EATING PATTERNS AND RISK OF COLON-CANCER

Colon cancer has been associated with several nutrients and foods. The authors used data from a population-based study conducted in Northern California, Utah, and Minnesota to examine associations between dieta ry eating patterns and risk of developing colon cancer. Through factor analysis, detailed dietary intake data obtained from 1,993 cases (dia gnosed in 1991-1994) and 2,410 controls were grouped into factors that were evaluated for relations with lifestyle characteristics and colon cancer risk. Several dietary patterns emerged. The dietary patterns w ith the most variation were labeled ''Western,'' ''prudent,'' ''high f at/sugar dairy,'' ''substituters,'' and ''drinkers.'' The ''Western'' dietary pattern was associated with a higher body mass index and a gre ater intake of total energy and dietary cholesterol. The ''prudent'' p attern was associated with higher levels of vigorous leisure time phys ical activity, smaller body size, and higher intakes of dietary fiber and folate. Persons who had high scores on the ''drinker'' pattern wer e also more likely to smoke cigarettes. The ''Western'' dietary patter n was associated with an increased risk of colon cancer in both men an d women. The association was strongest among people diagnosed prior to age 67 years (for men, odds ratio (OR) = 1.96, 95% confidence interva l (CI) 1.22-3.15;.for women, OR = 2.02, 95% CI 1.21-3.36) and among me n with distal tumors (OR = 2.25, 95% CI 1.47-3.46). The ''prudent'' di et was protective, with the strongest associations being observed amon g people diagnosed prior to age 67 years (men: OR = 0.63, 95% CI 0.43- 0.92; women: OR = 0.58, 95% CI 0.38-0.87); associations with this diet ary pattern were also strong among persons with proximal tumors (men: OR = 0.55, 95% CI 0.38-0.80; women: OR = 0.64, 95% GI 0.45-0.92). Alth ough ''substituters'' (people who substituted low fat dairy products f or high fat dairy products, margarine for buffer, poultry for red meat , and whole grains for refined grains) were at reduced risk of colon c ancer, the reduction in risk was not statistically significant. These data support the hypothesis that overall dietary intake pattern is ass ociated with colon cancer, and that the dietary pattern associated wit h the greatest increase in risk is the one which typifies a Western-st yle diet.