Associations of Evolutionary-Concordance Diet and Lifestyle Pattern Scores with Incident, Sporadic Adenoma in a Pooled Case-Control Study Open Access

Penley, McKenna (Summer 2020)

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The evolutionary-concordance hypothesis posits that differences in diet and lifestyle, relative to those of our Paleolithic-era ancestors, may explain the high incidence of major chronic diseases, including colorectal cancer (CRC), in modern Westernized countries. To address this, we previously reported evolutionary-concordance diet and lifestyle pattern scores to reflect closeness of diet and lifestyle patterns to those of Paleolithic-era humans, and found them to be associated with lower CRC incidence in women. Separate and joint associations of the scores with colorectal adenoma among men and women are unknown. 

We pooled data from three case-control studies of incident, sporadic colorectal adenomas (N = 771 cases, 1,990 controls), and used participants’ responses to food frequency and lifestyle questionnaires to calculate evolutionary-concordance diet (comprising 14 components) and lifestyle (comprising smoking status, body mass index, and physical activity) pattern scores, such that higher scores indicated higher evolutionary-concordance. We estimated associations of the scores with adenomas using multivariable unconditional logistic regression. 

The multivariable-adjusted odds ratios comparing those in the highest relative to the lowest quintiles of the diet and lifestyle scores were 0.84 (95% confidence interval [CI]: 0.62-1.12, Ptrend: 0.04) and 0.41 (95% CI: 0.29-0.59, Ptrend: <0.0001), respectively. The inverse associations were stronger for adenomas with higher risk characteristics, and among those with both high a diet and lifestyle score relative to those with both a low diet and lifestyle score. 

These results suggest that more evolutionary concordant diet and lifestyle patterns, separately and jointly, may be associated with lower risk for incident, sporadic colorectal adenoma. 

Table of Contents

Chapter 1: Background ....2

Chapter 2: Manuscript for Submission for Publication in a Peer-Reviewed Journal ....8

Chapter 3: Public Health Implications and Future Research Directions ....51

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