Mediterranean diet adherence and risk of colorectal cancer: the prospective Netherlands Cohort Study

Maya Schulpen, Piet A. van den Brandt*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Mediterranean diet (MD) adherence has been associated with a large variety of health benefits. However, prospective studies investigating the relation between MD adherence and colorectal cancer risk had inconsistent results. In this analysis of the Netherlands Cohort Study (NLCS), we evaluated sex- and subsite-specific associations of MD adherence with colorectal cancer risk. In 1986, 120,852 subjects filled out the NLCS baseline questionnaire, which incorporated a 150-item food frequency questionnaire. MD adherence was estimated through alternate Mediterranean diet scores including and excluding alcohol (aMED and aMEDr, respectively). Using 20.3 year follow-up data, 1993 male and 1574 female colorectal cancer cases could be included in multivariable case-cohort analyses. aMEDr was not significantly associated with colorectal cancer risk, regardless of sex. Hazard ratios (95% confidence intervals) per two-point increment were 1.04 (0.95-1.13) for men and 0.97 (0.88-1.07) for women. Additionally, there was no evidence of an inverse association with any of the colorectal cancer subsites (colon, proximal colon, distal colon, and rectum). In women, the association between aMEDr and colorectal cancer risk was significantly modified by smoking status (P-interaction = 0.015). Comparable results were obtained for the original aMED including alcohol. In conclusion, higher MD adherence was not associated with a reduced risk of colorectal cancer or anatomical subsites in the context of a Dutch population.

Original languageEnglish
Pages (from-to)25-35
Number of pages11
JournalEuropean Journal of Epidemiology
Volume35
Issue number1
DOIs
Publication statusPublished - Jan 2020

Keywords

  • Mediterranean diet
  • Colorectal cancer
  • Subsites
  • Cohort study
  • Epidemiology
  • Prevention
  • RESEARCH FUND/AMERICAN INSTITUTE
  • SCALE PROSPECTIVE COHORT
  • RESEARCH GUIDELINES
  • PATTERNS
  • QUALITY
  • QUESTIONNAIRE
  • NUTRITION
  • SURVIVAL
  • MODEL
  • INDEX

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