For more than 30 years, the associa...

For more than 30 years, the association between a lower risk of colorectal cancer and increased amounts of dietary fiber has been a matter of disputation Studies using different methodologies and issue measures have given contrasting ensues Two studies published in the same issue of Lancet close that dietary fiber intake is inversely related to the risk of large bowel cancer.

In the first consideration Peters and colleagues compared the fiber intake of about 34000 participants in a large cancer screening trial who had no polyp upon sigmoidoscopy with about 3,600 participants who were set up to have at least single in kind adenoma in the distal bowel. Questionnaires were used to gather sociodemographic information and detailed information about forage intake. The researchers calculated fiber intake and nutrient values for each participant using standardized techniques. The total dietary fiber intake ranged from 126 to 364 g by day. Participants with the highest fiber intake keeped to be older, male, and better educated. They also had better health habits (eg exercised more, smok les drank les alcohol, and were more likely to take aspirin, folate, and calcium).

The risk of adenoma was base to be inversely related to fiber intake. After multivariate analysis to adjust for other risk factors, participants in the highest quintile of fiber intake had a 27 percent decreased risk compared with participants in the lowest quintile. The inverse relationship was strongest for fiber derived from grains, cereals, and fruit.

In the other report, Bingham and colleagues described the relationship between dietary fiber and the incidence of colorectal cancer in more than 500000 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) consideration This study enrolled healthy adults 25 to 70 years of age living in 22 communities in 10 countries. The extensive data accumulateed included comprehensive dietary information. In the nearly 2 million person-years of accumulated follow-up since 1992 more than 1000 cases of colorectal cancer have been confirmed. The hazard ratio for the highest quintile of fiber intake (075) showed a significant reduction in risk. The protective result was dose-related and appeared to be operative for the two sides of the colon and for men and women The authors calculate that a mean intake of 35 g of fiber by day corresponded to a relative risk of 058 compared with the lowest quintile intake of 15 g by day. The protective effect appeared to be related to the total fiber intake regardless of the source of the fiber.

one as well as the other studies recommend increased fiber intake as a preventive measure against colon cancer. The EPIC application of mind stresses the need for change in population eating habits because a doubling of fiber intake could lead to a reduction of 40 percent in colorectal cancer risk.

Peter U et al. Dietary fibre and colorectal adenoma in a colorectal cancer early detection programme. Lancet May 3 2003;361:1491-5 and Bingham SA, et al. Dietary fibre in sustenance and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational cogitation Lancet May 3, 2003;361:1496-501.

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group