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American Journal of Clinical Nutrition, Vol. 74, No. 1, 141-148, July 2001
© 2001 American Society for Clinical Nutrition


Original Research Communication

Plant sterol intakes and colorectal cancer risk in the Netherlands Cohort Study on Diet and Cancer1,2,3

A Lena Normén1, Henny AM Brants1, Laura E Voorrips1, Henrik A Andersson1, Piet A van den Brandt1 and R Alexandra Goldbohm1

1 From the Department of Clinical Nutrition, Göteborg University, Göteborg, Sweden; the Department of Nutritional Epidemiology, TNO Nutrition and Food Research Institute, Zeist, Netherlands; and the Department of Epidemiology, Maastricht University, Maastricht, Netherlands.

Background: Plant sterols in vegetable foods might prevent colorectal cancer.

Objective: The objective was to study plant sterol intakes in relation to colorectal cancer risk in an epidemiologic study.

Design: The study was performed within the framework of the Netherlands Cohort Study on Diet and Cancer in 120852 subjects who completed a baseline questionnaire in 1986. After 6.3 y of follow-up, 620 colon and 344 rectal cancer cases were detected. A case-cohort approach was used to calculate confounder-adjusted rate ratios (RRs) and their 95% CIs for quintiles of plant sterol intake.

Results: The total mean (±SD) intake of campesterol, stigmasterol, ß-sitosterol, campestanol, and ß-sitostanol was 285 ± 97 mg/d. Major contributors to plant sterol intake were bread (38%), vegetable fats (26%), and fruit and vegetables (21%). For men, there was no clear association between intake of any of the plant sterols and colon cancer risk when age, smoking, alcohol use, family history of colorectal cancer, education level, and cholecystectomy were controlled for. Adjustment for energy did not alter the result. For rectal cancer, adjustment for energy resulted in positive associations between risk and campesterol and stigmasterol intakes. For women, there was no clear association between intake of any of the plant sterols and colorectal cancer risk.

Conclusion: A high dietary intake of plant sterols was not associated with a lower risk of colon and rectal cancers in the Netherlands Cohort Study on Diet and Cancer.

Key Words: Plant sterols • phytosterols • colon cancer • rectal cancer • bread • vegetable fat • prospective study • Netherlands Cohort Study on Diet and Cancer




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