Adherence to the Paleolithic diet and Paleolithic-like lifestyle reduce the risk of colorectal cancer in the United States: a prospective cohort study

作者全名："Xiao, Yi; Wang, Yaxu; Gu, Haitao; Xu, Zhiquan; Tang, Yunhao; He, Hongmei; Peng, Linglong; Xiang, Ling"

作者地址："[Xiao, Yi; Wang, Yaxu; Gu, Haitao; Xu, Zhiquan; Tang, Yunhao; He, Hongmei; Peng, Linglong] Chongqing Med Univ, Affiliated Hosp 2, Dept Gastrointestinal Surg, 288, Tianwen Ave, Chongqing 400010, Peoples R China; [Xiang, Ling] Chongqing Med Univ, Affiliated Hosp 2, Dept Clin Nutr, Chongqing, Peoples R China"

通信作者："Peng, LL (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Gastrointestinal Surg, 288, Tianwen Ave, Chongqing 400010, Peoples R China.; Xiang, L (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Clin Nutr, Chongqing, Peoples R China."

来源：JOURNAL OF TRANSLATIONAL MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001029435600002

JCR分区：Q1

影响因子：6.1

年份：2023

卷号：21

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Paleolithic diet; Paleolithic-like lifestyle; Colorectal cancer; Epidemiology; Cohort study

摘要："BackgroundThe plant-based paleolithic diet (PD) and the paleolithic-like lifestyle (PLL) may reduce the risk of chronic diseases, including colorectal adenomas. These dietary and lifestyle approaches are proposed to exert their effects through mechanisms such as reducing inflammation, oxidative stress, and insulin levels. However, whether PD and PLL is associated with the risk of colorectal cancer (CRC) has not been determined.MethodsA cohort of 74,721 individuals who participated in the PLCO study were included in this analysis. Adherence to the PD and PLL was assessed using PD and PLL scores, where higher scores indicated greater adherence. Multivariable Cox models were utilized to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of CRC and its subsites (proximal colon cancer and distal CRC). Subgroup analyses were conducted to identify potential effect modifiers.ResultsDuring a mean follow-up of 9.2 years, a total of 694 CRC cases were identified. Participants in the highest compared with the lowest quartiles of PD score had a lower risk of CRC (Q4 vs Q1: HR 0.76, 95% CI 0.61-0.95, P-trend = 0.009) and proximal colon cancer (Q4 vs Q1: HR 0.73, 95% CI 0.55-0.97, P-trend = 0.02). A stronger inverse association was observed for PLL score with the risk of CRC (Q4 vs Q1: HR 0.64, 95% CI 0.51-0.81, P-trend < 0.001), proximal colon (Q4 vs Q1: HR 0.62, 95% CI 0.46-0.83, P-trend = 0.001) and distal CRC (Q4 vs Q1: HR 0.69, 95% CI 0.48-0.98, P-trend = 0.03). Subgroup analyses revealed the inverse association of PD score with the risk of CRC was more pronounced in participants with BMI < 30 (Q4 vs Q1: HR 0.68, 95% CI 0.53-0.87) than in those with BMI & GE; 30 (Q4 vs Q1: HR 1.07, 95% CI 0.68-1.67) (P-interaction = 0.02).ConclusionsOur findings suggest that adhering to the PD and PLL could be a new option to reduce CRC risk."

基金机构： [PLCO-1215]

基金资助正文：AcknowledgementsWe sincerely appreciate the PLCO study group and PLCO participants. This research has been conducted using the PLCO resource (https://cdas.cancer.gov/plco/) under application number PLCO-1215.