The joint association of eating frequency and diet quality with colorectal cancer risk in the Health Professionals Follow-up Study.

Authors:
Rania A Mekary
Rania A Mekary
MCPHS University
Boston | United States
Frank B Hu
Frank B Hu
Harvard T.H. Chan School of Public Health
United States
Walter C Willett
Walter C Willett
Harvard T.H. Chan School of Public Health
Boston | United States
Stephanie Chiuve
Stephanie Chiuve
Harvard School of Public Health
Boston | United States
Kana Wu
Kana Wu
Harvard T.H. Chan School of Public Health
Boston | United States
Charles Fuchs
Charles Fuchs
Dana-Farber Cancer Institute and Harvard Medical School
Boston | United States
Teresa T Fung
Teresa T Fung
Simmons College
Edward Giovannucci
Edward Giovannucci
Harvard T.H. Chan School of Public Health
Boston | United States

Am J Epidemiol 2012 Apr 2;175(7):664-72. Epub 2012 Mar 2.

Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.

The results of most case-control studies have suggested a positive association between eating frequency and colorectal cancer risk. Because no prospective cohort studies have done so to date, the authors prospectively examined this association. In 1992, eating frequency was assessed in a cohort of 34,968 US men in the Health Professionals Follow-up Study. Cox proportional hazards regression models were used to estimate relative risks and 95% confidence intervals for various levels of eating frequency. Effect modifications by overall dietary quality (assessed using the Diet Approaches to Stop Hypertension score) and by factors that influence insulin resistance were further assessed. Between 1992 and 2006, a total of 583 cases of colorectal cancer were diagnosed. When comparing the highest eating frequency category (5-8 times/day) with the reference category (3 times/day), the authors found no evidence of an increased risk of colorectal cancer (multivariate relative risk = 0.88, 95% confidence interval: 0.62, 1.26) or colon cancer (multivariate relative risk = 0.78, 95% confidence interval: 0.49, 1.25). There was an implied inverse association with eating frequency among participants who had healthier diets (high Diet Approaches to Stop Hypertension score; P for interaction = 0.01), especially among men in the high-insulin-sensitivity group (body mass index (weight (kg)/height (m)(2)) <25, ≥2 cups of coffee/day, and more physical activity; P for interaction < 0.01, P for trend = 0.01). There was an implied protective association between increased eating frequency of healthy meals and colorectal cancer risk and in men with factors associated with higher insulin sensitivity.

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http://dx.doi.org/10.1093/aje/kwr363DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3324432PMC

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April 2012
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