Dietary Inflammatory Index, Dietary Non-Enzymatic Antioxidant Capacity, and Colorectal and Breast Cancer Risk (MCC-Spain Study).

Mireia Obón‐Santacana ,Nitin Shivappa ,María Ederra ,Juan Alguacil ,Vı́ctor Moreno ,Mikel Azpiri ,Ferran Moratalla ,Beatriz Arencibia Pérez ,James R Hébert ,Amaia Molinuevo ,Marina Pollán ,Elisabet Guinó ,Macarena Lozano‐Lorca ,Conchi Moreno‐Iribas ,Esther Molina‐Montes ,Dora Romaguera ,Rafael Marcos‐Gragera ,Núria Aragonés ,Adonina Tardón ,Adela Castelló ,Rocío Olmedo‐Requena ,Tania Fernández‐Villa ,Gemma Castaño‐Vinyals ,Vicente Martín ,Inés Gómez‐Acebo ,Leire Gil ,Esther Gràcia-Lavedán ,Ana Molina‐Barceló ,Manolis Kogevinas ,A Molina ,José María Huerta ,Trinidad Dierssen-Sotos ,Pilar Amiano

doi:10.3390/nu11061406

Abstract

Inflammation and antioxidant capacity have been associated with colorectal and breast cancer. We computed the dietary inflammatory index (DII®), and the total dietary non-enzymatic antioxidant capacity (NEAC) and associated them with colorectal and breast cancer risk in the population-based multi case-control study in Spain (MCC-Spain). We included 1852 colorectal cancer and 1567 breast cancer cases, and 3447 and 1486 population controls, respectively. DII score and NEAC were derived using data from a semi-quantitative validated food frequency questionnaire. Unconditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) for energy-adjusted DII (E-DII), and a score combining E-DII and NEAC. E-DII was associated with colorectal cancer risk (OR = 1.93, highest quartile versus lowest, 95%CI:1.60–2.32; p-trend: <0.001); this increase was observed for both colon and rectal cancer. Less pronounced increased risks were observed for breast cancer (OR = 1.22, highest quartile versus lowest, 95%CI:0.99–1.52, p-trend: >0.10). The combined score of high E-DII scores and low antioxidant values were associated with colorectal cancer risk (OR = 1.48, highest quartile versus lowest, 95%CI: 1.26–1.74; p-trend: <0.001), but not breast cancer. This study provides evidence that a pro-inflammatory diet is associated with increased colorectal cancer risk while findings for breast cancer were less consistent.

Highlights

Colorectal cancer (CRC) is the third most common cancer worldwide [1]
CRC cases compared to controls had higher energy-adjusted DII (E-DII) scores, indicating a more pro-inflammatory diet, tended to be older, heavier, and less active, and more frequently classified as having a low education and a family history of CRC (p < 0.001)
breast cancer (BC) cases compared to controls had higher E-DII scores, tended to be younger, and reported more frequently being smokers, premenopausal, and having a first-degree history of BC (p < 0.001)

Summary

Introduction

Colorectal cancer (CRC) is the third most common cancer worldwide [1]. Beyond non-modifiable risk factors such as age, male sex, family history of CRC, and genetic predisposition [2], epidemiological studies have identified a number of modifiable factors that have a direct impact on CRC risk, for example cigarette smoking, which increases risk [3], and regular use of aspirin, which decreases risk [4]. Breast cancer (BC) and CRC are the two most frequently diagnosed cancers [6,7]. BRCA1 or BRCA2 genes mutations, family history of BC or ovarian cancer, radiation, hormonal factors, physical inactivity, alcohol consumption, tobacco smoking and physical inactivity are important risk factors for BC [8,9]. The role of diet, remains controversial [9]

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