Published online Jul 28, 2020. doi: 10.3748/wjg.v26.i28.4108
Peer-review started: February 28, 2020
First decision: March 21, 2020
Revised: April 3, 2020
Accepted: July 16, 2020
Article in press: July 16, 2020
Published online: July 28, 2020
The results obtained to date concerning food groups, diet quality and colorectal cancer (CRC) risk vary according to criteria used and the study populations.
To study the relationships between food groups, diet quality and CRC risk, in an adult population of the Basque Country (North of Spain).
This observational study included 308 patients diagnosed with CRC and 308 age- and sex-matched subjects as controls. During recruitment, dietary, anthropometric, lifestyle, socioeconomic, demographic and health status information was collected. Adherence to the dietary recommendations was evaluated utilizing the Healthy Eating Index for the Spanish Diet and the MedDietScore. Conditional logistic regressions were used to evaluate the associations of food group intakes, diet quality scores, categorized in tertiles, with CRC risk.
The adjusted models for potential confounding factors showed a direct association between milk and dairy products consumption, in particular high-fat cheeses [odds ratio (OR) third tertile vs first tertile = 1.87, 95% confidence intervals (CI): 1.11-3.16], and CRC risk. While the consumption of fiber-containing foods, especially whole grains (OR third tertile vs first tertile = 0.62, 95%CI: 0.39-0.98), and fatty fish (OR third tertile vs first tertile = 0.53, 95%CI: 0.27-0.99) was associated with a lower risk for CRC. Moreover, higher MD adherence was associated with a reduced CRC risk in adjusted models (OR third tertile vs first tertile = 0.40, 95%CI: 0.20-0.80).
Direct associations were found for high-fat cheese, whereas an inverse relation was reported for fiber-containing foods and fatty fish, as well as adherence to a Mediterranean dietary pattern.
Core tip: This matched case-control study supports the role of diet in colorectal cancer (CRC) risk. The results suggest that high consumption of high-fat cheeses is associated with CRC risk, whereas, a high intake of fiber-containing foods, especially whole grains, and fatty fish, as well as adherence to the Mediterranean dietary pattern, was associated with a lower risk for CRC. Future studies are needed to better understand the influence of the dietary habits on CRC prevention in this population that can provide leads for the design and tailoring of future interventions, and guide counselling strategies for promoting a healthy lifestyle.