Diet quality indices and dietary patterns are associated with plasma metabolites in colorectal cancer patients

Anne J M R Geijsen,Augustin Scalbert,Matty P Weijenberg,Flip M Kruyt,Ellen Kampman,Dieuwertje E Kok,Audrey Gicquiau,David Achaintre,Evertine Wesselink,Andrea Gsur,Fränzel J B Van Duijnhoven,Pekka Keski-Rahkonen,Johannes H W De Wilt,Cornelia M Ulrich,Moniek Van Zutphen

doi:10.1007/s00394-021-02488-1

Abstract

PurposeEmerging evidence suggests that diet is linked to survival in colorectal cancer patients, although underlying mechanisms are not fully understood. The aim of this study was to evaluate whether dietary exposures are associated with metabolite concentrations in colorectal cancer patients.MethodsConcentrations of 134 metabolites of the Biocrates AbsoluteIDQ p180 kit were quantified in plasma samples collected at diagnosis from 195 stage I-IV colorectal cancer patients. Food frequency questionnaires were used to calculate adherence to the World Cancer Research Fund (WCRF) dietary recommendations and the Dutch Healthy Diet (DHD15) index as well as to construct dietary patterns using Principal Component Analysis. Multivariable linear regression models were used to determine associations between dietary exposures and metabolite concentrations. All models were adjusted for age, sex, body mass index, smoking status, analytical batch, cancer stage, and multiple testing using false discovery rate.ResultsParticipants had a mean (SD) age of 66 (9) years, were mostly men (60%), and mostly diagnosed with stage II and III cancer. For the dietary pattern analyses, Western, Carnivore, and Prudent patterns were identified. Better adherence to the WCRF dietary recommendations was associated with lower concentrations of ten phosphatidylcholines. Higher intake of the Carnivore pattern was associated with higher concentrations of two phosphatidylcholines. The DHD15-index, Western pattern, or Prudent pattern were not associated with metabolite concentrations.ConclusionIn the current study, the WCRF dietary score and the Carnivore pattern are associated with phosphatidylcholines. Future research should elucidate the potential relevance of phosphatidylcholine metabolism in the colorectal cancer continuum.Clinical trial registryClinicalTrials.gov Identifier: NCT03191110.

Highlights

Previous research suggests that there is a relation between diet and survival after colorectal cancer diagnosis [1]
The aim of the current study was to explore the associations between the diet, evaluated using diet quality indices and dietary patterns, and plasma metabolite concentrations in colorectal cancer patients
The World Cancer Research Fund (WCRF) dietary score and the Carnivore pattern were observed to be statistically significantly associated with several long-chain phosphatidylcholines

Summary

Introduction

Previous research suggests that there is a relation between diet and survival after colorectal cancer diagnosis [1]. Metabolomics measures a range of small molecules, many of which belong to a number of different biochemical pathways. Such metabolic profiles can provide a snapshot of the current metabolic state of the body, characteristic of a phenotype [7] and are, increasingly used to study the interface of diet, lifestyle and diseases [8,9,10]. Research has shown that dietary exposures can be associated with metabolite concentrations in blood. Predefined diet quality indices [11] as well as distinct dietary patterns such as veganism [12, 13] were reported to be associated with specific blood metabolites. Another study reported that a vegan diet was associated with lower concentrations of glycerophospholipids, sphingolipids and amino acids compared to a diet containing meat and/or fish [12]

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