Dietary fiber and whole-grain consumption in relation to colorectal cancer in the NIH-AARP Diet and Health Study

Arthur Schatzkin, Traci Mouw, Yikyung Park, Amy F. Subar, Victor Kipnis, Albert Hollenbeck, Michael F. Leitzmann, Frances E. Thompson

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212 Scopus citations

Abstract

Background: Whether the intake of dietary fiber can protect against colorectal cancer is a long-standing question of considerable public health import, but the epidemiologic evidence has been inconsistent. Objective: The objective was to investigate the relation between dietary fiber and whole-grain food intakes and invasive colorectal cancer in the prospective National Institutes of Health-AARP Diet and Health Study. Design: The analytic cohort consisted of 291 988 men and 197 623 women aged 50-71 y. Diet was assessed with a self-administered food-frequency questionnaire at baseline in 1995-1996; 2974 incident colorectal cancer cases were identified during 5 y of follow-up. The Cox proportional hazards model was used to estimate the relative risks (RRs) and 95% CIs. Results: Total dietary fiber intake was not associated with colorectal cancer. The multivariate RR for the highest compared with the lowest intake quintile (RRQ5-Q1) was 0.99 (95% CI: 0.85, 1.15; P for trend = .96). In analyses of fiber from different food sources, only fiber from grains was associated with a lower risk of colorectal cancer (multivariate RR Q5-Q1: 0.86; 95% CI: 0.76, 0.98; P for trend = 0.01). Whole-grain intake was inversely associated with colorectal cancer risk: the multivariate RRQ5-Q1 was 0.79 (95% CI: 0.70, 0.89) for the whole cohort (P for trend = 0.001). The association with whole grain was stronger for rectal than for colon cancer. Conclusions: In this large prospective cohort study, total dietary fiber intake was not associated with colorectal cancer risk, whereas whole-grain consumption was associated with a modest reduced risk.

Original languageEnglish
Pages (from-to)1353-1360
Number of pages8
JournalAmerican Journal of Clinical Nutrition
Volume85
Issue number5
StatePublished - May 1 2007
Externally publishedYes

Keywords

  • Cohort study
  • Colorectal cancer
  • Dietary fiber
  • Fiber sources
  • Whole grain

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    Schatzkin, A., Mouw, T., Park, Y., Subar, A. F., Kipnis, V., Hollenbeck, A., Leitzmann, M. F., & Thompson, F. E. (2007). Dietary fiber and whole-grain consumption in relation to colorectal cancer in the NIH-AARP Diet and Health Study. American Journal of Clinical Nutrition, 85(5), 1353-1360.