Association between the 2018 WCRF/AICR and the Low-Risk Lifestyle Scores with Colorectal Cancer Risk in the Predimed Study
- PMID: 32340309
- PMCID: PMC7230705
- DOI: 10.3390/jcm9041215
Association between the 2018 WCRF/AICR and the Low-Risk Lifestyle Scores with Colorectal Cancer Risk in the Predimed Study
Abstract
Limited longitudinal studies have been conducted to evaluate colorectal cancer (CRC) incidence based on the updated 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations or other global lifestyle indices, and none in aged populations at high cardiovascular risk. We aimed to assess the association between CRC incidence and adherence to two emerging lifestyles indices (2018 WCRF/AICR score and another low-risk lifestyle (LRL) score comprising smoking status, alcohol consumption, physical activity, diet, and body mass index) in the Spanish PREvencion con DIeta MEDiterranea (PREDIMED) cohort. We studied 7216 elderly men and women at high cardiovascular risk. The 2018 WCRF/AICR and LRL scores were calculated. Multivariable Cox proportional regression models were fitted to estimate the HRs (hazard ratios) and 95% confidence intervals (CIs) for incident CRC events. During a median interquartile range (IQR) follow-up of 6.0 (4.4-7.3) years, 97 CRC events were considered. A significant linear association was observed between each 1-point increment in the WCRF/AICR score (score range from 0 to 7) and CRC risk (HR (95% CI) = 0.79 (0.63-0.99)). Similarly, each 1-point increment in the LRL score (score range from 0 to 5) was associated with a 22% reduction in CRC risk (0.78 (0.64-0.96)). Adhering to emergent lifestyle scores might substantially reduce CRC incidence in elderly individuals. Further longitudinal studies, which take different lifestyle indexes into account, are warranted in the future.
Keywords: PREDIMED; WCRF/AICR score; colorectal cancer; lifestyle patterns; low-risk lifestyle index.
Conflict of interest statement
The authors declare no conflict of interest.
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References
-
- World Cancer Research Fund/American Institute for Cancer Research Diet, Nutrition, Physical Activity and Cancer: A Global Perspective. [(accessed on 15 February 2020)];Continuous Update Project Expert Report. 2018 Available online: https://www.wcrf.org/dietandcancer.
-
- Schwingshackl L., Bogensberger B., Hoffmann G. Diet Quality as Assessed by the Healthy Eating Index, Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension Score, and Health Outcomes: An Updated Systematic Review and Meta-Analysis of Cohort Studies. J. Acad. Nutr. Diet. 2018;118:74–100.e11. doi: 10.1016/j.jand.2017.08.024. - DOI - PubMed
Grants and funding
- CB06/03/The Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN) is an initiative of the Spanish Instituto de Salud Carlos III (ISCIII) which is funded by FEDER "A way to make Europe"/"Investing in your future"
- RTIC G03/140 and RD 06/0045/It is supported by the official funding agency for biomedical research of the Spanish government, ISCIII, through grants provided to research networks specifically developed for the trial through CIBEROBN
- CNIC 06/2007/grants from the Centro Nacional de Investigaciones Cardiovasculares
- PI04-2239, PI05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI07/0473, PI10/01407, PI10/02658, PI11/01647, and PI11/02505; PI13/00462/Fondo de Investigación Sanitaria-Fondo Europeo de Desarrollo Regional
- AGL-2009-13906-C02 and AGL2010-22319-C03/Ministerio de Ciencia e Innovación
- PI0105/2007/Fundación Mapfre 2010, Consejería de Salud de la Junta de Andalucía
- PROMETEO17/2017/Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana
- 27/2011/Navarra Regional Government
- x/The Fundación Patrimonio Comunal Olivarero and Hojiblanca SA (Málaga, Spain), California Walnut Commission (Sacramento, CA), Borges SA (Reus, Spain), and Morella Nuts SA (Reus, Spain) donated the olive oil, walnuts, almonds, and hazelnuts, respectively, u
- x/J. Salas-Salvadó, the senior author/gratefully acknowledges the financial support by ICREA under the ICREA Academia programme.
- FPU 16/00165/L. Barrubés has been awarded a grant by the Spanish Ministry of Education, Culture and Sports
- RC-0001-2018 and C-0029-2023/MMG was the recipient of the Nicolas Monardes Programme from the "Servicio Andaluz de Salud, Junta de Andalucía", Spain