Journal
AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 180, Issue 11, Pages 1088-1097Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwu235
Keywords
case-control studies; colorectal neoplasms; diet; dietary pattern; Mediterranean diet; Paleolithic diet
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Funding
- National Cancer Institute [P01 CA50305]
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The Western dietary pattern is associated with higher risk of colorectal neoplasms. Evolutionary discordance could explain this association. We investigated associations of scores for 2 proposed diet patterns, the Paleolithic and the Mediterranean, with incident, sporadic colorectal adenomas in a case-control study of colorectal polyps conducted in Minnesota (1991-1994). Persons with no prior history of colorectal neoplasms completed comprehensive questionnaires prior to elective, outpatient endoscopy; of these individuals, 564 were identified as cases and 1,202 as endoscopy-negative controls. An additional group of community controls frequency-matched on age and sex (n = 535) was also recruited. Both diet scores were calculated for each participant and categorized into quintiles, and associations were estimated using unconditional logistic regression. The multivariable-adjusted odds ratios comparing persons in the highest quintiles of the Paleolithic and Mediterranean diet scores relative to the lowest quintiles were, respectively, 0.71 (95% confidence interval (CI): 0.50, 1.02; P-trend = 0.02) and 0.74 (95% CI: 0.54, 1.03; P-trend = 0.05) when comparing cases with endoscopy-negative controls and 0.84 (95% CI: 0.56, 1.26; P-trend = 0.14) and 0.77 (95% CI: 0.53, 1.11; P-trend = 0.13) when comparing cases with community controls. These findings suggest that greater adherence to the Paleolithic diet pattern and greater adherence to the Mediterranean diet pattern may be similarly associated with lower risk of incident, sporadic colorectal adenomas. case-control studies; colorectal neoplasms; diet; dietary pattern; Mediterranean diet; Paleolithic diet
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