Lifestyle and colorectal cancer: A case-control study

Evaluating the Reproducibility and Verifiability of Nutrition Research: A Case Study of Studies Assessing the Relationship Between Potatoes and Colorectal Cancer

Background

The credibility of nutritional research is dependent on the rigor with which studies are conducted and the ability for independent assessment to be performed. Despite the importance of these, more work is needed in the field of nutrition to buttress the trustworthiness of nutrition research.

Objective

To develop and apply a process for evaluating the rigor, reproducibility, and verifiability of nutritional research, using the relationship between potato consumption and Colorectal cancer (CRC) as a case study.

Methods

We updated existing systematic reviews to include studies on potatoes and CRC, assessing their design, execution, and reporting quality. We attempted to reproduce and verify the results of included studies by requesting raw data from authors and following statistical methods as described in the publications. Rigor was evaluated using four different tools: ROBINS-E, STROBE-Nut, Newcastle-Ottawa scale, and additional criteria related to transparency.

Results

Eighteen studies were included, none of which publicly share data. We managed to access data for only two studies, successfully reproducing and verifying the results for one. The majority of studies exhibited a high risk of bias, with significant limitations in reporting quality and methodological rigor.

Conclusions

Research on the relationship between potato consumption and CRC risk is insufficiently reproducible and verifiable, undermining the trustworthiness of its findings. This study highlights the need for improving transparency, data sharing, and methodological rigor in nutritional research. Our approach provides a model for assessing the credibility of research in other areas of nutrition.

Association between being breastfed in infancy and adult colorectal cancer risk among Japanese men and women

It has been postulated that being breastfed in infancy affects not only health status in childhood but also disease risk in adulthood. To investigate the association of being breastfed with the risks of adult colorectal cancer and benign tumor, we conducted a case-control study including 1190 colorectal cancer and 1585 benign tumor cases and 5301 controls, admitted to a single hospital in Miyagi Prefecture, Japan, between 1997 and 2013. History of having been breastfed was assessed using a self-administered questionnaire, and odds ratios (ORs) were estimated using unconditional logistic regression. There was no association between being breastfed and colorectal cancer risk (breastfed versus formula-only fed, OR = 1.21; 95% CI 0.87-1.67). There was also no association with the risk of benign tumor (OR = 1.04). On the other hand, analyses stratified by sex and birth year found heterogeneous associations. Women born after 1950 who had been breastfed tended to have increased risks of colorectal cancer (OR = 1.58) and benign tumor (OR = 1.51) relative to those who had been formula-only fed, although not statistically significant. In men born after 1950, being breastfed was associated with a significantly decreased risk of benign tumor (OR = 0.57; 95% CI 0.33-0.98).

Potato Consumption and Risk of Site-Specific Cancers in Adults: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies

The etiology of cancer type may vary significantly due to anatomy, embryology, and physiology of the cancer site. Although the association between potato consumption and colorectal cancer (CRC) was summarized in a 2018 meta-analysis of 5 cohort studies, to the best of our knowledge, no meta-analysis has evaluated potato consumption in relation to multiple cancer sites in adults. Medline/PubMed, ISI Web of Knowledge, Scopus, and the Cochrane Database of Systematic Reviews were searched for relevant publications through August 2020. We selected cohort or case-control studies conducted in adults that reported risk estimates (relative risk [RRs], HRs, and ORs) of potato intake for any cancer type. Random effects meta-analyses compared high and low intake categories. Twenty prospective cohort studies (total n = 785,348) including 19,882 incident cases, and 36 case-control studies (21,822 cases; 66,502 controls) were included. Among cohort studies, we did not find an association between high versus low intake of total potato (white and yellow) consumption and overall cancers: 1.04 (95% CI: 0.96, 1.11; tau2 = 0.005, n = 18). We found no relation between total potato consumption (high compared with low intake) and risk of CRC, pancreatic cancer, colon, gastric, breast, prostate, kidney, lung, or bladder cancer in cohort or case-control studies. We did not find an association between high versus low consumption of potato preparations (boiled/fried/mashed/roasted/baked) and risk of gastrointestinal-, sex-hormone-, or urinary-related cancers in cohort or case-control studies. Certainty of the evidence was low for total cancer, CRC, colon, rectal, renal, pancreatic, breast, prostate, and lung cancer and very low for gastric and bladder cancer. In conclusion, potato intake or potato preparations were not associated with multiple cancer sites when comparing high and low intake categories. This finding was consistent with the findings from the 2018 meta-analysis regarding potato intake and risk of CRC.

