title: Adolescent and mid-life diet: risk of colorectal cancer in the NIH-AARP Diet and Health Study.
abstract: BACKGROUND
  Colorectal cancer has a natural history of several decades; therefore, the diet consumed decades before diagnosis may aid in understanding this malignancy.
  
  
  OBJECTIVE
  The objective was to investigate diet during adolescence and 10 y before baseline (ages 40-61 y) in relation to colorectal cancer.
  
  
  METHODS
  Participants in the NIH-AARP Diet and Health Study (n = 292,797) completed a 124-item food-frequency questionnaire (FFQ) about diet in the past 12 mo and two 37-item FFQs about diet at ages 12-13 y and 10 y previously. Cox regression was used to estimate multivariate HRs and 95% CIs for colon (n = 2794) and rectal (n = 979) cancers within quintiles of exposures.
  
  
  RESULTS
  Colon cancer risk was lower in the highest than in the lowest quintile of vitamin A (HR: 0.82; 95% CI: 0.72, 0.92) and vegetable (HR: 0.81, 0.70, 0.92) intakes during adolescence. Those in the highest intake category 10 y previously for calcium (HR: 0.83; 95% CI: 0.73, 0.94), vitamin A (HR: 0.81; 95% CI: 0.71, 0.92), vitamin C (HR: 0.83; 95% CI: 0.72, 0.95), fruit (HR: 0.84; 95% CI: 0.73, 0.97), and milk (HR: 0.78; 95% CI: 0.67, 0.90) had a lower risk of colon cancer, but a higher risk was observed for total fat (HR: 1.15; 95% CI: 1.01, 1.30), red meat (HR: 1.31; 95% CI: 1.12, 1.53), and processed meat (HR: 1.24; 95% CI: 1.06, 1.45). For rectal cancer, milk was inversely associated (HR: 0.75; 95% CI: 0.58, 0.96) with risk.
  
  
  CONCLUSIONS
  Adolescent and midlife diet may play a role in colorectal carcinogenesis.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Rockville, MD, USA. rudereh@mail.nih.gov
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Ruder
authors.forename: Anne C M
authors.initials: AC
authors.lastname: Thiébaut
authors.forename: Frances E
authors.initials: FE
authors.lastname: Thompson
authors.forename: Nancy
authors.initials: N
authors.lastname: Potischman
authors.forename: Amy F
authors.initials: AF
authors.lastname: Subar
authors.forename: Yikyung
authors.initials: Y
authors.lastname: Park
authors.forename: Barry I
authors.initials: BI
authors.lastname: Graubard
authors.forename: Albert R
authors.initials: AR
authors.lastname: Hollenbeck
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Cross
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002136:Calcium, Dietary / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D015179:Colorectal Neoplasms / Q000209:etiology* / Q000517:prevention & control; D004032:Diet; D004034:Diet Surveys; D004041:Dietary Fats / Q000009:adverse effects*; D005260:Female; D005511:Food Handling; D005638:Fruit; D006801:Humans; D008297:Male; D008460:Meat / Q000009:adverse effects*; D018977:Micronutrients / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D008892:Milk; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014801:Vitamin A / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D002136:Calcium, Dietary; D004041:Dietary Fats; D018977:Micronutrients; D014801:Vitamin A
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