Singh, P.N., G.E. Fraser, 1998. Dietary risk factors for colon cancer in a low-risk population. Am J Epidemiol. 148:761-74.
In a 6-year prospective study, the authors examined the relation between diet and incident colon cancer among 32,051 non-Hispanic white cohort members of the Adventist Health Study California, 1976-1982) who, at baseline, had no documented or reported history of cancer. The risk of colon cancer was determined from proportional hazards regression with adjustment for age and other covariates. The authors found a positive association with total meat intake (risk ratio (RR) for >1 time/week vs. no meat intake = 1.85, 95% confidence interval (CI) 1.19-2.87; p for trend = 0.01) and, among subjects who favored specific types of meat, positive associations with red meat intake (RR for >1 time/week vs. no red meat intake = 1.90, 95% CI 1.16-3.11; p for trend = 0.02) and white meat intake (RR for >1 time/week vs. no white meat intake = 3.29, 95% CI 1.60-6.75; p for trend = 0.006). An inverse association with legume intake (RR for >2 times/week vs. <1time/week = 0.53, 95% CI 0.33-0.86; p for trend = 0.03) was observed. Among men, a positive association with body mass index was observed (relative to the RR for tertile III (>25.6 kg/m2) vs. tertile I (<22.5 kg/m2) = 2.63, 95% CI 1.12-6.13; p for trend = 0.05). A complex relation was identified whereby subjects exhibiting a high red meat intake, a low legume intake, and a high body mass experienced a more than threefold elevation in risk relative to all other patterns based on these variables. This pattern of putative risk factors would likely contribute to increases in both insulin resistance (high body mass, high red meat intake) and glycemic load (low legume intake), a synergism that, if causal, implicates hyperinsulinemic exposure in colon carcinogenesis. The overall findings from this cohort identify both red meat intake and white meat intake as important dietary risk factors for colon cancer and raise the possibility that the risk due to red meat intake reflects a more complex etiology.
Hebert, J.R., T.G. Hurley, B.C. Olendzki, J. Teas, Y. Ma, J.S. Ha, 1998. Nutritional and socioeconomic factors in relation to prostate cancer mortality: a cross-national study. J Natl Cancer Inst. 90:1637-47.
Background: Large international variations in rates of prostate cancer incidence and mortality suggest that environmental factors have a strong influence on the development of this disease. The purpose of this study was to identify predictive variables for prostate cancer mortality in data from 59 countries. Methods: Data on prostate cancer mortality, food consumption, tobacco use, socioeconomic factors, reproductive factors, and health indicators were obtained from United Nations sources. Linear regression models were fit to these data. The influence of each variable fit in the regression models was assessed by multiplying the regression coefficient b by the 75th (X75) and 25th (X25) percentile values of the variable. The difference, bX75 − bX25, is the estimated effect of the variable across its interquartile range on mortality rates measured as deaths per 100 000 males aged 45-74 years. Reported P values are two-sided. Results: Prostate cancer mortality was inversely associated with estimated consumption of cereals (bX75 − bX25 = −7.31 deaths; P = .001), nuts and oilseeds (bX75 − bX25 = −1.72 deaths; P = .003), and fish (bX75 − bX25 = −1.47 deaths; P = .001). In the 42 countries for which we had appropriate data, soy products were found to be significantly protective (P = .0001), with an effect size per kilocalorie at least four times as large as that of any other dietary factor. Besides variables related to diet, we observed an association between prostate cancer mortality rates and a composite of other health-related, sanitation, and economic variables (P = .003). Conclusions: The specific food-related results from this study are consistent with previous information and support the current dietary guidelines and hypothesis that grains, cereals, and nuts are protective against prostate cancer. The findings also provide a rationale for future study of soy products in prostate cancer prevention trials.
American Institute for Cancer Research, 1997. World Cancer Research Fund. Food, nutrition and the prevention of cancer: a global perspective. Nuts and Seeds. 450-1.