Impact of seaweed intake on health

Seaweeds contain minerals, vitamins, soluble dietary fibers, and flavonoids, which are regarded as preventive agents against lifestyle-related diseases. Seaweeds are consumed commonly in East Asian countries including Japan. Thus, intake of seaweeds might contribute to Japanese longevity via prevention of lifestyle-related diseases. Recently, two large Japanese cohort studies have reported the association of seaweed intake with reduced risk of cardiovascular diseases. On the other hand, seaweeds also contain iodine and heavy metals such as arsenic species, which are considered to have adverse effects on health. We here reviewed studies of the association between seaweed intake and mortality from or incidence of cancer and cardiovascular diseases, and their risk factors such as blood pressure or serum lipids. We also summarized the adverse effects of iodine and arsenic species in seaweeds. Although seaweeds have not been widely consumed in Western countries, dietary diversification and an increased proportion of immigrants from East Asia may increase seaweed consumption in those countries. Further epidemiological studies including observational and interventional studies are necessary to clarify the effects of seaweeds on disease and health.

Associations of Japanese food intake with survival of stomach and colorectal cancer: A prospective patient cohort study

Dietary factors may affect the prognosis of digestive tract cancer, but evidence has been sparse. We investigated the association between pretreatment intake of 6 Japanese foods (including soy food, miso [soybean paste] soup and seaweed) and the risk of death among patients with histologically confirmed major digestive tract cancers (stomach, 1931; colon, 793; rectum, 510) diagnosed during 1997‐2013 at a single institution in Japan. Pretreatment dietary intake was assessed using a food frequency questionnaire, and the patients were followed until December 2016. The Cox proportional hazards model was used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Among the patients with stomach cancer, frequent intake of soy food was inversely associated with the risk of all‐cause (P_trend for four frequency groups = 0.01; HR = 0.72, 95% CI: 0.50‐1.04 for highest vs lowest group) and stomach cancer (P_trend = 0.03; HR = 0.63, 95% CI: 0.40‐0.99) death. A similar inverse association was also found for intake of miso soup. In contrast, frequent seaweed intake was inversely associated with the risk of all‐cause death among the patients with colon cancer (P_trend = 0.03). Rectal cancer patients who had frequently consumed seaweed tended to have a lower risk of rectal cancer death (P_trend = 0.02). These findings indicate that pretreatment intake of Japanese foods such as soybean products and seaweed may have favorable effects on patient survival of stomach and colorectal cancer, although this needs to be confirmed by further research.

Vegetable consumption and colorectal cancer risk: an evaluation based on a systematic review and meta-analysis among the Japanese population

OBJECTIVE

The association between vegetable consumption and colorectal cancer risk remains unclear and may differ by region. We performed a systematic review and meta-analysis of epidemiologic studies on this issue among the Japanese population.

METHODS

A systematic review and meta-analysis was performed by searching MEDLINE through PubMed and the Ichushi database for cohort and case-control studies that were published by the end of December 2014. Associations were evaluated based on their magnitude and the strength of the evidence. Meta-analysis was performed by using the random effects model to estimate the summary relative risk with 95% confidence interval according to the study design. The final judgment was made based on a consensus of the research group members with consideration for both epidemiological evidence and biological plausibility.

