title: Dietary polyamine intake and colorectal cancer risk in postmenopausal women.
abstract: BACKGROUND
  Putrescine, spermidine, and spermine (i.e., polyamines) are small cationic amines synthesized by cells or acquired from the diet or gut bacteria. Polyamines are required for both normal and colorectal cancer (CRC) cell growth.
  
  
  OBJECTIVE
  We investigated the association between dietary polyamines and risk of CRC incidence and mortality.
  
  
  METHODS
  The study was a prospective analysis in 87,602 postmenopausal women in the Women's Health Initiative Observational Study. Multivariate Cox regression was used to calculate HRs and 95% CIs.
  
  
  RESULTS
  Total dietary polyamine intake (mean ± SD: 289.2 ± 127.4 μmol/d) was not positively associated with CRC in fully adjusted models. Instead, intake ≥179.67 μmol/d was associated with reduced risk of CRC [HR (95% CI): 0.82 (0.68, 1.00), 0.81 (0.66, 0.99), 0.91 (0.74, 1.12), and 0.80 (0.62, 1.02) for quintiles 2-5, respectively, compared with quintile 1]. Reduced risk was not significant across all quintiles. Polyamines were not significantly associated with CRC-specific mortality in fully adjusted models. When stratified by risk factors for CRC, only body mass index (BMI) and fiber intake significantly modified the association between polyamine intake and CRC. In women with BMI (in kg/m²) ≤25 or fiber consumption above the median, polyamine intake was associated with significantly lower risk of CRC.
  
  
  CONCLUSIONS
  No positive association between dietary polyamines and CRC or CRC-specific mortality risk in women was observed. Instead, a protective effect of dietary polyamines was suggested in women with some CRC risk-lowering behaviors in particular. These results are consistent with emerging evidence that exogenous polyamines may be beneficial in colon health and warrant additional study.
authors.affiliation: Departments of Nutritional Sciences, ashley.vargas@nih.gov.
authors.forename: Ashley J
authors.identifier: http://orcid.org/0000-0002-4789-0675
authors.initials: AJ
authors.lastname: Vargas
authors.affiliation: The University of Arizona Cancer Center, Tucson, AZ;
authors.forename: Erin L
authors.initials: EL
authors.lastname: Ashbeck
authors.affiliation: The University of Arizona Cancer Center, Tucson, AZ;
authors.forename: Betsy C
authors.initials: BC
authors.lastname: Wertheim
authors.affiliation: University of Iowa College of Public Health, University of Iowa, Iowa City, IA; and.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Wallace
authors.affiliation: Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA.
authors.forename: Marian L
authors.initials: ML
authors.lastname: Neuhouser
authors.affiliation: Departments of Nutritional Sciences, College of Public Health, The University of Arizona, Tucson, AZ; The University of Arizona Cancer Center, Tucson, AZ;
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Thomson
authors.affiliation: Departments of Nutritional Sciences, Molecular and Cellular Biology, and The University of Arizona Cancer Center, Tucson, AZ;
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Thompson
mesh_terms: D000368:Aged; D000375:Aging; D015992:Body Mass Index; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D004032:Diet / Q000009:adverse effects; D004043:Dietary Fiber / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008875:Middle Aged; D018673:Nutrition Policy; D050177:Overweight / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D010349:Patient Compliance; D011073:Polyamines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017698:Postmenopause; D016016:Proportional Hazards Models; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D004043:Dietary Fiber; D011073:Polyamines
keywords: Women's Health Initiative; colon cancer; colorectal cancer; diet; dietary polyamines; dietary putrescine; polyamines; putrescine