| 1. |
- Jakszyn, Paula, et al.
(författare)
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Inflammatory potential of the diet and risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition study
- 2020
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 147:4, s. 1027-1039
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Tidskriftsartikel (refereegranskat)abstract
- Proinflammatory diets are associated with risk of developing colorectal cancer (CRC), however, inconsistencies exist in subsite- and sex-specific associations. The relationship between CRC and combined lifestyle-related factors that contribute toward a low-grade inflammatory profile has not yet been explored. We examined the association between the dietary inflammatory potential and an inflammatory profile and CRC risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. This cohort included 476,160 participants followed-up of 14 years and 5,991 incident CRC cases (3,897 colon and 2,094 rectal tumors). Dietary inflammatory potential was estimated using an Inflammatory Score of the Diet (ISD). An Inflammatory Profile Score (IPS) was constructed, incorporating the ISD, physical activity level and abdominal obesity. The associations between the ISD and CRC and IPS and CRC were assessed using multivariable regression models. More proinflammatory diets were related to a higher CRC risk, particularly for colon cancer; hazard ratio (HR) for highest versus lowest ISD quartile was 1.15 (95% confidence interval [CI] 1.04–1.27) for CRC, 1.24 (95% CI 1.09–1.41) for colon cancer and 0.99 (95% CI 0.83–1.17) for rectal cancer. Associations were more pronounced in men and not significant in women. The IPS was associated with CRC risk, particularly colon cancer among men; HRs for the highest versus lowest IPS was 1.62 (95% CI 1.31–2.01) for colon cancer overall and 2.11 (95% CI 1.50–2.97) for colon cancer in men. Our study shows that more proinflammatory diets and a more inflammatory profile are associated with higher risk of CRC, principally colon cancer and in men.
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| 2. |
- Roos, Susanne, et al.
(författare)
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Bowel symptoms, self-image and comorbidity impact on well-being of women with coeliac disease
- 2011
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Ingår i: Journal of Nursing and Healthcare of Chronic Illness. - Oxford : Wiley-Blackwell. - 1752-9816 .- 1752-9824. ; 3:3, s. 302-309
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To explore if gastrointestinal (GI) symptoms, self-image and comorbidity are related to well-being in women with coeliac disease (CD) and whether a history of CD in childhood impacts on well-being in adulthood. Background. Women in Sweden living with CD show a reduced level of well-being and report a high rate of GI complaints for unclear reasons. The self-image of these women is unknown. Design. A cross-sectional survey of 231 Swedish women with CD on long-term treatment (≥5 years) with a gluten-free diet (GFD) was conducted in 2010. Results. The study showed that well-being is related to a high rate GI symptoms (OR 16·9, 95% CI 5·6-50·7), a negative self-image (OR 8·9, 95% CI 3·5-22·9) and comorbidity (OR 3·3, 95% CI 1·7-6·4). There was no impact of childhood symptoms on well-being, GI symptoms, self-image or comorbidity in adulthood. Half of the study population showed reduced well-being compared with norms. Practically all women (97%) declared that they were always or usually following a GFD and 62% reported at least one disease besides CD. Conclusion. The study demonstrated that the well-being of women living with CD is affected by GI complaints, self-image and a high rate of comorbidity whereas a history of signs and symptoms of CD in childhood not seems to impact on the well-being in adulthood. Relevance to clinical practice. Gastrointestinal symptoms, self-image and comorbidity are factors contributing to a low level of well-being of CD women living on a GFD. Launching a multi-disciplinary team for follow-up would represent a novel approach to support these women and may prove valuable in improving their subjective health.
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| 3. |
- Vulcan, Alexandra, et al.