Since the early ‘80s, a number of expert reports have reviewed the literature on diet and cancer and made recommendations designed to reduce the risk of cancer. The report, of which this is a summary, builds on that earlier work. The experts recommend that populations consume nutritionally adequate and varied diets, based primarily on foods of plant origin. They specifically recommend that the public choose predominantly plant-based diets rich in a variety of vegetables and fruits, legumes and minimally processed starchy staple foods. The report notes, “While there are as yet no useful epidemiological data on nuts and seeds, it is biologically plausible that diets high in specific nuts and seeds or these foods as a whole, protect against cancers.”
Mills, P.K., W.L. Beeson, R.L. Phillips, G.E. Fraser, 1989. Cohort study of diet, lifestyle, and prostate cancer in Adventist men. Cancer. 64:598-604.
Dietary and lifestyle characteristics were evaluated in relation to subsequent prostatic cancer risk in a cohort of approximately 14,000 Seventh-day Adventist men who completed a detailed lifestyle questionnaire in 1976 and who were monitored for cancer incidence until the end of 1982. During the 6-year follow-up period, 180 histologically confirmed prostatic cancers were detected among some 78,000 man-years of follow-up. Increasing educational attainment was associated with significantly decreased risk of prostate cancer in this study; age at first marriage was also inversely associated with risk, although this was not significant. There was no relationship between body mass index (as measured by Quetelet’s Index) and risk. A history of prostate “trouble” was associated with a 60% increase in risk which was highly significant. Although there were suggestive relationships between increasing animal product consumption and increased risk, these results did not persist after accounting for the influence of fruit and vegetable consumption. Nor was exposure to the vegetarian lifestyle during the childhood years associated with alterations in subsequent risk. However, increasing consumption of beans, lentils and peas, tomatoes, raisin, dates, and other dried fruit were all associated with significantly decreased prostate cancer risk.
Kune, S., G.A. Kune, L.F. Watson, 1987. Case-control study of dietary etiological factors: the Melbourne colorectal cancer study. Nutr Cancer. 9:21-42.
A brief description is given of a large and comprehensive population-based investigation of colorectal cancer with a new study design. The study design allows the simultaneous examination of the incidence pattern, all the hypothesized causes and all the survival determinants of colorectal cancer of a defined population in a single data set. The relevance of this approach to surgeons in the primary prevention of and screening for colorectal cancer is illustrated in relation to the findings. Thus a diet with a low intake of fat and red meat and high intake of plant foods seems the most important factor in the primary prevention of colorectal cancer. In the screening for this cancer, high-risk groups include those with a previous colorectal cancer, a previous adenomatous polyp, a family history of colorectal cancer in first-degree relatives, Jews, those with an unsatisfactory diet and for rectal cancer, also those who are heavy beer consumers.
Pickle, L.W., M.H. Greene, R.G. Ziegler, A. Toledo, R. Hoover, H.T. Lynch, J.F. Fraumeni, Jr., 1984. Colorectal cancer in rural Nebraska. Cancer Research. 44:363-9.
A case-control interview study of colorectal cancer was conducted in two rural counties of eastern Nebraska to determine reasons for the elevated colon cancer mortality rates during 1950 to 1969. Comparison of the information provided by 86 colorectal cancer cases and 176 matched controls (or their next of kin) revealed an increased risk among persons of Czech background, with persons of Bohemian and Moravian extraction predominating in this area. The data suggest an interaction between Bohemian ancestry and certain dietary patterns in the pathogenesis of colon cancer in this region. Colon cancer risk was elevated among commercial beer drinkers regardless of their ethnic back ground, although Bohemians reported heavier consumption. An excess risk was also associated with intestinal polyps, reported more often by Moravians, and with familial occurrence of gastrointestinal and other cancers. Since 1969, the mortality and incidence rates for colon cancer in this area have declined, possibly as a consequence of acculturation of the American-born descendants of Czech immigrants.
