Dietary Fiber and Colorectal Cancer Risk: A Nested Case-Control Study Using Food Diaries

Christina C. Dahm; Ruth H. Keogh; Elizabeth A. Spencer; Darren C. Greenwood; Tim J. Key; Ian Fentiman; Martin J. Shipley; Eric J. Brunner; Janet E. Cade; Victoria J. Burley; Gita Mishra; Alison M. Stephen; Diana Kuh; Ian R. White; Robert Luben; Marleen A. H. Lentjes; Kay Tee Khaw; Sheila A. Rodwell (Bingham)

doi:10.1093/jnci/djq092

Dietary Fiber and Colorectal Cancer Risk: A Nested Case-Control Study Using Food Diaries

Christina C. Dahm, Ruth H. Keogh, Elizabeth A. Spencer, Darren C. Greenwood, Tim J. Key, Ian Fentiman, Martin J. Shipley, Eric J. Brunner, Janet E. Cade, Victoria J. Burley, Gita Mishra, Alison M. Stephen, Diana Kuh, Ian R. White, Robert Luben, Marleen A. H. Lentjes, Kay Tee Khaw^*, Sheila A. Rodwell (Bingham)

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

191 Citations (Scopus)

Abstract

Background: Results of epidemiological studies of dietary fiber and colorectal cancer risk have not been consistent, possibly because of attenuation of associations due to measurement error in dietary exposure ascertainment.

Methods: To examine the association between dietary fiber intake and colorectal cancer risk, we conducted a prospective case-control study nested within seven UK cohort studies, which included 579 case patients who developed incident colorectal cancer and 1996 matched control subjects. We used standardized dietary data obtained from 4- to 7-day food diaries that were completed by all participants to calculate the odds ratios for colorectal, colon, and rectal cancers with the use of conditional logistic regression models that adjusted for relevant covariates. We also calculated odds ratios for colorectal cancer by using dietary data obtained from food-frequency questionnaires that were completed by most participants. All statistical tests were two-sided.

Results: Intakes of absolute fiber and of fiber intake density, ascertained by food diaries, were statistically significantly inversely associated with the risks of colorectal and colon cancers in both age-adjusted models and multivariable models that adjusted for age; anthropomorphic and socioeconomic factors; and dietary intakes of folate, alcohol, and energy. For example, the multivariable-adjusted odds ratio of colorectal cancer for highest vs the lowest quintile of fiber intake density was 0.66 (95% confidence interval = 0.45 to 0.96). However, no statistically significant association was observed when the same analysis was conducted using dietary data obtained by food-frequency questionnaire (multivariable odds ratio = 0.88, 95% confidence interval = 0.57 to 1.36).

Conclusions: Intake of dietary fiber is inversely associated with colorectal cancer risk. Methodological differences (ie, study design, dietary assessment instruments, definition of fiber) may account for the lack of convincing evidence for the inverse association between fiber intake and colorectal cancer risk in some previous studies.

Original language	English
Pages (from-to)	614-626
Number of pages	13
Journal	Journal of the National Cancer Institute
Volume	102
Issue number	9
DOIs	https://doi.org/10.1093/jnci/djq092
Publication status	Published - 5 May 2010

Keywords

FREQUENCY QUESTIONNAIRE
MEASUREMENT ERROR
RELATIVE RISK
CONFIDENCE-INTERVALS
ADENOMA RECURRENCE
NATIONAL-SURVEY
POOLED ANALYSIS
NORFOLK COHORT
UNITED-STATES
BREAST-CANCER

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/jnci/djq092

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Dahm, C. C., Keogh, R. H., Spencer, E. A., Greenwood, D. C., Key, T. J., Fentiman, I., Shipley, M. J., Brunner, E. J., Cade, J. E., Burley, V. J., Mishra, G., Stephen, A. M., Kuh, D., White, I. R., Luben, R., Lentjes, M. A. H., Khaw, K. T., & Rodwell (Bingham), S. A. (2010). Dietary Fiber and Colorectal Cancer Risk: A Nested Case-Control Study Using Food Diaries. Journal of the National Cancer Institute, 102(9), 614-626. https://doi.org/10.1093/jnci/djq092