(författare)
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A colorectal cancer diet quality index is inversely associated with colorectal cancer in the Malmö diet and cancer study
- 2019
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Ingår i: European Journal of Cancer Prevention. - 0959-8278. ; 28:6, s. 463-471
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Tidskriftsartikel (refereegranskat)abstract
- The World Cancer Research Fund International has concluded strong evidence for that high intake of dairy products and foods containing dietary fiber and low intake of processed meat are associated with decreased risk of colorectal cancer (CRC). As food items are consumed together, it is important to study dietary patterns. The aim of the present study was to examine the association between an a priori constructed dietary index and incident CRC and between intake of processed meat, fiber, and dairy products and CRC. In the Malmö Diet and Cancer study cohort, 923 cases of CRC were identified, during 502 136 person-years of follow-up. A Colorectal Diet Quality Index (CDQI) was constructed regarding intakes of processed meat, fiber, and dairy products in relation to CRC. Higher index indicated a higher dietary quality. Higher CDQI was associated with lower risk of CRC [hazard ratios (HR): 0.57 for highest compared with lowest quintile; 95% confidence interval (CI): 0.43, 0.75; P<0.001]. Intake of dairy products was inversely associated with risk of CRC [HR for highest vs. lowest quintile was 0.77 (CI: 0.62, 0.96); P = 0.008], as was dietary fiber [HR for highest vs. lowest quintile was 0.77 (CI: 0.61, 0.98); P = 0.043]. High intake of processed meat was associated with CRC [HR for highest vs. lowest quintile was 1.31; CI: 1.05, 1.63; P = 0.012]. High adherence to a predefined CRC-specific diet quality index was inversely associated with the risk of CRC and gave a stronger association with CRC, than when analyzing the components of the CDQI individually.
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| 4. |
- Vulcan, Alexandra, et al.
(författare)
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Fibre intake and incident colorectal cancer depending on fibre source, sex, tumour location and Tumour, Node, Metastasis stage.
- 2015
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Ingår i: British Journal of Nutrition. - 1475-2662. ; 114:6, s. 959-969
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Tidskriftsartikel (refereegranskat)abstract
- Studies on fibre intake and incident colorectal cancer (CRC) indicate inverse associations. Differences by tumour stage have not been examined. We examined associations between fibre intake and its sources, and incidental CRC. Separate analyses were carried out on the basis of sex, tumour location and the Tumour, Node, Metastasis (TNM) classification. The Malmö Diet and Cancer Study is a population-based cohort study, including individuals aged 45-74 years. Dietary data were collected through a modified diet history method. The TNM classification was obtained from pathology/clinical records and re-evaluated. Among 27 931 individuals (60 % women), we found 728 incident CRC cases during 428 924 person-years of follow-up. Fibre intake was inversely associated with CRC risk (P trend=0·026). Concerning colon cancer, we observed borderline interaction between fibre intake and sex (P=0·052) and significant protective association restricted to women (P trend=0·013). Intake of fruits and berries was inversely associated with colon cancer in women (P trend=0·022). We also observed significant interactions between intakes of fibre (P=0·048) and vegetables (P=0·039) and sex on rectal cancer, but no significant associations were seen between intake of fibre, or its sources, in either of the sexes. Except for inverse associations between intake of fibre-rich cereal products and N0- and M0-tumours, we did not observe significant associations with different TNM stages. Our findings suggest different associations between fibre intake and CRC depending on sex, tumour site and fibre source. High fibre intake, especially from fruits and berries, may, above all, prevent tumour development in the colon in women. No clear differences by TNM classification were detected.
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| 5. |
- Vulcan, Alexandra, et al.
(författare)
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High blood glucose levels are associated with higher risk of colon cancer in men : A cohort study
- 2017
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Ingår i: BMC Cancer. - : Springer Science and Business Media LLC. - 1471-2407. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: High levels of blood glucose are thought to be associated with colorectal cancer (CRC) and hyperinsulinemia, an interstage in the development of CRC. The purpose of this study was to examine associations between incident CRC and blood glucose; plasma insulin; and the homeostasis model assessment for insulin resistance (HOMA2-IR), respectively, and to determine whether these associations were dependent on sex and cancer site. Methods: The Malmö Diet and Cancer cardiovascular cohort comprises 6103 individuals. During 81,781 person-years of follow-up, 145 cases of CRC were identified. The hazard ratio of measured blood glucose and plasma insulin and calculated HOMA2-IR were estimated with Cox proportional hazard regression. Results: An association was found between high levels of blood glucose and risk of CRC (HR: 1.72 for the highest compared with the lowest quartile 95% CI: 1.05, 2.84; ptrend=0.044), and colon cancer (HR: 1.70 for the highest compared with the lowest quartile 95% CI: 0.87, 3.33; ptrend=0.032). In men, an association was found between blood glucose and CRC (HR: 2.80 for the highest compared with the lowest quartile 95% CI: 1.37, 5.70; ptrend=0.001), and colon cancer (HR: 4.48 for the highest compared with the lowest quartile 95% CI: 1.27, 15.84; ptrend=0.007), but this was not found in women. No associations between plasma insulin, or HOMA2-IR, and CRC, were found. Conclusion: High levels of blood glucose in men are associated with risk of colon cancer. The findings contribute to facilitating to identify those most in need of prevention and screening.
