Dietary fiber and colorectal cancer risk: A nested case-control study using food diaries

Dahm, Christina C., Keogh, Ruth H., Spencer, Elizabeth A., Greenwood, Darren C., Key, Tim J., Fentiman, Ian S., Shipley, Martin J., Brunner, Eric J., Cade, Janet E., Burley, Victoria J., Mishra, Gita, Stephen, Alison M., Kuh, Diana, White, Ian R., Luben, Robert, Lentjes, Marleen A. H., Khaw, Kay Tee and Rodwell, Sheila 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. doi:10.1093/jnci/djq092

Author Dahm, Christina C.
Keogh, Ruth H.
Spencer, Elizabeth A.
Greenwood, Darren C.
Key, Tim J.
Fentiman, Ian S.
Shipley, Martin J.
Brunner, Eric J.
Cade, Janet E.
Burley, Victoria J.
Mishra, Gita
Stephen, Alison M.
Kuh, Diana
White, Ian R.
Luben, Robert
Lentjes, Marleen A. H.
Khaw, Kay Tee
Rodwell, Sheila A.
Title Dietary fiber and colorectal cancer risk: A nested case-control study using food diaries
Journal name Journal of the National Cancer Institute   Check publisher's open access policy
ISSN 0027-8874
Publication date 2010-05-05
Sub-type Article (original research)
DOI 10.1093/jnci/djq092
Volume 102
Issue 9
Start page 614
End page 626
Total pages 13
Place of publication Oxford, U.K.
Publisher Oxford University Press
Language eng
Formatted 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.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
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