Heme and Chlorophyll Intake and Risk of Colorectal Cancer in the Netherlands Cohort Study

Balder, H.F.; Vogel, Johan de; Jansen, Margje C.J.F.; Weijenberg, Matty P.; Brandt, Piet A. van den; Westenbrink, Susanne; Meer, Roelof van der; Goldbohm, R. Alexandra

doi:10.1158/1055-9965.epi-05-0772

Cited by 172 publications

(163 citation statements)

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“…Our results for haem iron may vary from earlier research (Lee et al, 2004; that calculated haem iron as standard proportions of total iron from meat (Monsen and Balintfy, 1982;Balder et al, 2006), as we estimated haem iron based on measured values from meat samples. The pattern of risk that we observed for haem iron was similar to that for red meat.…”

Section: Discussioncontrasting

confidence: 95%

Intake of meat, meat mutagens, and iron and the risk of breast cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

et al. 2009

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BACKGROUND: Epidemiological evidence on meat intake and breast cancer is inconsistent, with little research on potentially carcinogenic meat-related exposures. We investigated meat subtypes, cooking practices, meat mutagens, iron, and subsequent breast cancer risk. METHODS: Among 52 158 women (aged 55 -74 years) in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, who completed a food frequency questionnaire, 1205 invasive breast cancer cases were identified. We estimated meat mutagen and haem iron intake with databases accounting for cooking practices. Using Cox proportional hazards regression, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) within quintiles of intake. RESULTS: Comparing the fifth to the first quintile, red meat (HR ¼ 1.23; 95% CI ¼ 1.00 -1.51, P trend ¼ 0.22), the heterocyclic amine (HCA), 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx), (HR ¼ 1.26; 95% CI ¼ 1.03 -1.55; P trend ¼ 0.12), and dietary iron (HR ¼ 1.25; 95% CI ¼ 1.02 -1.52; P trend ¼ 0.03) were positively associated with breast cancer. We observed elevated, though not statistically significant, risks with processed meat, the HCA 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline (DiMeIQx), mutagenic activity, iron from meat, and haem iron from meat. CONCLUSION: In this prospective study, red meat, MeIQx, and dietary iron elevated the risk of invasive breast cancer, but there was no linear trend in the association except for dietary iron.

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Section: Discussioncontrasting

confidence: 95%

Intake of meat, meat mutagens, and iron and the risk of breast cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

et al. 2009

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“…Heme iron, which has greater bioavailability compared to non-heme iron, has been shown experimentally to have cytotoxic and hyperproliferative effects in the rat colon (Sesink et al, 1999). To date, three cohort studies have reported on the association of heme iron intake and risk of colon or colorectal cancer (Lee et al, 2004;Larsson et al, 2005;Balder et al, 2006), and suggest a possible positive association of intake with risk, which may be enhanced in consumers of alcohol. However, there are inconsistencies in the association found in these studies by subsite (Lee et al, 2004;Larsson et al, 2005) and by sex (Balder et al, 2006), as well as with regard to the role of effect modification by alcohol consumption.…”

mentioning

confidence: 99%

A cohort study of dietary iron and heme iron intake and risk of colorectal cancer in women

