title: Macro- and micronutrients consumption and the risk for colorectal cancer among Jordanians.
abstract: OBJECTIVE
  Diet and lifestyle have been reported to be important risk factors for the development of colorectal cancer (CRC). However, the association between total energy and nutrient intake and the risk of developing CRC has not been clearly explained. The aim of our study is to examine the relationship between total energy intake and other nutrients and the development of CRC in the Jordanian population.
  
  
  METHODS
  Dietary data was collected from 169 subjects who were previously diagnosed with CRC, and 248 control subjects (matched by age, gender, occupation and marital status). These control subjects were healthy and disease free. Data was collected between January 2010 and December 2012, using interview-based questionnaires. Logistic regression was used to evaluate the association between quartiles of total energy, macro- and micronutrient intakes with the risk of developing CRC in our study population.
  
  
  RESULTS
  Total energy intake was associated with a higher risk of developing CRC (OR = 2.60 for the highest versus lowest quartile of intake; 95% CI: 1.21-5.56, p-trend = 0.03). Intakes of protein (OR = 3.62, 95% CI: 1.63-8.05, p-trend = 0.002), carbohydrates (OR = 1.41, 95% CI: 0.67-2.99, p-trend = 0.043), and percentage of energy from fat (OR = 2.10, 95% CI: 0.38-11.70, p-trend = 0.009) significantly increased the risk for the development of CRC. Saturated fat, dietary cholesterol and sodium intake showed a significant association with the risk of developing CRC (OR = 5.23, 95% CI: 2.33-11.76; OR = 2.48, 95% CI: 1.18-5.21; and OR = 3.42, 95% CI: 1.59-7.38, respectively), while vitamin E and caffeine intake were indicative of a protective effect against the development of CRC, OR = 0.002 (95% CI: 0.0003-0.011) and 0.023 (95%CI: 0.008-0.067), respectively.
  
  
  CONCLUSIONS
  Our results suggest an increased risk for the development of CRC in subjects with high dietary intake of energy, protein, saturated fat, cholesterol, and sodium, and diets high in vitamin E and caffeine were suggestive of a protective effect against the risk of developing CRC.
  
  
  CONCLUSIONS
  This is the first study in Jordan to suggest that it may be possible to reduce CRC risk by adjusting the intake of some macro-and micronutrients.
authors.affiliation: Department of Clinical Nutrition & Dietetic, The Hashemite University, P.O. Box 150459, Zarqa 13115, Jordan. rtayyem@hu.edu.jo.
authors.forename: Reema F
authors.initials: RF
authors.lastname: Tayyem
authors.affiliation: Department of Health Sciences, College of Arts and Sciences, Qatar University, P.O. Box 2713, Doha, Qatar. hbawadi@qu.edu.qa.
authors.forename: Hiba A
authors.initials: HA
authors.lastname: Bawadi
authors.affiliation: Chief Gastroenterology Division, King Hussein Cancer Center, P.O. Box 35102, Amman 11180, Jordan. ishehadeh@khcc.jo.
authors.forename: Ihab N
authors.initials: IN
authors.lastname: Shehadah
authors.affiliation: Department of Clinical Nutrition & Dietetic, The Hashemite University, P.O. Box 150459, Zarqa 13115, Jordan. suhad.abumweis@hu.edu.jo.
authors.forename: Suhad S
authors.initials: SS
authors.lastname: Abu-Mweis
authors.affiliation: Department of Clinical Nutrition & Dietetic, The Hashemite University, P.O. Box 150459, Zarqa 13115, Jordan. elonafrsh2003@yahoo.com.
authors.forename: Lana M
authors.initials: LM
authors.lastname: Agraib
authors.affiliation: Faculty of Medicine, The Hashemite University, P.O. Box 150459, Zarqa 13115, Jordan. k_banihani@hu.edu.jo.
authors.forename: Kamal E
authors.initials: KE
authors.lastname: Bani-Hani
authors.affiliation: Department of General and Pediatric Surgery, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan. tmrjaberi@hotmail.com.
authors.forename: Tareq
authors.initials: T
authors.lastname: Al-Jaberi
authors.affiliation: Chief Gastroenterology Division, Prince Hamza Hospital, P.O. Box 86, Amman 11118, Jordan. jwan97@hotmail.com.
authors.forename: Majed
authors.initials: M
authors.lastname: Al-Nusairr
authors.affiliation: Cancer Prevention and Control Program, Moores Cancer Center, University of California, San Diego, La Jolla, CA 92093, USA. dheath@ucsd.edu.
authors.forename: Dennis D
authors.initials: DD
authors.lastname: Heath
mesh_terms: D000328:Adult; D000368:Aged; D016588:Anticarcinogenic Agents / Q000627:therapeutic use*; D002110:Caffeine / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000209:etiology* / Q000517:prevention & control; D004032:Diet; D004034:Diet Surveys; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007597:Jordan; D016015:Logistic Models; D008297:Male; D018977:Micronutrients / Q000627:therapeutic use*; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014810:Vitamin E / Q000627:therapeutic use*
chemical_list: D016588:Anticarcinogenic Agents; D018977:Micronutrients; D014810:Vitamin E; D002110:Caffeine