title: Adherence to the European food safety authority's dietary recommendations and colorectal cancer risk.
abstract: OBJECTIVE
  The European Food Safety Authority (EFSA) recently published dietary guidelines for the intakes of carbohydrates, fiber, fats and water. We evaluated their role on the risk of a specific disease, known to be related to diet.
  
  
  METHODS
  We used data from an Italian case-control study including 1953 colorectal cancer (CRC) cases and 4154 controls. We developed a so-called EFSA index summing up 1 point for adherence to each EFSA guideline. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) of CRC and its subsites were derived from unconditional multiple logistic regression models, for both the index and its components.
  
  
  RESULTS
  When each EFSA index component was analyzed separately, we found significant increased risks of CRC for non adherence to the guidelines on linoleic (OR=1.20, 95% CI, 1.07-1.36) and alpha-linolenic fatty acids (OR=1.19, 95% CI, 1.06-1.34). When all the guidelines were included in the same model, no significant association emerged. Compared with minimal adherence, the ORs of CRC for subsequent EFSA index scores were 1.03 (95% CI, 0.72-1.47), 1.05 (95% CI, 0.75-1.48), 1.04 (95% CI, 0.81-1.60), 0.99 (95% CI, 0.69-1.43), and 1.04 (95% CI, 0.67-1.61). No significant association emerged for colon and rectal cancer separately, and for males and females.
  
  
  CONCLUSIONS
  Overall adherence to the EFSA dietary guidelines is not associated to colorectal, colon and rectal cancer risk in our population. Adherence to guidelines on linoleic and alpha-linolenic fatty acids may have a modest beneficial role on CRC risk.
authors.affiliation: Sezione di Statistica Medica e Biometria Giulio A. Maccacaro, Dipartimento di Medicina del Lavoro Clinica del Lavoro L. Devoto, Università degli Studi di Milano, Milan, Italy. federica.turati@unimi.it
authors.forename: F
authors.initials: F
authors.lastname: Turati
authors.forename: V
authors.initials: V
authors.lastname: Edefonti
authors.forename: F
authors.initials: F
authors.lastname: Bravi
authors.forename: M
authors.initials: M
authors.lastname: Ferraroni
authors.forename: R
authors.initials: R
authors.lastname: Talamini
authors.forename: A
authors.initials: A
authors.lastname: Giacosa
authors.forename: M
authors.initials: M
authors.lastname: Montella
authors.forename: M
authors.initials: M
authors.lastname: Parpinel
authors.forename: C
authors.initials: C
authors.lastname: La Vecchia
authors.forename: A
authors.initials: A
authors.lastname: Decarli
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000517:prevention & control; D016001:Confidence Intervals; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004043:Dietary Fiber / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004043:Dietary Fiber