Dietary patterns and colorectal cancer risk in middle-aged adults: A large population-based prospective cohort study

Sangah Shin; Eiko Saito; Norie Sawada; Junko Ishihara; Ribeka Takachi; Akiko Nanri; Taichi Shimazu; Taiki Yamaji; Motoki Iwasaki; Shizuka Sasazuki; Manami Inoue; Shoichiro Tsugane; JPHC Study Group

doi:10.1016/j.clnu.2017.04.015

Dietary patterns and colorectal cancer risk in middle-aged adults: A large population-based prospective cohort study

Clin Nutr. 2018 Jun;37(3):1019-1026. doi: 10.1016/j.clnu.2017.04.015. Epub 2017 May 5.

Authors

Collaborators

JPHC Study Group:
S Tsugane⁹, N Sawada⁹, M Iwasaki⁹, S Sasazuki⁹, T Yamaji⁹, T Shimazu⁹, T Hanaoka⁹, J Ogata¹⁰, S Baba¹⁰, T Mannami¹⁰, A Okayama¹⁰, Y Kokubo¹⁰, K Miyakawa¹¹, F Saito¹¹, A Koizumi¹¹, Y Sano¹¹, I Hashimoto¹¹, T Ikuta¹¹, Y Tanaba¹¹, H Sato¹¹, Y Roppongi¹¹, T Takashima¹¹, H Suzuki¹¹, Y Miyajima¹², N Suzuki¹², S Nagasawa¹², Y Furusugi¹², N Nagai¹², Y Ito¹², S Komatsu¹², T Minamizono¹², H Sanada¹³, Y Hatayama¹³, F Kobayashi¹³, H Uchino¹³, Y Shirai¹³, T Kondo¹³, R Sasaki¹³, Y Watanabe¹³, Y Miyagawa¹³, Y Kobayashi¹³, M Machida¹³, K Kobayashi¹³, M Tsukada¹³, Y Kishimoto¹⁴, E Takara¹⁴, T Fukuyama¹⁴, M Kinjo¹⁴, M Irei¹⁴, H Sakiyama¹⁵, K Imoto¹⁶, H Yazawa¹⁶, T Seo¹⁶, A Seiko¹⁶, F Ito¹⁶, F Shoji¹⁶, R Saito¹⁶, A Murata¹⁷, K Minato¹⁷, K Motegi¹⁷, T Fujieda¹⁷, S Yamato¹⁷, K Matsui¹⁸, T Abe¹⁸, M Katagiri¹⁸, M Suzuki¹⁸, M Doi¹⁹, A Terao¹⁹, Y Ishikawa¹⁹, T Tagami¹⁹, H Sueta²⁰, H Doi²⁰, M Urata²⁰, N Okamoto²⁰, F Ide²⁰, H Goto²⁰, R Fujita²⁰, N Onga²¹, H Takaesu²¹, M Uehara²¹, T Nakasone²¹, M Yamakawa²¹, F Horii²², I Asano²², H Yamaguchi²², K Aoki²², S Maruyama²², M Ichii²², M Takano²², Y Tsubono²³, K Suzuki²⁴, Y Honda²⁵, K Yamagishi²⁵, S Sakurai²⁵, N Tsuchiya²⁵, M Kabuto²⁶, M Yamaguchi²⁷, Y Matsumura²⁷, S Sasaki²⁷, S Watanabe²⁷, M Akabane²⁸, T Kadowaki²⁹, M Inoue²⁹, M Noda³⁰, T Mizoue³⁰, Y Kawaguchi³¹, Y Takashima³², Y Yoshida³², K Nakamura³³, R Takachi³³, J Ishihara³⁴, S Matsushima³⁵, S Natsukawa³⁵, H Shimizu³⁶, H Sugimura³⁷, S Tominaga³⁸, N Hamajima³⁹, H Iso⁴⁰, T Sobue⁴⁰, M Iida⁴¹, W Ajiki⁴¹, A Ioka⁴¹, S Sato⁴², E Maruyama⁴³, M Konishi⁴⁴, K Okada⁴⁴, I Saito⁴⁴, N Yasuda⁴⁵, S Kono⁴⁶, S Akiba⁴⁷, T Isobe⁴⁸, Y Sato⁴⁹

