Dietary flavonoids and colorectal adenoma recurrence in the Polyp Prevention Trial.
Two recent case-control studies suggested that some flavonoid subgroups may play a role in preventing colorectal cancer. Previous prospective cohort studies generally reported no association; however, only a small subset of flavonoids was evaluated and partial flavonoid databases were used. We used the newly constructed U.S. Department of Agriculture flavonoid database to examine the association between consumption of total flavonoids, 6 flavonoid subgroups, and 29 individual flavonoids with adenomatous polyp recurrence in the Polyp Prevention Trial. The Polyp Prevention Trial was a randomized dietary intervention trial, which examined the effectiveness of a low-fat, high-fiber, high-fruit, and high-vegetable diet on adenoma recurrence. Intakes of flavonoids were estimated from a food frequency questionnaire. Multivariate logistic regression models (adjusted for age, body mass index, sex, regular non-steroidal anti-inflammatory use, and dietary fiber intake) were used to estimate odds ratios and 95% confidence intervals for both any and advanced adenoma recurrence within quartiles of energy-adjusted flavonoid intake (baseline, during the trial, and change during the trial). Total flavonoid intake was not associated with any or advanced adenoma recurrence. However, high intake of flavonols, which are at greater concentrations in beans, onions, apples, and tea, was associated with decreased risk of advanced adenoma recurrence (4th versus 1st quartile during the trial; odds ratio, 0.24; 95% confidence interval, 0.11, 0.53; P(trend) = 0.0006). Similar inverse associations were observed to a smaller extent for isoflavonoids, the flavonol kaempferol, and the isoflavonoids genistein and formononetin. Our data suggest that a flavonol-rich diet may decrease the risk of advanced adenoma recurrence.
Laboratory of Cancer Prevention, National Cancer Institute-Frederick, Room 110, Building 576, Frederick, MD 21702-1201, USA. gb246f@nih.gov
Gerd
G
Bobe
Leah B
LB
Sansbury
Paul S
PS
Albert
Amanda J
AJ
Cross
Lisa
L
Kahle
Jason
J
Ashby
Martha L
ML
Slattery
Bette
B
Caan
Electra
E
Paskett
Frank
F
Iber
James Walter
JW
Kikendall
Peter
P
Lance
Cassandra
C
Daston
James R
JR
Marshall
Arthur
A
Schatzkin
Elaine
E
Lanza
D000236:Adenoma / Q000453:epidemiology / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D005419:Flavonoids / Q000008:administration & dosage*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D014481:United States / Q000453:epidemiology
D005419:Flavonoids