American Journal of Epidemiology Advance Access published online on June 4, 2008
American Journal of Epidemiology, doi:10.1093/aje/kwn097
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Original Contribution |
Index-based Dietary Patterns and Risk of Colorectal Cancer
The NIH-AARP Diet and Health Study
1 National Cancer Institute, Bethesda, MD
2 University of Cambridge, Cambridge, England
3 The World Cancer Research Fund, London, England
4 Lund University, Malmö, Sweden
5 University of Minnesota, Minneapolis, MN
6 Imperial College London, London, England
7 AARP, Washington, DC
Correspondence to Dr. Jill Reedy, Risk Factor Monitoring and Methods Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, MSC 7344, EPN 4005, 6130 Executive Boulevard, Bethesda, MD 20892-7344 (e-mail: reedyj{at}mail.nih.gov).
Received for publication July 27, 2007. Accepted for publication March 20, 2008.
The authors compared how four indexes—the Healthy Eating Index-2005, Alternate Healthy Eating Index, Mediterranean Diet Score, and Recommended Food Score—are associated with colorectal cancer in the National Institutes of Health-AARP Diet and Health Study (n = 492,382). To calculate each score, they merged data from a 124-item food frequency questionnaire completed at study entry (1995–1996) with the MyPyramid Equivalents Database (version 1.0). Other variables included energy, nutrients, multivitamins, and alcohol. Models were stratified by sex and adjusted for age, ethnicity, education, body mass index, smoking, physical activity, and menopausal hormone therapy (in women). During 5 years of follow-up, 3,110 incident colorectal cancer cases were ascertained. Although the indexes differ in design, a similarly decreased risk of colorectal cancer was observed across all indexes for men when comparing the highest scores with the lowest: Healthy Eating Index-2005 (relative risk (RR) = 0.72, 95% confidence interval (CI): 0.62, 0.83); Alternate Healthy Eating Index (RR = 0.70, 95% CI: 0.61, 0.81); Mediterranean Diet Score (RR = 0.72, 95% CI: 0.63, 0.83); and Recommended Food Score (RR = 0.75, 95% CI: 0.65, 0.87). For women, a significantly decreased risk was found with the Healthy Eating Index-2005, although Alternate Healthy Eating Index results were similar. Index-based dietary patterns that are consistent with given dietary guidelines are associated with reduced risk.
colorectal neoplasms; food habits; risk
Abbreviations: CI, confidence interval; NIH, National Institutes of Health; RR, relative risk
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