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Dietary patterns as identified by factor analysis and colorectal cancer among middle-aged Americans^1,2,3

¹ From the Division of Epidemiology and Community Health and The Masonic Cancer Center, University of Minnesota, Minneapolis, MN (AF); the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (TR, ML, and AS); Lund University, Department of Clinical Sciences, Malmo, Sweden (EW); the Department of Public Health and Primary Care, Cambridge University, Cambridge, United Kingdom (PNM); the Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD (JR and AFS); the Division of Cancer Prevention, National Cancer Institute, Bethesda, MD (VK); the Division of Epidemiology, Public Health & Primary Care, Imperial College London, London, United Kingdom (TM); and the Environmental Analysis Department, AARP, Washington, DC (ARH)

Background: Although diet has long been suspected as an etiological factor for colorectal cancer, studies of single foods and nutrients have provided inconsistent results.

Objective: We used factor analysis methods to study associations between dietary patterns and colorectal cancer in middle-aged Americans.

Design: Diet was assessed among 293 615 men and 198 767 women in the National Institutes of Health–AARP Diet and Health Study. Principal components factor analysis identified 3 primary dietary patterns: a fruit and vegetables, a diet foods, and a red meat and potatoes pattern. State cancer registries identified 2151 incident cases of colorectal cancer in men and 959 in women between 1995 and 2000.

Results: Men with high scores on the fruit and vegetable pattern were at decreased risk [relative risk (RR) for quintile (Q) 5 versus Q1: 0.81; 95% CI: 0.70, 0.93; P for trend = 0.004]. Both men and women had a similar risk reduction with high scores on the diet food factor: men (RR: 0.82; 95% CI: 0.72, 0.94; P for trend = 0.001) and women (RR: 0.87; 95% CI: 0.71, 1.07; P for trend = 0.06). High scores on the red meat factor were associated with increased risk: men (RR: 1.17; 95% CI: 1.02, 1.35; P for trend = 0.14) and women (RR: 1.48; 95% CI: 1.20, 1.83; P for trend = 0.0002).

Conclusions: These results suggest that dietary patterns characterized by a low frequency of meat and potato consumption and frequent consumption of fruit and vegetables and fat-reduced foods are consistent with a decreased risk of colorectal cancer.

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Defining dietary consumption: is the sum greater than its parts?

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