Original Article

European Journal of Clinical Nutrition (2009) 63, 707–717; doi:10.1038/ejcn.2008.40; published online 6 August 2008

Associations between food patterns defined by cluster analysis and colorectal cancer incidence in the NIH–AARP diet and health study

E Wirfält1, D Midthune2, J Reedy2, P Mitrou2,3, A Flood4, A F Subar2, M Leitzmann2, T Mouw2, A R Hollenbeck5, A Schatzkin2 and V Kipnis2

  1. 1Nutrition Epidemiology, Department of Clinical Sciences (Malmö), Lund University, Malmö, Sweden
  2. 2National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
  3. 3Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
  4. 4Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN, USA
  5. 5AARP, Washington, DC, USA

Correspondence: Dr E Wirfält, Nutrition Epidemiology, Department of Clinical Sciences (Malmö), Clinical Research Centre, Lund University, Entrance 72, Malmö SE-205 02, Sweden. E-mail: elisabet.wirfalt@med.lu.se

Received 22 February 2008; Revised 17 June 2008; Accepted 30 June 2008; Published online 6 August 2008.

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Abstract

Background/Objectives:

 

To examine associations between food patterns, constructed with cluster analysis, and colorectal cancer incidence within the National Institutes of Health–AARP Diet and Health Study.

Subjects/Methods:

 

A prospective cohort, aged 50–71 years at baseline in 1995–1996, followed until the end of 2000. Food patterns were constructed, separately in men (n=293 576) and women (n=198 730), with 181 food variables (daily intake frequency per 1000 kcal) from a food frequency questionnaire. Four large clusters were identified in men and three in women. Cox proportional hazards regression examined associations between patterns and cancer incidence.

Results:

 

In men, a vegetable and fruit pattern was associated with reduced colorectal cancer incidence (multivariate hazard ratio, HR: 0.85; 95% confidence interval, CI: 0.76, 0.94), when compared to less salutary food choices. Both the vegetable and fruit pattern and a fat-reduced foods pattern were associated with reduced rectal cancer incidence in men. In women, a similar vegetable and fruit pattern was associated with colorectal cancer protection (age-adjusted HR: 0.82; 95% CI: 0.70, 0.95), but the association was not statistically significant in multivariate analysis.

Conclusions:

 

These results, together with findings from previous studies support the hypothesis that micronutrient dense, low-fat, high-fiber food patterns protect against colorectal cancer.

Keywords:

food patterns, cluster analysis, colorectal cancer, prospective cohort

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