Ultra-Processed Food Intake and Smoking Interact in Relation with Colorectal Adenomas.

Naomi Fliss-Isakov,Oren Shibolet,Shira Zelber-Sagi,Revital Kariv,Dana Ivancovsky-Wajcman

doi:10.3390/nu12113507

Naomi Fliss-Isakov, Oren Shibolet + Show 3 more

Open Access

https://doi.org/10.3390/nu12113507

Copy DOI

Journal: Nutrients	Publication Date: Nov 14, 2020
Citations: 17	License type: CC BY 4.0

Affiliation: Tel Aviv University, University of Haifa

Abstract

Smoking and ultra-processed foods (UPFs), a substantial part of the western diet, have been suggested to have a potential carcinogenic effect, though epidemiologic data are lacking. We aimed to examine the association between high UPF intake and colorectal adenomas, and to test the interaction with smoking. In a case-control study among consecutive subjects undergoing colonoscopy in a tertiary center during 2010–2015, UPF intake and smoking were compared between cases with colorectal adenomas and controls. Within 652 participants (cases, n = 294 and controls, n = 358), high UPF intake (defined as percent of kcal from UPF above the study sample upper tertile) was positively associated with adenomas (Odds ratio (OR) = 1.75, 95% Confidence interval (CI) 1.14–2.68), advanced and proximal adenomas (OR = 2.17, 1.29–3.65 and OR = 2.38, 1.37–4.11) among the whole study sample; and with adenomas (OR = 3.54, 1.90–6.61), non-advanced adenomas (OR = 2.60, 1.20–5.63), advanced adenomas (OR = 4.76, 2.20–10.30), proximal adenomas (OR = 6.23, 2.67–14.52), and distal adenomas (OR = 2.49, 1.21–5.13) among smokers. Additionally, a dose-dependent association was observed between tertiles of UPF intake and adenomas only among smokers (p for trend < 0.001). A significant interaction between smoking and high UPF intake was detected (p for interaction = 0.004). High intake of UPFs is strongly and independently associated with colorectal adenomas, especially advanced and proximal adenoma, and interacts with smoking. Results highlight smokers as more susceptible to the negative health effects of UPF consumption on colorectal neoplasia.

Highlights

Colorectal cancer (CRC) is the world’s third most common cancer and the fourth most deadly cancer, with almost 900,000 deaths annually [1,2]
High ultra-processed foods (UPFs) intake was significantly associated with male gender
Unhealthy lifestyles, including smoking, physical inactivity, and obesity, tended to be higher, and the consumption of a healthy diet tended to be lower among participants consuming high UPF, but these differences were not statistically significant

Summary

Introduction

Colorectal cancer (CRC) is the world’s third most common cancer and the fourth most deadly cancer, with almost 900,000 deaths annually [1,2]. In addition to a genetic background, it has been shown that metabolic profile [3], lifestyle [4], dietary habits [5,6], and smoking [4,7] are strongly and independently associated with colorectal polyps, the direct precursors of CRC. Smoking and dietary factors have been reported to interact in their association with colorectal neoplasia [8,9,10]. According to the Food and Agriculture Organization of the United Nations, food processing includes physical, biological, and chemical techniques, used to prepare ready to eat, drink, or heat foods and beverages. The most common UPFs are snacks, drinks, and ready-to-eat meals

Objectives

Methods

Results

Discussion

Conclusion