Dietary Intake of Advanced Glycation End Products (AGEs) and Mortality among Individuals with Colorectal Cancer.

Ziling Mao,Zhiwei Zhao,Anne Kirstine Eriksen,Elom K Aglago,Salvatore Panico,Fulvio Ricceri,Rosario Tumino,David J Hughes,Li Jiao,Mazda Jenab,Gianluca Severi,Anna Birukov,Verena Katzke,Guri Skeie,Pilar Amiano,Anne Tjønneland,Elisabete Weiderpass,Matthias B Schulze,Aurelio Barricarte Gurrea,Jonas Manjer,Ingegerd Johansson,Veronika Fedirko,Rudolf Kaaks,Torkjel M Sandanger,Vittorio Krogh,Heinz Freisling,H Bas Bueno‐De‐Mesquita ,Roel Vermeulen ,Marta Crous‐Bou ,María‐José Sánchez ,Marie‐Christine Boutron‐Ruault ,Joseph A Rothwell ,Aurora Perez‐Cornago ,María‐Dolores Chirlaque ,Inger Torhild Gram ,J Ramón Quiŕos ,Casper G Schalkwijk

doi:10.3390/nu13124435

Abstract

Advanced glycation end-products (AGEs) may promote oxidative stress and inflammation and have been linked to multiple chronic diseases, including cancer. However, the association of AGEs with mortality after colorectal cancer (CRC) diagnosis has not been previously investigated. Multivariable Cox proportional hazards models were used to calculate hazard ratios and corresponding 95% confidence intervals for associations between dietary intake of AGEs with CRC-specific and all-cause mortality among 5801 participant cases diagnosed with CRC in the European Prospective Investigation into Cancer and Nutrition study between 1993 and 2013. Dietary intakes of AGEs were estimated using country-specific dietary questionnaires, linked to an AGE database, that accounted for food preparation and processing. During a median of 58 months of follow-up, 2421 cases died (1841 from CRC). Individually or combined, dietary intakes of AGEs were not associated with all-cause and CRC-specific mortality among cases. However, there was a suggestion for a positive association between AGEs and all-cause or CRC-specific mortality among CRC cases without type II diabetes (all-cause, Pinteraction = 0.05) and CRC cases with the longest follow-up between recruitment and cancer diagnosis (CRC-specific, Pinteraction = 0.003; all-cause, Pinteraction = 0.01). Our study suggests that pre-diagnostic dietary intakes of AGEs were not associated with CRC-specific or all-cause mortality among CRC patients. Further investigations using biomarkers of AGEs and stratifying by sex, diabetes status, and timing of exposure to AGEs are warranted.

Highlights

Colorectal cancer (CRC) is the third leading cause of cancer death worldwide [1].Large differences in incidence rates across countries and rapid changes in incidence among migrant populations suggest that modifiable environmental factors, including diet and lifestyle, play an important role in colorectal cancer (CRC) etiology [2]
CRC cases in the highest compared to the lowest quintile of the combined advanced glycation end products (AGE) were less likely to be current smokers and, on average, had lower red meat consumption
Our findings suggest that pre-diagnostic dietary intakes of AGEs were not associated with CRC-specific and all-cause mortality among CRC patients in this large prospective study

Summary

Introduction

Colorectal cancer (CRC) is the third leading cause of cancer death worldwide [1]. Large differences in incidence rates across countries and rapid changes in incidence among migrant populations suggest that modifiable environmental factors, including diet and lifestyle, play an important role in CRC etiology [2]. Despite advances in screening and treatment, there is an increasing number of CRC survivors that are at risk for CRC recurrence and death [3]. Multiple lifestyle and dietary factors such as tobacco smoking, obesity, and heavy alcohol intake have been linked to the risk of CRC [4]. Knowledge of the risk factors affecting survival after CRC diagnosis is limited. It is of interest to Nutrients 2021, 13, 4435 determine whether modifiable factors may affect cancer survival, those that could be modified by changes in diet or lifestyle

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Conclusion