Diet Quality and Colorectal Cancer Risk in the Women's Health Initiative Observational Study

Ashley J. Vargas, Marian L. Neuhouser, Stephanie M. George, Cynthia A. Thomson, Gloria Y.F. Ho, Thomas E. Rohan, Ikuko Kato, Rami Nassir, Lifang Hou, Joann E. Manson

Research output: Contribution to journalArticlepeer-review

57 Scopus citations

Abstract

Diet quality index scores on Healthy Eating Index 2010 (HEI-2010), Alternative HEI-2010, alternative Mediterranean Diet Index, and the Dietary Approaches to Stop Hypertension (DASH) index have been inversely associated with all-cause and cancer-specific death. This study assessed the association between these scores and colorectal cancer (CRC) incidence as well as CRC-specific mortality in the Women's Health Initiative Observational Study (1993-2012), a US study of postmenopausal women. During an average of 12.4 years of follow-up, there were 938 cases of CRC and 238 CRC-specific deaths. We estimated multivariate hazard ratios and 95% confidence intervals for relationships between quintiles of diet scores (from baseline food frequency questionnaires) and outcomes. HEI-2010 score (hazard ratios were 0.81, 0.77, and 0.73 with P values of 0.04, 0.01, and <0.01 for quintiles 3-5 vs. quintile 1, respectively) and DASH score (hazard ratios were 0.72, 0.74, and 0.78 with P values of <0.01, <0.01, and 0.03 for quintiles 3-5 vs. quintile 1, respectively), but not other diet scores, were associated with a lower risk of CRC in adjusted models. No diet scores were significantly associated with CRC-specific mortality. Closer adherence to HEI-2010 and DASH dietary recommendations was inversely associated with risk of CRC in this large cohort of postmenopausal women.

Original languageEnglish (US)
Pages (from-to)23-32
Number of pages10
JournalAmerican Journal of Epidemiology
Volume184
Issue number1
DOIs
StatePublished - Jul 1 2016
Externally publishedYes

Keywords

  • Alternative Healthy Eating Index
  • Alternative Mediterranean Diet
  • Dietary Approaches to Stop Hypertension
  • Healthy Eating Index
  • colorectal cancer
  • diet
  • diet quality
  • dietary patterns

ASJC Scopus subject areas

  • General Medicine

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