Abstract
White rice is a staple food for Japanese, a population at high risk for colorectal cancer (CRC). We investigated the association between white rice intake and CRC among Japanese Americans in the Multiethnic Cohort (MEC) study. The Multiethnic Cohort Study is a prospective study established in Hawaii and California in 1993-1996. Usual dietary intake was assessed by a validated quantitative food frequency questionnaire at baseline. Cox proportional hazards models were used to compute hazard ratios (HR) and 95% confidence intervals (CI) for quartiles of intake and to perform trend tests across sex-specific quartiles with adjustment for relevant confounders. We identified 1,553 invasive CRC cases among 49,136 Japanese Americans (23,595 men and 25,541 women) during a mean follow-up of 19 years. White rice consumption was not associated with overall CRC incidence in men (p-trend = 0.11) or women (p-trend = 0.56). After excluding participants with a history of diabetes, the inverse associations were significant for CRC (p-trend = 0.03, HR for quartile 4 (Q4) vs. 1 = 0.81; 95% CI: 0.64-1.03) and tumors of the distal colon (p-trend = 0.006, HR for Q4 vs. Q1: 0.66; 0.44-0.99) among men but not women. White rice consumption was not associated with an increased risk of overall CRC among Japanese Americans. An inverse association was observed with risk of CRC and distal colon cancer in men without a history of diabetes.
Highlights
White rice is a primary staple food for many people of Japanese ancestry and a main component of the traditional Japanese diet
Japanese Americans have experienced a very high colorectal cancer (CRC) incidence and are at increased CRC risk compared to Caucasians as demonstrated in the Multiethnic Cohort (MEC) Study.[23]
We hypothesized that white rice consumption may significantly increase the risk of incident CRC in men and women because white rice increases risk for T2DM, which is a known risk factor for CRC
Summary
White rice is a primary staple food for many people of Japanese ancestry and a main component of the traditional Japanese diet. Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second leading cause of cancer death in men and women in the United States.[6]. Lifestyle factors, such as obesity,[7,8] physical inactivity,[9,10] smoking,[11,12] alcohol consumption,[13,14] and dietary patterns low in dietary fiber,[15,16] calcium and vitamin D,17,18 and folate[19,20] and rich in red meat[21,22] may contribute to the rising risk for CRC across populations. Japanese Americans have experienced a very high CRC incidence and are at increased CRC risk compared to Caucasians as demonstrated in the Multiethnic Cohort (MEC) Study (age-adjusted RR 1.40; 95% confidence interval [CI], 1.21–1.61).[23]. We investigated the association between white rice intake and CRC among Japanese Americans in the Multiethnic Cohort (MEC) study
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