Paleolithic and Mediterranean Diet Scores and Risk of Colorectal Adenoma Open Access

Valenzuela, Kristine Abigail (2012)

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Paleolithic and Mediterranean Diet Scores and Risk of Colorectal Adenoma
Background: A Westernized diet and lifestyle is associated with risk for colorectal cancer and
adenomas. Evolutionary discordance could explain this association.
Objective: We investigated associations of scores for two proposed healthy diet patterns, the
"Paleolithic" and Mediterranean diets, with risk for incident, sporadic colorectal adenomas.
Methods: In the Minnesota Cancer Prevention Research Unit case-control study of colorectal
polyps, 1,248 participants with no history of colorectal neoplasms completed extensive
questionnaires, including a Willett food frequency questionnaire, prior to an elective, outpatient
colonoscopy. Of these participants 564 were identified as cases and 684 as colonoscopy-negative
controls. An additional group of 535 frequency-matched population controls were also recruited.
Paleolithic and the Mediterranean diet scores were calculated and categorized into quintiles, and
associations were estimated using unconditional logistic regression.
Results: The Paleolithic and the Mediterranean diet patterns were similarly inversely associated
with colorectal adenomas when comparing the cases to the population controls: the
multivariable-adjusted odds ratios [OR] were 0.66 (95% confidence interval [CI] 0.45 - 0.96, ptrend
= 0.03) and 0.65 (95% CI 0.44 - 0.96, ptrend = 0.03) for those in the highest relative to the lowest
quintiles of the Paleolithic and Mediterranean diet scores, respectively. The associations tended
to be stronger in men (OR 0.51 [95% CI 0.31 - 0.85, ptrend = 0.01] for the Paleolithic diet score,
and OR 0.60 [95% CI 0.37 - 0.99, ptrend = 0.03] for the Mediterranean diet score) and those who
were overweight or obese (OR 0.45 [95% CI 0.25 - 0.82, ptrend < 0.01] for the Paleolithic diet
score, and OR 0.41 [95% CI 0.22 - 0.78, ptrend < 0.01] for the Mediterranean diet score). However,
there was no evidence for an association of either dietary pattern with risk for adenoma in the
comparisons involving the colonoscopy-negative controls.
Conclusion: These findings suggest that higher adherence to the Paleolithic or Mediterranean
diet patterns may be similarly associated with lower risk for incident, sporadic colorectal
adenomas; however, especially considering the discrepant findings from the comparisons of the
cases with the two different control groups, further study is needed.

Table of Contents

Paleolithic and Mediterranean Diet Scores and Risk of Colorectal Adenoma

Table of Contents

1- Literature Review

6- Manuscript Chapter

19- Public Health Implications, Possible Future Directions

21- Tables

31- Appendix

39- References

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