Affiliations

¹ Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Institute of Environmental Medicine, Seoul National University Medical Research Center, 102 Daehak-ro, Jongro-gu, Seoul 03080, South Korea; Department of Preventive Medicine, Seoul National University College of Medicine, 102 Daehak-ro, Jongro-gu, Seoul 03080, South Korea.
² Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
³ Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
⁴ Department of Nutrition Science, Sagami Women's University, 2-1-1 Bunkyo, Minami-ku, Sagamihara 252-0383, Japan.
⁵ Department of Food Science and Nutrition, Faculty of Human Life and Environment, Nara Women's University, Kitauoyanishi-machi, Nara 630-8506, Japan.
⁶ Department of Epidemiology and Prevention, International Clinical Research Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
⁷ Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. Electronic address: [email protected].
⁸ Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. Electronic address: [email protected].
⁹ National Cancer Center, Tokyo, Japan.
¹⁰ National Cerebral and Cardiovascular Center, Osaka, Japan.
¹¹ Iwate Prefectural Ninohe Public Health Center, Iwate, Japan.
¹² Akita Prefectural Yokote Public Health Center, Akita, Japan.
¹³ Nagano Prefectural Saku Public Health Center, Nagano, Japan.
¹⁴ Okinawa Prefectural Chubu Public Health Center, Okinawa, Japan.
¹⁵ Okinawa Prefectural Chubu Public Health Center, Okinawa, Japan; Okinawa Prefectural Miyako Public Health Center, Okinawa, Japan.
¹⁶ Katsushika Public Health Center, Tokyo, Japan.
¹⁷ Ibaraki Prefectural Mito Public Health Center, Ibaraki, Japan.
¹⁸ Niigata Prefectural Kashiwazaki and Nagaoka Public Health Center, Niigata, Japan.
¹⁹ Kochi Prefectural Chuo-higashi Public Health Center, Kochi, Japan.
²⁰ Nagasaki Prefectural Kamigoto Public Health Center, Nagasaki, Japan.
²¹ Okinawa Prefectural Miyako Public Health Center, Okinawa, Japan.
²² Osaka Prefectural Suita Public Health Center, Osaka, Japan.
²³ Tohoku University, Miyagi, Japan.
²⁴ Research Institute for Brain and Blood Vessels Akita, Akita, Japan.
²⁵ University of Tsukuba, Ibaraki, Japan.
²⁶ National Institute for Environmental Studies, Ibaraki, Japan.
²⁷ National Institute of Health and Nutrition, Tokyo, Japan.
²⁸ Tokyo University of Agriculture, Tokyo, Japan.
²⁹ The University of Tokyo, Tokyo, Japan.
³⁰ National Center for Global Health and Medicine, Tokyo, Japan.
³¹ Tokyo Medical and Dental University, Tokyo, Japan.
³² Kyorin University, Tokyo, Japan.
³³ Niigata University, Niigata, Japan.
³⁴ Sagami Women's University, Kanagawa, Japan.
³⁵ Saku General Hospital, Nagano, Japan.
³⁶ Sakihae Institute, Gifu, Japan.
³⁷ Hamamatsu University School of Medicine, Shizuoka, Japan.
³⁸ Aichi Cancer Center, Aichi, Japan.
³⁹ Nagoya University, Aichi, Japan.
⁴⁰ Osaka University, Osaka, Japan.
⁴¹ Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, Japan.
⁴² Chiba Prefectural Institute of Public Health, Chiba, Japan.
⁴³ Kobe University, Hyogo, Japan.
⁴⁴ Ehime University, Ehime, Japan.
⁴⁵ Kochi University, Kochi, Japan.
⁴⁶ Kyushu University, Fukuoka, Japan.
⁴⁷ Kagoshima University, Kagoshima, Japan.
⁴⁸ Keio University, Tokyo, Japan.
⁴⁹ Tokyo Gakugei University, Tokyo, Japan.

PMID: 28526274
DOI: 10.1016/j.clnu.2017.04.015

Abstract

Background & aims: A finding between dietary pattern and cancer may provide visions beyond the assessment of individual foods or nutrients. We examined the influence of dietary pattern with colorectal cancer (CRC) among a Japanese population.

Methods: A total of 93,062 subjects (43,591 men, 49,471 women) who participated in the Japan Public Health Center-based Prospective Study were followed from 1995-1998 to the end of 2012, during which 2482 cases of CRC (1514 men, 968 women) were newly identified. Dietary data was obtained from a validated food-frequency questionnaire between 1995 and 1998.

Results: Three dietary pattern was derived from principal components factor: prudent, westernized, and traditional pattern. After controlled for potential confounders, the prudent pattern showed a decreased association of CRC risk in men (HR for highest quintile vs lowest: 0.85; 95% CI: 0.72-1.00; P trend <0.05), slightly more strongly with distal colon cancer (P trend <0.05); but an increased risk of rectal cancer in women (P trend <0.05). The westernized pattern showed a significant positive linear trend for colon (P trend <0.05) and distal cancer (P trend <0.05) in women. There was no apparent association of traditional Japanese dietary pattern on the overall or any specific sites risk of CRC.

Conclusions: A prudent dietary pattern showed an inverse association with CRC risk in men, and a westernized pattern was related with a higher risk of colon and distal cancer in women.

Keywords: Cohort; Colorectal cancer; Dietary pattern; Epidemiology; Factor analysis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Cohort Studies
Colorectal Neoplasms / epidemiology*
Diet / methods*
Diet Surveys / statistics & numerical data*
Female
Humans
Japan / epidemiology
Male
Middle Aged
Prospective Studies
Risk Factors
Surveys and Questionnaires