Associations between food patterns defined by cluster analysis and colorectal cancer incidence in the NIH-AARP diet and health study

• Published in: European journal of clinical nutrition Vol. 63; no. 6; pp. 707 - 717
• Main Authors: Wirfalt, E, Midthune, D, Reedy, J, Mitrou, P, Flood, A, Subar, A.F, Leitzmann, M, Mouw, T, Hollenbeck, A.R, Schatzkin, A, Kipnis, V
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.06.2009; Nature Publishing Group
• Subjects: administration & dosage; Aged; Biological and medical sciences; Cancer; Clinical Nutrition; Cluster Analysis; Cohort Studies; Colorectal cancer; Colorectal carcinoma; colorectal neoplasms; Colorectal Neoplasms - epidemiology; Colorectal Neoplasms - etiology; Colorectal Neoplasms - prevention & control; Confidence intervals; Demographic aspects; Diet; Diet Surveys; Diet, Fat-Restricted; Dietary Fiber; Dietary Fiber - administration & dosage; eating habits; Epidemiology; etiology; Feeding. Feeding behavior; Female; Food; Food habits; Food intake; Fruit; Fruits; fruits (food); Fundamental and applied biological sciences. Psychology; Gastroenterology. Liver. Pancreas. Abdomen; gender differences; Hazard identification; Health aspects; Health Sciences; human diseases; human nutrition; Humans; Hälsovetenskap; Incidence; Internal Medicine; low fat foods; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; men; Metabolic Diseases; Middle Aged; Multivariate analysis; Nutrition and Dietetics; Nutrition research; Näringslära; Näringslära och dietkunskap; original-article; Prevention; prevention & control; Proportional Hazards Models; Public Health; Risk factors; Sex Factors; Statistical analysis; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors; United States; United States - epidemiology; Vegetables; Vertebrates: anatomy and physiology, studies on body, several organs or systems; women; United States; food patterns; prospective cohort; colorectal cancer; cluster analysis; Cluster analysis; Rectal disease; Health; Colorectal cancer; Metabolic diseases; Malignant tumor; Feeding; Incidence; Colonic disease; Prospective; Association; Diet; Cohort study; Digestive diseases; Intestinal disease; Cancer; Food
• ISSN: 0954-3007; 1476-5640; 1476-5640
• DOI: 10.1038/ejcn.2008.40

Background/Objectives: To examine associations between food patterns, constructed with cluster analysis, and colorectal cancer incidence within the National Institutes of Health-AARP Diet and Health Study. Subjects/Methods: A prospective cohort, aged 50-71 years at baseline in 1995-1996, followed until the end of 2000. Food patterns were constructed, separately in men (n=293 576) and women (n=198 730), with 181 food variables (daily intake frequency per 1000 kcal) from a food frequency questionnaire. Four large clusters were identified in men and three in women. Cox proportional hazards regression examined associations between patterns and cancer incidence. Results: In men, a vegetable and fruit pattern was associated with reduced colorectal cancer incidence (multivariate hazard ratio, HR: 0.85; 95% confidence interval, CI: 0.76, 0.94), when compared to less salutary food choices. Both the vegetable and fruit pattern and a fat-reduced foods pattern were associated with reduced rectal cancer incidence in men. In women, a similar vegetable and fruit pattern was associated with colorectal cancer protection (age-adjusted HR: 0.82; 95% CI: 0.70, 0.95), but the association was not statistically significant in multivariate analysis. Conclusions: These results, together with findings from previous studies support the hypothesis that micronutrient dense, low-fat, high-fiber food patterns protect against colorectal cancer.