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Western diet may increase recurrence, mortality risk in patients with colon cancer
Higher intakes of meat, fat and grain associated with decreased disease-free, recurrence-free and overall survival.
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For patients treated for stage III colon cancer, a diet high in meat, fat, refined grains and dessert foods may increase the risk for cancer recurrence or death, according to results from a recent study.
Researchers conducted a prospective observational study of patients with stage III colon cancer. They analyzed data from 1,009 patients who were part of the Cancer and Leukemia Group B (CALGB) adjuvant therapy trial between April 1999 and May 2001. Patients answered a questionnaire about dietary intake during adjuvant therapy and six months after treatment. Researchers followed patients for cancer recurrence or death.
Results were published in the Journal of the American Medical Association.
Using factor analysis, researchers identified two major dietary patterns among respondents: the prudent and the Western. The prudent pattern was characterized by high intakes of fruits and vegetables, poultry and fish. The Western pattern was characterized by high intakes of meat, fat, refined grains and dessert.
At a median follow-up of 5.3 years, 324 patients had cancer recurrence, 223 died of cancer and 28 died without known cancer recurrence. The researchers observed an association between a higher intake of a Western diet after cancer diagnosis and significantly worse disease-free survival.
When the researchers compared patients with the lowest intakes of a Western diet with those with the highest intakes, they found that patients with the highest intakes had a decreased disease–free survival (HR=3.25; 95% CI, 2.04-5.19).
Overall survival
The researchers also found that the Western diet pattern was similarly associated with a detriment in recurrence-free survival (HR=2.85; 95% CI, 1.75-4.63) and overall survival (HR=2.32; 95% CI, 1.36-3.96) when they compared the patients with the highest and lowest intakes of the Western diet.
Sex, age, nodal stage, BMI, physical activity level, baseline performance status and treatment group did not significantly affect the reduction in disease-free survival among the patients.
The researchers observed no significant association between the prudent dietary pattern and cancer recurrence or mortality.
“The data suggest that a diet characterized by higher intakes of red and processed meats, sweets and desserts, french fries and refined grains increases the risk for cancer recurrence and decreases survival,” the researchers wrote. “Further analyses are underway to better delineate specific nutrients or food groupings that may have the strongest association.”
Editor’s note: These data are derived from a study of chemotherapy that was ultimately negative, so it shows that we can learn from negative trials. Often, patients with cancer ask us what they can do to prevent recurrence and we do not usually have an answer. This study will allow us to at least make a confident recommendation on diet patterns. – Alan Venook, MD
For more information:
- Meyerhardt JA, Niedzwiecki D, Hollis D, et al. Association of dietary patterns with cancer recurrence and survival in patients with stage III colon cancer. JAMA. 2007;298:754-764.