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| 6. |
- Vulcan, Alexandra, et al.
(författare)
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Intake of different types of red meat, poultry, and fish and incident colorectal cancer in women and men: results from the Malmö Diet and Cancer Study.
- 2017
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Ingår i: Food and Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-661X .- 1654-6628. ; 61:1
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Tidskriftsartikel (refereegranskat)abstract
- Background : Colorectal cancer (CRC) is considered one of the most common forms of cancer in the Western world. High intake of red and processed meat is considered to increase CRC development. Objective : This study examined associations between intake of red meats, poultry, and fish and incident CRC, and if weight status modifies the associations. Design : In the Malmö Diet and Cancer Study, dietary data was collected through a modified diet history method. Via the Swedish Cancer Registry, 728 cases of CRC were identified during 428 924 person-years of follow-up of 16 944 women and 10 987 men. Results : Beef intake was inversely associated with colon cancer. However, in men high intake of beef was associated with increased risk of rectal cancer. High intake of pork was associated with increased incidence of CRC, and colon cancer. Processed meat was associated with increased risk of CRC in men. Fish intake was inversely associated with risk of rectal cancer. No significant interactions were found between different types of meat and weight status. Conclusions : Findings suggest that associations between meat intake and CRC differ depending on meat type, sex, and tumor location in the bowel. Weight status did not modify observed associations.
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| 7. |
- Vulcan, Alexandra
(författare)
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Nutrition and colorectal cancer - The role of BMI, sex, biomarkers and dietary index
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Colorectal cancer (CRC) is one of the most common forms of cancer. The cause of CRC is multifactorial, and lifestyle factors are thought to be a major contributor to the development of CRC. It can be hypothesised that the association between food intake and the risk of developing CRC depends not only on the food consumed, but what it is consumed in combination with. The associations between food and CRC may also depend on other lifestyle-related factors, such as blood glucose and insulin levels, insulin resistance, and body composition, or sex and clinicopathological characteristics, such as tumour location and tumour-stage. It is not confirmed that the association between a nutrient and CRC is equal to the associations between the different food groups that a nutrient comes from or that the food sources of the nutrients all creates the same associations.The aim of this thesis is therefore to examine associations between dietary intakes and CRC in the Malmö Diet and Cancer cohort, and whether the associations are modified by different preconditions.In the Malmö Diet and Cancer study (MDC) we examined food intake and levels of blood glucose, plasma insulin and insulin resistance by hazard regression regarding incident CRC. In MDC, baseline examinations were performed between 1991 and 1996, where information on body composition, and socioeconomic- and lifestyle factors was obtained, together with collection of blood samples. Food intake was recorded by a modified diet history method. Information on incident cases of CRC was identified via the Swedish cancer registry.We found that high fibre intake was associated with lower risk for CRC, especially with lower risk for colon cancer in women, and that high intake of fruits and berries was associated with lower risk of CRC in women. Regarding meat intake, we found that high intake of pork, as well as intake of processed meat, was associated with risk of CRC. In addition, we found that high fasting blood glucose was associated with higher risk of CRC, especially in colon cancer in men.Finally, we found that high adherence to a predefined CRC-specific diet quality index, based on World Cancer Research Found’s conclusions regarding diet, was inversely associated with risk of CRC, and gave a stronger association with CRC than when analysing the components of the index individually.In conclusion, this thesis found different preconditions for associations between food intake and CRC, dependent on sex, meat subtype, fibre source, and the location of the tumour, but not for presence of overweight and diabetes in this population of inhabitants in Malmö.
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