American Journal of Epidemiology Vol. 144, No. 11: 1015-1025
Copyright © 1996 by The Johns Hopkins University School of Hygiene and Public Health
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Relation of Vegetable, Fruit, and Grain Consumption to Colorectal Adenomatous Polyps
1Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, MetroHealth Medical Center 2500 MetroHealth Drive, Cleveland, OH 44109-1998
2National Institute of Environmental Health Sciences Epidemiology Branch Research Triangle Park, NC
3Department of Preventive Medicine, University of Southern California School of Medicine Los Angeles, CA
4Divisions of Gastroenterology, Bellflower (E. R. L) and Sunset (H. D. F.) Kaiser Permanente Medical Centers Los Angeles, CA
Previous studies suggest that colorectal cancer risk decreases with higher intake of vegetables, fruits, and grains. Few studies, however, have examined these factors in relation to occurrence of colorectal polyps. The authors used case-control data from 488 matched pairs to evaluate associations of vegetables, fruits, and grains with polyps. Subjects were southern Califomians aged 50–74 years who had a sigmoidoscopy in 1991–1993. Diet in the year before sigmoidoscopy was measured with a food frequency questionnaire. Frequent consumption of vegetables, fruits, and grains was associated with decreased polyp prevalence. Specifically, the adjusted odds ratio comparing the highest with the lowest quintile of intake for vegetables was 0.47 (95% confidence interval (Cl) 0.29–0.76), for fruits was 0.65 (95% Cl 0.40–1.05), and for grains was 0.55 (95% Cl 0.33–0.91). The authors also found inverse associations for high carotenoid vegetables, cruciferae, high vitamin C fruits, garlic, and tofu (or soybeans). After further adjusting for potentially anticarcinogenic constituents of these foods, high carotenoid vegetables, cruciferous vegetables, garlic, and tofu (or soybeans) remained inversely associated with polyps. These findings support the hypothesis that high intake of vegetables, fruits, or grains decreases the risk of polyps and suggest that any protective effects might reflect unmeasured constituents in these foods. Am J Epidemiol 1996;144:1015–25.
case-control studies; cereals; colonic neoplasms; diet; fruit; garlic; vegetables
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