Food groups, diet quality and colorectal cancer risk in the Basque country

Authors: ALEGRIA-LERTXUNDI, IKER - University Of Basque Country; AGUIRRE, CARMELO - Galdakao-Usansolo University Hospital; BUJANDA, LUIS - University Of Basque Country; FERNANDEZ, FRANCISCO - Galdakao-Usansolo University Hospital; POLO, FRANCISCO - Basurto University Hospital; ORDOVAS, JOSE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; ETXEZARRAGA, M. CARMEN - University Of Basque Country; ZABALZA, INAKI - Galdakao-Usansolo University Hospital; LARZABAL, MIKEL - Centro De Investigacion Biomedica En Red (CIBER)-Epidemiología Y Salud Pública; PORTILLO, ISABEL - Osakidetza Basque Health Service; M DE PANCORBO, MARIAN - University Of Basque Country; GARCIA-ETXEBARRIA, KOLDO - Centro De Investigacion Biomedica En Red (CIBER)-Epidemiología Y Salud Pública; RONCANDIO, ANA M - University Of Basque Country; ARROYO-IZAGA, MARTA - University Of Basque Country

Submitted to: World Journal of Gastroenterology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/16/2020
Publication Date: 7/28/2020
Citation: Alegria-Lertxundi, I., Aguirre, C., Bujanda, L., Fernandez, F.J., Polo, F., Ordovas, J.M., Etxezarraga, M., Zabalza, I., Larzabal, M., Portillo, I., M de Pancorbo, M., Garcia-Etxebarria, K., Roncandio, A., Arroyo-Izaga, M. 2020. Food groups, diet quality and colorectal cancer risk in the Basque country. World Journal of Gastroenterology. 26(28):4108-4125. https://doi.org/10.3748/wjg.v26.i28.4108.
DOI: https://doi.org/10.3748/wjg.v26.i28.4108

Interpretive Summary: The relation between diet and cancer and the definition of diets that are suitable to prevent different types of cancer are unclear, especially for colorectal cancer (CRC) and vary among populations. In this study, investigators at the HNRCA in Boston, in collaboration with Spanish researchers examined the relationships between food groups, diet quality and CRC risk, in an adult population of the Basque Country (North of Spain). The data showed a direct association between milk and dairy products consumption, in particular high-fat cheeses and CRC risk. While the consumption of fiber-containing foods, especially whole grains and fatty fish was associated with a lower risk for CRC. Moreover, higher Mediterranean Diet adherence was associated with a reduced CRC risk. In summary, direct associations were found for high-fat cheese, whereas an inverse relation was reported for fiber-containing foods and fatty fish, as well as adherence to a Mediterranean dietary pattern in this population.

Technical Abstract: BACKGROUND The results obtained to date concerning food groups, diet quality and colorectal cancer (CRC) risk vary according to criteria used and the study populations. AIM To study the relationships between food groups, diet quality and CRC risk, in an adult population of the Basque Country (North of Spain). METHODS This observational study included 308 patients diagnosed with CRC and 308 age and sex-matched subjects as controls. During recruitment, dietary, anthropometric, lifestyle, socioeconomic, demographic and health status information was collected. Adherence to the dietary recommendations was evaluated utilizing the Healthy Eating Index for the Spanish Diet and the MedDietScore. Conditional logistic regressions were used to evaluate the associations of food group intakes, diet quality scores, categorized in tertiles, with CRC risk. RESULTS The adjusted models for potential confounding factors showed a direct association between milk and dairy products consumption, in particular high-fat cheeses [odds ratio (OR) third tertile vs first tertile = 1.87, 95% confidence intervals (CI): 1.11-3.16], and CRC risk. While the consumption of fiber-containing foods, especially whole grains (OR third tertile vs first tertile = 0.62, 95%CI: 0.39-0.98), and fatty fish (OR third tertile vs first tertile = 0.53, 95%CI: 0.27-0.99) was associated with a lower risk for CRC. Moreover, higher MD adherence was associated with a reduced CRC risk in adjusted models (OR third tertile vs first tertile = 0.40, 95%CI: 0.20-0.80). CONCLUSION Direct associations were found for high-fat cheese, whereas an inverse relation was reported for fiber-containing foods and fatty fish, as well as adherence to a Mediterranean dietary pattern.