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Association of the inflammatory balance of diet and lifestyle with colorectal cancer among Korean adults: a case-control study
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Shinyoung Jun, Jeonghee Lee, Jae Hwan Oh, Hee Jin Chang, Dae Kyung Sohn, Aesun Shin, Jeongseon Kim
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Epidemiol Health. 2022;44:e2022084. Published online September 30, 2022
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DOI: https://doi.org/10.4178/epih.e2022084
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Abstract
OBJECTIVES
Dietary and lifestyle exposures may affect the risk of colorectal cancer (CRC) by promoting chronic inflammation. Therefore, we assessed the separate and joint associations of dietary and lifestyle inflammation scores (DIS and LIS, respectively) with CRC.
METHODS Data from 919 pathologically confirmed CRC cases and 1,846 age- and sex-matched controls recruited at the National Cancer Center Korea were analyzed. We calculated the DIS and LIS, which characterize the collective contributions of 19 dietary and 4 lifestyle factors, respectively, to systemic inflammation by applying weights based on high-sensitivity C-reactive protein. A higher score represented a higher balance of pro- to anti-inflammatory exposures. Unconditional logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for CRC risk compared across the DIS and LIS tertile categories, with the lowest tertile as the reference group.
RESULTS The highest DIS tertile had significantly increased odds of having CRC (OR, 2.65; 95% CI, 2.10 to 3.36), and the odds increased with increasing DIS. The highest LIS tertile group had 1.28-fold higher odds of having CRC (95% CI, 1.03 to 1.58). In the cross-classification analysis, the odds of having CRC increased as the DIS and LIS jointly increased until the DIS reached the highest tertile, where the risk was very high (3-fold or more) regardless of the LIS.
CONCLUSIONS In conclusion, a higher balance of pro-inflammatory relative to anti-inflammatory dietary and lifestyle factors, especially dietary factors, was associated with higher CRC risk among Korean adults.
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Summary
Korean summary
본 연구는 국립암센터에서 수집한 대장암 환자-대조군 데이터를 활용하여, 새롭게 개발된 식이 염증 지수(Dietary Inflammation Score, DIS) 및 생활습관 염증 지수(Lifestyle Inflammation Score, LIS)와 대장암 발생 위험 간의 연관성을 탐색하였다. 분석 결과, 식이 염증 지수 혹은 생활습관 염증 지수가 높은 집단에서 대장암 위험이 더 높아, 식이와 생활습관이 체내 염증 수준을 높여 대장암 발생 위험을 높일 가능성이 제기되었다
Key Message
Dietary inflammation score (DIS) and lifestyle inflammation score (LIS) quantify the collective effect of dietary and lifestyle factors, respectively, on systemic inflammation. In this case-control study, we assessed the associations of DIS and LIS with colorectal cancer risk among Korean adults. Our results suggest that a higher balance of pro-to anti-inflammatory dietary and lifestyle factors may be associated with higher risk for colorectal cancer. The findings from our study support that reducing inflammation through dietary or lifestyle changes could potentially reduce the risk for colorectal cancer.
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Gastric cancer risk is reduced by predominantly antioxidant factors in the oxidative balance: a hospital-based case-control study
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Jimi Kim, Jeonghee Lee, Il Ju Choi, Young Il Kim, Jeongseon Kim
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Epidemiol Health. 2022;e2022089. Published online October 17, 2022
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DOI: https://doi.org/10.4178/epih.e2022089
[Accepted]
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Abstract
Objectives
Gastric carcinogenesis is linked to oxidative stress from both exogenous and endogenous exposures. This study aims to determine the association between the risk of gastric cancer and the oxidative balance score (OBS) comprising antioxidant and pro-oxidant factors, including diet and lifestyle.
Methods For this hospital-based case-control study, 808 controls and 404 patients with gastric cancer who had clinical records indicating Helicobacter pylori infection and the histological subtype were recruited. The OBS was based on diet and lifestyle factors obtained from a 106-item semiquantitative food frequency questionnaire and a constructed questionnaire. Logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).
Results Higher OBS were associated with a reduced gastric cancer risk (OR, 95% CI T3 vs. T1 = 0.49, 0.33-0.71, P for trend < 0.001). In the subgroup analysis, antioxidant factors showed inverse associations with the gastric cancer risk (OR, 95% CI T3 vs. T1 = 0.53, 0.35-0.79, P for trend = 0.003). A stronger association with antioxidant factors was observed in patients with intestinal gastric cancer (OR, 95% CI T3 vs. T1 = 0.34, 0.19-0.62, P for trend < 0.001) and those with H. pylori infection (OR, 95% CI T3 vs. T1 = 0.57, 0.37-0.88, P for trend = 0.014).
Conclusions Antioxidant factors from diet and lifestyle predominantly reduce the risk of gastric cancer compared to pro-oxidant factors. A combined effect on oxidative stress, which involves an altered balance between antioxidants and pro-oxidants, is important to modulate the risk of gastric cancer.
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Korean summary
Key Message
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