et al. 2007

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In a cohort study of 49 654 Canadian women, we assessed the association of colorectal cancer with total iron and heme iron intake, excluding iron supplements. Among women aged 40 -59 years, followed for an average of 16.4 years, we identified 617 incident colorectal cancer cases. Data from a food frequency questionnaire administered at baseline were used to calculate red meat intake and intake of total dietary iron, iron from meat, and heme iron. Analyses were carried out for all cases and for the proximal colon, distal colon, and rectum, using Cox proportional hazards models. We found no association of intake of iron, heme iron, or iron from meat with risk of colorectal cancer overall or with any of the subsites, nor was there effect modification by alcohol consumption or hormonal replacement therapy. Free iron is a pro-oxidant, and may contribute to colorectal carcinogenesis by promoting free radical production and lipid peroxidation (Nelson, 1992;Toyokuni, 1996;Huang, 2003). Epidemiologic studies examining the association of iron intake and markers of body iron stores with risk of colorectal cancer or colorectal polyps have yielded some evidence of positive associations (Knekt et al, 1994;Bird et al, 1996;Wurzelmann et al, 1996;Tseng et al, 1997;Kato et al, 1999). In addition, epidemiologic studies have shown a modest association between red meat intake, the major source of dietary iron, and risk of colon and colorectal cancer (Norat and Riboli, 2001;Larsson and Wolk, 2006). However, few studies have examined the association of intake of heme iron, derived principally from red meat, with colorectal cancer risk. Heme iron, which has greater bioavailability compared to non-heme iron, has been shown experimentally to have cytotoxic and hyperproliferative effects in the rat colon (Sesink et al, 1999). To date, three cohort studies have reported on the association of heme iron intake and risk of colon or colorectal cancer (Lee et al, 2004;Larsson et al, 2005;Balder et al, 2006), and suggest a possible positive association of intake with risk, which may be enhanced in consumers of alcohol. However, there are inconsistencies in the association found in these studies by subsite (Lee et al, 2004;Larsson et al, 2005) and by sex (Balder et al, 2006), as well as with regard to the role of effect modification by alcohol consumption. We used data from a large cohort study of Canadian women to assess the risk of colorectal cancer in association with total iron and heme iron intake, as well as potential effect modification by alcohol consumption and hormone replacement use. METHODS AND MATERIALS Study populationOur investigation was conducted in the Canadian National Breast Screening Study (NBSS), a randomised controlled trial of screening for breast cancer, which has been described in detail elsewhere (Miller et al, 1992;Terry et al, 2002). In brief, 89 835 women aged 40 -59 years were recruited from the general Canadian population between 1980 and 1985. On enrolment into the study, information was obtained from participant...

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“…Total intake of meat iron was calculated from the reported intake of 22 meat items and 2 mixed dishes containing meat. Heme iron intake was computed by two different methods using different proportions for heme iron from different types of meat: 69% for beef; 39% for pork, ham, bacon, pork-based luncheon meats, and veal; 26% for chicken and fish; and 21% for liver (20); and, alternatively, using 40% as the average proportion of heme iron in all meats (21). Results were similar for both methods, and we present data using the first approach.…”

Section: Methodsmentioning

confidence: 94%

Dietary Iron and Heme Iron Intake and Risk of Breast Cancer: A Prospective Cohort Study

Kabat

Miller

Jain

et al. 2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Recent studies suggest that elevated body iron levels may contribute to breast carcinogenesis; however, epidemiologic evidence is lacking. We used data from a large cohort study of Canadian women to assess breast cancer in association with total iron and heme iron intake. Among 49,654 women ages 40 to 59 followed for an average of 16.4 years, we identified 2,545 incident breast cancer cases. Data from a food frequency questionnaire administered at baseline were used to calculate total dietary iron and heme iron intake. Using Cox proportional hazards models, we found no association of iron or heme iron intake with risk of breast cancer overall, in women consuming 30+ g of alcohol per day, or in women who had ever used hormone replacement therapy. The present study offers no support for an association of iron or heme iron intake with breast cancer risk or for a modification by iron of the effect of alcohol or estrogen. However, further cohort studies with repeated measurement of iron intake are warranted. (Cancer Epidemiol Biomarkers Prev 2007;16(6):1306 -8)

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Heme and Chlorophyll Intake and Risk of Colorectal Cancer in the Netherlands Cohort Study

Cited by 172 publications

References 34 publications

Intake of meat, meat mutagens, and iron and the risk of breast cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

Intake of meat, meat mutagens, and iron and the risk of breast cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

A cohort study of dietary iron and heme iron intake and risk of colorectal cancer in women

Dietary Iron and Heme Iron Intake and Risk of Breast Cancer: A Prospective Cohort Study

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