RESULTS

We identified six cohort studies and 11 case-control studies on vegetable intake and colorectal cancer among the Japanese population. Of the cohort studies, one study showed a weak inverse association with colon cancer and another study showed a weak positive association with rectal cancer in men, but other studies found no associations between vegetable consumption and colon and rectal cancers. With regard to case-control studies, one study found a strong inverse association with colon cancer, and three studies showed a weak-to-strong inverse association with rectal cancer. In meta-analysis, the summary relative risk (95% confidence interval) for the highest vs. the lowest categories of vegetable consumption were 1.00 (0.92-1.10) and 0.75 (0.59-0.96) for cohort and case-control studies, respectively.

CONCLUSIONS

There was insufficient evidence to support an association between intake of vegetables and the risk of colorectal cancer among the Japanese population.

Supplementation of Seaweeds Extracts Suppresses Azoxymethane-induced Aberrant DNA Methylation in Colon and Liver of ICR Mice

Background:

Seamustard and seatangle are commonly consumed seaweeds in Korea and rich sources of non-digestible polysaccharides which possess biological activities. However anti-mutagenic and anti-cancer activities of these seaweeds under physiological condition have not been clarified yet. The objective of this study was to investigate the effect of seaweeds consumption on azoxymethane (AOM) -induced DNA methylation at N⁷ and O⁶ position of guanine base, an indicator of DNA damage related to cancer initiation.

Methods:

Thirty ICR mice were divided into five groups and fed one of the following diets for two weeks: control diet, diet containing 10% water-soluble or water-insoluble fraction of seamustard or seatangle. After two weeks of experimental diet AOM was injected at 6 hours before sacrifice and N⁷-methylguanine (N⁷-meG) and O⁶-methylguanine (O⁶-meG) from the colon and liver DNA were quantified using a gas chromatography-mass spectroscopy.

Results:

Water-soluble fractions of both seamustard and seatangle significantly reduced AOM-induced production of N⁷-meG guanine in colon and liver. Also water-soluble fractions of these seaweeds suppressed the level of methylation at O⁶-guanine of colon and liver directly responsible for tumorigenesis. While water-insoluble fraction of seamustard suppressed the production of N⁷-meG in liver this seaweed fraction decreased O⁶-meG and the ratio of O⁶/N⁷-meG in liver. Water insoluble fraction of seatangle decreased both O⁶- and N⁷-meG in colon and liver. Supplementation of all seaweeds extracts increased fecal weight of animals and the increase of fecal weight by water-insoluble fraction of seaweeds were higher than that by water-soluble fraction.

Conclusion:

Seamustard and seatangle intake may effectively prevent colon and liver carcinogenesis by decreasing DNA damage and the mechanism of inhibiting carcinogenesis by seaweeds in a long term study are warranted.

Fish consumption and colorectal cancer risk: an evaluation based on a systematic review of epidemiologic evidence among the Japanese population

OBJECTIVE

The association between fish consumption and colorectal cancer risk remains inconclusive. The present study systematically reviewed and meta-analyzed epidemiologic data on the association between fish consumption and colorectal cancer risk among Japanese.

METHODS

Original data were obtained from MEDLINE searched using PubMed or from searches of the Ichushi database, complemented with manual searches. The associations were evaluated based on the strength of evidence, the magnitude of association and biologic plausibility. Meta-analysis was conducted according to the study design.

RESULTS

Five cohort studies and 12 case-control studies were identified. Fish consumption was not significantly associated with colorectal, colon or rectal cancer risks. One cohort study showed a weak positive association with colorectal cancer, and another showed a weak inverse association with colon cancer in men and a moderate and weak inverse association with colon and rectal cancers in women. As regards case-control studies, four studies reported a weak inverse association, whereas one showed a weak positive association with colon cancer. Regarding rectal cancer, four case-control studies showed a weak inverse association, but two reported a weak-to-moderate positive association. The pooled relative risk/odds ratio (95% confidence interval) of colorectal cancer for the highest versus lowest category of fish consumption was 1.03 (0.89-1.18) and 0.84 (0.75-0.94) for cohort and case-control studies, respectively.

CONCLUSIONS

There was insufficient evidence to support an association between fish consumption and the risk of colorectal cancer among Japanese.

