors.initials: M
authors.lastname: Dorronsoro
authors.forename: Carlos A
authors.initials: CA
authors.lastname: González
authors.forename: Eva
authors.initials: E
authors.lastname: Ardanaz
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro
authors.forename: José R
authors.initials: JR
authors.lastname: Quirós
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Key
authors.forename: Nicholas E
authors.initials: NE
authors.lastname: Day
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: Androniki
authors.initials: A
authors.lastname: Naska
authors.forename: Vittorio
authors.initials: V
authors.lastname: Krogh
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Panico
authors.forename: Paolo
authors.initials: P
authors.lastname: Vineis
authors.forename: H B
authors.initials: HB
authors.lastname: Bueno-de-Mesquita
authors.forename: Marga C
authors.initials: MC
authors.lastname: Ocké
authors.forename: Petra H M
authors.initials: PH
authors.lastname: Peeters
authors.forename: Göran
authors.initials: G
authors.lastname: Berglund
authors.forename: Göran
authors.initials: G
authors.lastname: Hallmans
authors.forename: Eiliv
authors.initials: E
authors.lastname: Lund
authors.forename: Guri
authors.initials: G
authors.lastname: Skeie
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kaaks
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
mesh_terms: D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000209:etiology* / Q000517:prevention & control*; D015986:Confounding Factors, Epidemiologic; D004032:Diet; D004043:Dietary Fiber; D005260:Female; D005492:Folic Acid / Q000494:pharmacology*; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis
chemical_list: D004043:Dietary Fiber; D005492:Folic Acid