title: Associations between food patterns defined by cluster analysis and colorectal cancer incidence in the NIH-AARP diet and health study.
abstract: OBJECTIVE
  To examine associations between food patterns, constructed with cluster analysis, and colorectal cancer incidence within the National Institutes of Health-AARP Diet and Health Study.
  
  
  METHODS
  A prospective cohort, aged 50-71 years at baseline in 1995-1996, followed until the end of 2000. Food patterns were constructed, separately in men (n=293,576) and women (n=198,730), with 181 food variables (daily intake frequency per 1000 kcal) from a food frequency questionnaire. Four large clusters were identified in men and three in women. Cox proportional hazards regression examined associations between patterns and cancer incidence.
  
  
  RESULTS
  In men, a vegetable and fruit pattern was associated with reduced colorectal cancer incidence (multivariate hazard ratio, HR: 0.85; 95% confidence interval, CI: 0.76, 0.94), when compared to less salutary food choices. Both the vegetable and fruit pattern and a fat-reduced foods pattern were associated with reduced rectal cancer incidence in men. In women, a similar vegetable and fruit pattern was associated with colorectal cancer protection (age-adjusted HR: 0.82; 95% CI: 0.70, 0.95), but the association was not statistically significant in multivariate analysis.
  
  
  CONCLUSIONS
  These results, together with findings from previous studies support the hypothesis that micronutrient dense, low-fat, high-fiber food patterns protect against colorectal cancer.
authors.affiliation: Nutrition Epidemiology, Department of Clinical Sciences (Malmö), Lund University, Malmö, Sweden. elisabet.wirfalt@med.lu.se
authors.forename: E
authors.initials: E
authors.lastname: Wirfält
authors.forename: D
authors.initials: D
authors.lastname: Midthune
authors.forename: J
authors.initials: J
authors.lastname: Reedy
authors.forename: P
authors.initials: P
authors.lastname: Mitrou
authors.forename: A
authors.initials: A
authors.lastname: Flood
authors.forename: A F
authors.initials: AF
authors.lastname: Subar
authors.forename: M
authors.initials: M
authors.lastname: Leitzmann
authors.forename: T
authors.initials: T
authors.lastname: Mouw
authors.forename: A R
authors.initials: AR
authors.lastname: Hollenbeck
authors.forename: A
authors.initials: A
authors.lastname: Schatzkin
authors.forename: V
authors.initials: V
authors.lastname: Kipnis
mesh_terms: D000368:Aged; D016000:Cluster Analysis; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D004032:Diet; D004034:Diet Surveys; D018752:Diet, Fat-Restricted; D004043:Dietary Fiber / Q000008:administration & dosage; D005260:Female; D005638:Fruit; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D014675:Vegetables