Naturally nutrient rich (NNR) score and the risk of colorectal cancer: a case-control study

BackgroundThe association between colorectal cancer (CRC) and nutrients has been studied frequently. However, the association of nutrient density of diets with the risk of CRC has been less studied. This study aimed to investigate the association between CRC and naturally nutrient rich (NNR) score in Iranian adults.MethodThis case-control study included 160 patients with colorectal cancer and 320 controls aged 35-70 years in Tehran, Iran. Dietary intake was assessed using a 168-item food frequency questionnaire. The NNR score was obtained by calculating the average daily value of 14 nutrients including protein, vitamins A, C, D, E, B1, B2, B12, calcium, zinc, iron, folate, potassium and unsaturated fatty acids.ResultsRegarding dietary intake of the components of NNR score, the case group had a lower intake of polyunsaturated fat (15.41 +/- 4.44 vs 16.54 +/- 4.20 g/day, p=0.01), vitamin E (10.15 +/- 4.16 vs 13.1 +/- 5.33; p=0.001), vitamin B1 (2 +/- 0.86 vs 2.19 +/- 0.84 mg/day, p=0.03) and folate (516.45 +/- 96.59 vs 571.05 +/- 80.31; p=0.001) and a higher intake of oleic acid (8.21 +/- 5.46 vs 5.59 +/- 3.17 g/day, p=0.01) compared with the control group. Colorectal cancer risk was inversely associated with the NNR score after adjusting for the confounders (OR 0.92; 95% CI 0.88 to 0.97; p=0.03).ConclusionLow NNR scores may be linked to CRC. If confirmed by future longitudinal research, this result may help prevent CRC by recommending nutrient-rich diets.

Automated summary

The study found that CRC patients had lower NNR scores and consumed less polyunsaturated fat, vitamin E, vitamin B1, and folate compared to the control group. After adjusting for confounders, a low NNR score was inversely associated with the risk of colorectal cancer.