@article{79ae147e8020442897a3ad24a5b28e99,

title = "Dietary Fiber and Colorectal Cancer Risk: A Nested Case-Control Study Using Food Diaries",

abstract = "Background: Results of epidemiological studies of dietary fiber and colorectal cancer risk have not been consistent, possibly because of attenuation of associations due to measurement error in dietary exposure ascertainment.Methods: To examine the association between dietary fiber intake and colorectal cancer risk, we conducted a prospective case-control study nested within seven UK cohort studies, which included 579 case patients who developed incident colorectal cancer and 1996 matched control subjects. We used standardized dietary data obtained from 4- to 7-day food diaries that were completed by all participants to calculate the odds ratios for colorectal, colon, and rectal cancers with the use of conditional logistic regression models that adjusted for relevant covariates. We also calculated odds ratios for colorectal cancer by using dietary data obtained from food-frequency questionnaires that were completed by most participants. All statistical tests were two-sided.Results: Intakes of absolute fiber and of fiber intake density, ascertained by food diaries, were statistically significantly inversely associated with the risks of colorectal and colon cancers in both age-adjusted models and multivariable models that adjusted for age; anthropomorphic and socioeconomic factors; and dietary intakes of folate, alcohol, and energy. For example, the multivariable-adjusted odds ratio of colorectal cancer for highest vs the lowest quintile of fiber intake density was 0.66 (95% confidence interval = 0.45 to 0.96). However, no statistically significant association was observed when the same analysis was conducted using dietary data obtained by food-frequency questionnaire (multivariable odds ratio = 0.88, 95% confidence interval = 0.57 to 1.36).Conclusions: Intake of dietary fiber is inversely associated with colorectal cancer risk. Methodological differences (ie, study design, dietary assessment instruments, definition of fiber) may account for the lack of convincing evidence for the inverse association between fiber intake and colorectal cancer risk in some previous studies.",

keywords = "FREQUENCY QUESTIONNAIRE, MEASUREMENT ERROR, RELATIVE RISK, CONFIDENCE-INTERVALS, ADENOMA RECURRENCE, NATIONAL-SURVEY, POOLED ANALYSIS, NORFOLK COHORT, UNITED-STATES, BREAST-CANCER",

author = "Dahm, {Christina C.} and Keogh, {Ruth H.} and Spencer, {Elizabeth A.} and Greenwood, {Darren C.} and Key, {Tim J.} and Ian Fentiman and Shipley, {Martin J.} and Brunner, {Eric J.} and Cade, {Janet E.} and Burley, {Victoria J.} and Gita Mishra and Stephen, {Alison M.} and Diana Kuh and White, {Ian R.} and Robert Luben and Lentjes, {Marleen A. H.} and Khaw, {Kay Tee} and {Rodwell (Bingham)}, {Sheila A.}",

year = "2010",

month = may,

day = "5",

doi = "10.1093/jnci/djq092",

language = "English",

volume = "102",

pages = "614--626",

journal = "Journal of the National Cancer Institute",

issn = "0027-8874",

publisher = "Oxford University Press",

number = "9",

}

Dahm, CC, Keogh, RH, Spencer, EA, Greenwood, DC, Key, TJ, Fentiman, I, Shipley, MJ, Brunner, EJ, Cade, JE, Burley, VJ, Mishra, G, Stephen, AM, Kuh, D, White, IR, Luben, R, Lentjes, MAH, Khaw, KT & Rodwell (Bingham), SA 2010, 'Dietary Fiber and Colorectal Cancer Risk: A Nested Case-Control Study Using Food Diaries', Journal of the National Cancer Institute, vol. 102, no. 9, pp. 614-626. https://doi.org/10.1093/jnci/djq092

TY - JOUR

T1 - Dietary Fiber and Colorectal Cancer Risk

T2 - A Nested Case-Control Study Using Food Diaries

AU - Dahm, Christina C.

AU - Keogh, Ruth H.

AU - Spencer, Elizabeth A.

AU - Greenwood, Darren C.

AU - Key, Tim J.

AU - Fentiman, Ian

AU - Shipley, Martin J.

AU - Brunner, Eric J.

AU - Cade, Janet E.

AU - Burley, Victoria J.

AU - Mishra, Gita

AU - Stephen, Alison M.

AU - Kuh, Diana

AU - White, Ian R.

AU - Luben, Robert

AU - Lentjes, Marleen A. H.

