Eating frequency and risk of colorectal cancer

Abstract

Purpose Eating frequency is a modifiable aspect of dietary behavior that may affect risk of colorectal cancer (CRC). Although most previous case-control studies indicate a positive association, two prospective studies suggest an inverse association between eating frequency and CRC risk, with evidence of effect modification by diet composition. We examined the association between eating frequency and CRC in a large, prospective cohort study, and explored whether this relationship was modified by sex, coffee consumption or dietary glycemic load. Methods Between 2000 and 2002, 67,912 western Washington residents aged 50–76 reported average daily meal and snack frequency using a mailed questionnaire as part of the VITamins And Lifestyle (VITAL) study. Participants were followed for CRC through linkage with SEER through 2008, over which time 409 CRC cases developed. Hazard Ratios and 95% Confidence Intervals were obtained using Cox regression. Results In age and sex adjusted models higher (5+ times/d) vs lower (1–2 times/d) eating frequency was associated with a HR of 0.62 (95% CI 0.43–0.88, P trend =0.001). However, following further adjustment for BMI, race/ethnicity, alcohol and other known CRC risk factors the relationship was no longer statistically significant (HR: 0.76; 95% CI: 0.51, 1.14). No effect modification was observed by sex (Pinteraction=0.45), coffee consumption (Pinteraction=0.44) or dietary glycemic load (Pinteraction=0.90). In subgroup analyses by tumor site, higher vs. lower eating frequency was associated with lower risk for colon (HR 0.65 95% CI 0.39–1.07, Ptrend=0.04), but not rectal cancers (HR = 1.08 95% CI 0.54–2.18, Ptrend=0.94). Conclusion The weak inverse association observed between eating frequency and CRC is consistent with findings from other prospective studies. Modification of this relationship by diet quality and participant characteristics should be considered in future studies.

Coffee Consumption and Risk of Colorectal Cancer: A Systematic Review and Meta-Analysis of Prospective Studies

“…The full list of studies included [12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37] and their main characteristics are shown in Table 2.…”

The impact of a higher eating frequency on the diet quality and nutritional status of women with breast cancer undergoing chemotherapy

“…Recent evidence also suggests that dietary behaviours related to lower daily eating frequency (EF) may negatively influence the diet quality (9)(10)(11) and the metabolic health of humans (12) , including the risk of developing cancer (13,14) . Specifically for BC, one single study, to our knowledge, found that a lower number of daily eating episodes in healthy women would be related to the increase in biomarkers linked to systemic inflammation and, consequently, to an increased risk of developing the disease, but the study did not evaluate the impact on diet quality (13) .…”

Association of the glycaemic index and glycaemic load with colorectal cancer in the population of Córdoba (Argentina): results of a case–control study using a multilevel modelling approach

“…It has been suggested that eating frequently results in an increased secretion of bile acids into the gut lumen and that dehydroxylation and deconjugation by colonic bacteria induce these bile acids to convert into secondary bile acids, which may have tumourigenic effects (48,49) . However, prospective studies suggest an inverse association between eating frequency and CRC risk, with evidence of effect modification by diet composition (50) . People spend most of their lives in the postprandial state since the true fasting state occurs only in the last 2 h of a regular night sleep (51) ; therefore, quality of food consumed will be key in the effect on health.…”