Antioxidant marine products in cancer chemoprevention

SIGNIFICANCE

Oxidative stress resulting from excessive reactive oxygen/nitrogen/electrophilic species (ROS/RNS/RES) can lead to diseases such as cancer. The health benefits of dietary fruits and vegetables with antioxidant potential have received a great deal of attention. On the other hand, marine botanicals have been less well characterized and still remain as terra incognita.

RECENT ADVANCES

In some parts of the world, appreciable quantities of seaweeds are consumed on a daily basis. Along with current globalization, cuisines using seaweeds are now being used throughout the world, sometimes considered as healthy delicacies. Thus, it is relevant to explore the medicinal and pharmacological properties of seaweeds, as well as the health ramifications of this dietary practice.

CRITICAL ISSUES

We currently review the antioxidant potential of seaweed components such as sulfated polysaccharides, phenolic compounds (phlorotannins and bromophenols), and fucoxanthins. In addition to seaweeds, the chemistry and antioxidant activities of some marine fungi and bacteria are described. Since antioxidants are considered promising cancer chemopreventive agents, the in vitro, in vivo, and clinical aspects of antioxidant marine products are presented, and potential implications are discussed.

FUTURE DIRECTIONS

Although some data suggest that health benefits are derived from the consumption of marine natural products, further epidemiological or clinical studies are needed to strengthen these observations. In addition, many studies have demonstrated the antioxidant effects of seaweeds with in vitro models, but further characterization of bioavailability is necessary to suggest the significance of these responses. It is also important to define the safety of some seaweeds containing inorganic arsenics.

Alcohol Drinking and Colorectal Cancer Risk: an Evaluation Based on a Systematic Review of Epidemiologic Evidence among the Japanese Population

BACKGROUND

It remains unclear whether alcohol drinking is causally associated with colorectal cancer. On the basis of a systematic review of epidemiological evidence, we evaluated this association among the Japanese population, who may be more susceptible to alcohol-related diseases than Western populations.

METHODS

Original data were obtained from searches of MEDLINE using PubMed, complemented with manual searches. The evaluation of associations was based on the strength of evidence and the magnitude of association, together with biological plausibility as previously evaluated by the International Agency for Research on Cancer.

RESULTS

We identified 5 cohort studies and 13 case-control studies. A moderate or strong positive association was observed between alcohol drinking and colon cancer risk in all large-scale cohort studies, with some showing a dose-response relation, and among several case-control studies. The risk of colon or colorectal cancer was increased even among moderate drinkers consuming <46 g of alcohol per day, levels at which no material increase in the risk was observed in a pooled analysis of Western studies. A positive association with rectal cancer was also reported, but it was less consistent, and the magnitude of the association was generally weaker compared with colon cancer.

CONCLUSION

We conclude that alcohol drinking probably increases the risk of colorectal cancer among the Japanese population. More specifically, the association for the colon is probable, whereas that for the rectum is possible.

Tobacco smoking and colorectal cancer risk: an evaluation based on a systematic review of epidemiologic evidence among the Japanese population

BACKGROUND

It is unclear whether tobacco smoking is related to colorectal cancer risk in Japan. We evaluated the association among the Japanese population based on a systematic review of epidemiologic evidence.

METHODS

Original data were obtained from searches of MEDLINE using PubMed, complemented with manual searches. The evaluation of associations was based on the strength of evidence and the magnitude of association, together with biological plausibility as previously evaluated by the International Agency for Research on Cancer.

RESULTS

A total of six cohort studies and 15 case-control studies were thus identified. A substantial degree of heterogeneity was observed in the association between smoking and colon cancer; most case-control studies published before 1994 reported an inverse association, whereas studies conducted over the last decade did not find any significant association. Recent cohort studies have shown a non-significant 20-40% increase in colon cancer risk associated with current smoking. Several recent case-control studies and some cohort studies have identified a weak to strong positive association between smoking and rectal cancer.

CONCLUSION

We conclude that tobacco smoking possibly increases the risk of colorectal cancer among the Japanese population. More specifically, tobacco smoking may possibly increase the risk of rectal cancer; however, epidemiologic evidence is still insufficient to demonstrate any clear association with colon cancer.