AU - Khaw, Kay Tee

AU - Rodwell (Bingham), Sheila A.

PY - 2010/5/5

Y1 - 2010/5/5

N2 - Background: Results of epidemiological studies of dietary fiber and colorectal cancer risk have not been consistent, possibly because of attenuation of associations due to measurement error in dietary exposure ascertainment.Methods: To examine the association between dietary fiber intake and colorectal cancer risk, we conducted a prospective case-control study nested within seven UK cohort studies, which included 579 case patients who developed incident colorectal cancer and 1996 matched control subjects. We used standardized dietary data obtained from 4- to 7-day food diaries that were completed by all participants to calculate the odds ratios for colorectal, colon, and rectal cancers with the use of conditional logistic regression models that adjusted for relevant covariates. We also calculated odds ratios for colorectal cancer by using dietary data obtained from food-frequency questionnaires that were completed by most participants. All statistical tests were two-sided.Results: Intakes of absolute fiber and of fiber intake density, ascertained by food diaries, were statistically significantly inversely associated with the risks of colorectal and colon cancers in both age-adjusted models and multivariable models that adjusted for age; anthropomorphic and socioeconomic factors; and dietary intakes of folate, alcohol, and energy. For example, the multivariable-adjusted odds ratio of colorectal cancer for highest vs the lowest quintile of fiber intake density was 0.66 (95% confidence interval = 0.45 to 0.96). However, no statistically significant association was observed when the same analysis was conducted using dietary data obtained by food-frequency questionnaire (multivariable odds ratio = 0.88, 95% confidence interval = 0.57 to 1.36).Conclusions: Intake of dietary fiber is inversely associated with colorectal cancer risk. Methodological differences (ie, study design, dietary assessment instruments, definition of fiber) may account for the lack of convincing evidence for the inverse association between fiber intake and colorectal cancer risk in some previous studies.

AB - Background: Results of epidemiological studies of dietary fiber and colorectal cancer risk have not been consistent, possibly because of attenuation of associations due to measurement error in dietary exposure ascertainment.Methods: To examine the association between dietary fiber intake and colorectal cancer risk, we conducted a prospective case-control study nested within seven UK cohort studies, which included 579 case patients who developed incident colorectal cancer and 1996 matched control subjects. We used standardized dietary data obtained from 4- to 7-day food diaries that were completed by all participants to calculate the odds ratios for colorectal, colon, and rectal cancers with the use of conditional logistic regression models that adjusted for relevant covariates. We also calculated odds ratios for colorectal cancer by using dietary data obtained from food-frequency questionnaires that were completed by most participants. All statistical tests were two-sided.Results: Intakes of absolute fiber and of fiber intake density, ascertained by food diaries, were statistically significantly inversely associated with the risks of colorectal and colon cancers in both age-adjusted models and multivariable models that adjusted for age; anthropomorphic and socioeconomic factors; and dietary intakes of folate, alcohol, and energy. For example, the multivariable-adjusted odds ratio of colorectal cancer for highest vs the lowest quintile of fiber intake density was 0.66 (95% confidence interval = 0.45 to 0.96). However, no statistically significant association was observed when the same analysis was conducted using dietary data obtained by food-frequency questionnaire (multivariable odds ratio = 0.88, 95% confidence interval = 0.57 to 1.36).Conclusions: Intake of dietary fiber is inversely associated with colorectal cancer risk. Methodological differences (ie, study design, dietary assessment instruments, definition of fiber) may account for the lack of convincing evidence for the inverse association between fiber intake and colorectal cancer risk in some previous studies.

KW - FREQUENCY QUESTIONNAIRE

KW - MEASUREMENT ERROR

KW - RELATIVE RISK

KW - CONFIDENCE-INTERVALS

KW - ADENOMA RECURRENCE

KW - NATIONAL-SURVEY

KW - POOLED ANALYSIS

KW - NORFOLK COHORT

KW - UNITED-STATES

KW - BREAST-CANCER

U2 - 10.1093/jnci/djq092

DO - 10.1093/jnci/djq092

M3 - Article

SN - 0027-8874

VL - 102

SP - 614

EP - 626

JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

IS - 9

ER -

Dietary Fiber and Colorectal Cancer Risk: A Nested Case-Control Study Using Food Diaries

Abstract

Keywords

UN SDGs

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