Dietary flavonoids and colorectal adenoma recurrence in the polyp prevention trial

Gerd Bobe, Leah B. Sansbury, Paul S. Albert, Amanda J. Cross, Lisa Kahle, Jason Ashby, Martha L. Slattery, Bette Caan, Electra Paskett, Frank Iber, James Walter Kikendall, Michael P Lance, Cassandra Daston, James R. Marshall, Arthur Schatzkin, Elaine Lanza

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

Two recent case-control studies suggested that some flavonoid subgroups may play a role in preventing colorectal cancer. Previous prospective cohort studies generally reported no association; however, only a small subset of flavonoids was evaluated and partial flavonoid databases were used. We used the newly constructed U.S. Department of Agriculture flavonoid database to examine the association between consumption of total flavonoids, 6 flavonoid subgroups, and 29 individual flavonoids with adenomatous polyp recurrence in the Polyp Prevention Trial. The Polyp Prevention Trial was a randomized dietary intervention trial, which examined the effectiveness of a low-fat, high-fiber, high-fruit, and high-vegetable diet on adenoma recurrence. Intakes of flavonoids were estimated from a food frequency questionnaire. Multivariate logistic regression models (adjusted for age, body mass index, sex, regular non-steroidal anti-inflammatory use, and dietary fiber intake) were used to estimate odds ratios and 95% confidence intervals for both any and advanced adenoma recurrence within quartiles of energy-adjusted flavonoid intake (baseline, during the trial, and change during the trial). Total flavonoid intake was not associated with any or advanced adenoma recurrence. However, high intake of flavonols, which are at greater concentrations in beans, onions, apples, and tea, was associated with decreased risk of advanced adenoma recurrence (4th versus 1st quartile during the trial; odds ratio, 0.24; 95% confidence interval, 0.11, 0.53; Ptrend = 0.0006). Similar inverse associations were observed to a smaller extent for isoflavonoids, the flavonol kaempferol, and the isoflavonoids genistein and formononetin. Our data suggest that a flavonol-rich diet may decrease the risk of advanced adenoma recurrence.

Original languageEnglish (US)
Pages (from-to)1344-1353
Number of pages10
JournalCancer Epidemiology Biomarkers and Prevention
Volume17
Issue number6
DOIs
StatePublished - Jun 2008

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Polyps
Flavonoids
Adenoma
Recurrence
Logistic Models
Odds Ratio
Databases
Confidence Intervals
Diet
Adenomatous Polyps
United States Department of Agriculture
Flavonols
Onions
Genistein
Dietary Fiber
Malus
Tea
Vegetables
Case-Control Studies
Colorectal Neoplasms

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Bobe, G., Sansbury, L. B., Albert, P. S., Cross, A. J., Kahle, L., Ashby, J., ... Lanza, E. (2008). Dietary flavonoids and colorectal adenoma recurrence in the polyp prevention trial. Cancer Epidemiology Biomarkers and Prevention, 17(6), 1344-1353. https://doi.org/10.1158/1055-9965.EPI-07-0747

Dietary flavonoids and colorectal adenoma recurrence in the polyp prevention trial. / Bobe, Gerd; Sansbury, Leah B.; Albert, Paul S.; Cross, Amanda J.; Kahle, Lisa; Ashby, Jason; Slattery, Martha L.; Caan, Bette; Paskett, Electra; Iber, Frank; Kikendall, James Walter; Lance, Michael P; Daston, Cassandra; Marshall, James R.; Schatzkin, Arthur; Lanza, Elaine.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 17, No. 6, 06.2008, p. 1344-1353.

Research output: Contribution to journalArticle

Bobe, G, Sansbury, LB, Albert, PS, Cross, AJ, Kahle, L, Ashby, J, Slattery, ML, Caan, B, Paskett, E, Iber, F, Kikendall, JW, Lance, MP, Daston, C, Marshall, JR, Schatzkin, A & Lanza, E 2008, 'Dietary flavonoids and colorectal adenoma recurrence in the polyp prevention trial', Cancer Epidemiology Biomarkers and Prevention, vol. 17, no. 6, pp. 1344-1353. https://doi.org/10.1158/1055-9965.EPI-07-0747
Bobe, Gerd ; Sansbury, Leah B. ; Albert, Paul S. ; Cross, Amanda J. ; Kahle, Lisa ; Ashby, Jason ; Slattery, Martha L. ; Caan, Bette ; Paskett, Electra ; Iber, Frank ; Kikendall, James Walter ; Lance, Michael P ; Daston, Cassandra ; Marshall, James R. ; Schatzkin, Arthur ; Lanza, Elaine. / Dietary flavonoids and colorectal adenoma recurrence in the polyp prevention trial. In: Cancer Epidemiology Biomarkers and Prevention. 2008 ; Vol. 17, No. 6. pp. 1344-1353.
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abstract = "Two recent case-control studies suggested that some flavonoid subgroups may play a role in preventing colorectal cancer. Previous prospective cohort studies generally reported no association; however, only a small subset of flavonoids was evaluated and partial flavonoid databases were used. We used the newly constructed U.S. Department of Agriculture flavonoid database to examine the association between consumption of total flavonoids, 6 flavonoid subgroups, and 29 individual flavonoids with adenomatous polyp recurrence in the Polyp Prevention Trial. The Polyp Prevention Trial was a randomized dietary intervention trial, which examined the effectiveness of a low-fat, high-fiber, high-fruit, and high-vegetable diet on adenoma recurrence. Intakes of flavonoids were estimated from a food frequency questionnaire. Multivariate logistic regression models (adjusted for age, body mass index, sex, regular non-steroidal anti-inflammatory use, and dietary fiber intake) were used to estimate odds ratios and 95{\%} confidence intervals for both any and advanced adenoma recurrence within quartiles of energy-adjusted flavonoid intake (baseline, during the trial, and change during the trial). Total flavonoid intake was not associated with any or advanced adenoma recurrence. However, high intake of flavonols, which are at greater concentrations in beans, onions, apples, and tea, was associated with decreased risk of advanced adenoma recurrence (4th versus 1st quartile during the trial; odds ratio, 0.24; 95{\%} confidence interval, 0.11, 0.53; Ptrend = 0.0006). Similar inverse associations were observed to a smaller extent for isoflavonoids, the flavonol kaempferol, and the isoflavonoids genistein and formononetin. Our data suggest that a flavonol-rich diet may decrease the risk of advanced adenoma recurrence.",
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