Association between the 2018 WCRF/AICR and the Low-Risk Lifestyle Scores with Colorectal Cancer Risk in the Predimed Study
by
Laura Barrubés 1,2, Nancy Babio 1,2,*
, Pablo Hernández-Alonso 1,2,3,*, Estefania Toledo 2,4, Judith B. Ramírez Sabio 5,6, Ramón Estruch 2,7,8, Emilio Ros 2,8,9, Montserrat Fitó 2,10, Angel M Alonso-Gómez 2,11, Miquel Fiol 2,12, Jose Lapetra 2,13, Lluís Serra-Majem 2,14, Xavier Pintó 2,15, Miguel Ruiz-Canela 2,4, Dolores Corella 2,6, Olga Castañer 2,10, Manuel Macías-González 2,3 and Jordi Salas-Salvadó 1,2
Laura Barrubés 1,2, Nancy Babio 1,2,*, Pablo Hernández-Alonso 1,2,3,*, Estefania Toledo 2,4, Judith B. Ramírez Sabio 5,6, Ramón Estruch 2,7,8, Emilio Ros 2,8,9, Montserrat Fitó 2,10, Angel M Alonso-Gómez 2,11, Miquel Fiol 2,12, Jose Lapetra 2,13, Lluís Serra-Majem 2,14, Xavier Pintó 2,15, Miguel Ruiz-Canela 2,4, Dolores Corella 2,6, Olga Castañer 2,10, Manuel Macías-González 2,3 and Jordi Salas-Salvadó 1,2
1
Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Hospital Universitari San Joan de Reus, Institut d’Investigació Pere Virgili (IISPV), 43201 Reus, Spain
2
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
3
Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, University of Malaga (IBIMA), 29071 Málaga, Spain
4
Department of Preventive Medicine and Public Health, University of Navarra-Navarra Institute for Health Research, 31009 Pamplona, Spain
5
Oncology Service, Sagunto Hospital, 46520 Valencia, Spain
6
Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
7
Department of Internal Medicine, Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain
8
August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain
9
Lipid Clinic, Endocrinology & Nutrition Service, Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain
10
Cardiovascular Risk and Nutrition Research (REGICOR Group), Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain
11
Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01007 Vitoria-Gasteiz, Spain
12
Balearic Islands Health Research Institute (IdISBa) and Son Espases Hospital, 07120 Palma, Spain
13
Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud Universitario San Pablo, 41013 Sevilla, Spain
14
Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, 35017 Las Palmas, Spain
15
Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, 08907 Hospitalet de Llobregat, Spain
*
Authors to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(4), 1215; https://doi.org/10.3390/jcm9041215
Received: 27 March 2020 / Revised: 15 April 2020 / Accepted: 21 April 2020 / Published: 23 April 2020
(This article belongs to the Section Epidemiology & Public Health)
Limited longitudinal studies have been conducted to evaluate colorectal cancer (CRC) incidence based on the updated 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations or other global lifestyle indices, and none in aged populations at high cardiovascular risk. We aimed to assess the association between CRC incidence and adherence to two emerging lifestyles indices (2018 WCRF/AICR score and another low-risk lifestyle (LRL) score comprising smoking status, alcohol consumption, physical activity, diet, and body mass index) in the Spanish PREvencion con DIeta MEDiterranea (PREDIMED) cohort. We studied 7216 elderly men and women at high cardiovascular risk. The 2018 WCRF/AICR and LRL scores were calculated. Multivariable Cox proportional regression models were fitted to estimate the HRs (hazard ratios) and 95% confidence intervals (CIs) for incident CRC events. During a median interquartile range (IQR) follow-up of 6.0 (4.4–7.3) years, 97 CRC events were considered. A significant linear association was observed between each 1-point increment in the WCRF/AICR score (score range from 0 to 7) and CRC risk (HR (95% CI) = 0.79 (0.63–0.99)). Similarly, each 1-point increment in the LRL score (score range from 0 to 5) was associated with a 22% reduction in CRC risk (0.78 (0.64–0.96)). Adhering to emergent lifestyle scores might substantially reduce CRC incidence in elderly individuals. Further longitudinal studies, which take different lifestyle indexes into account, are warranted in the future.
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Keywords:
WCRF/AICR score; low-risk lifestyle index; colorectal cancer; PREDIMED; lifestyle patterns
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MDPI and ACS Style
Barrubés, L.; Babio, N.; Hernández-Alonso, P.; Toledo, E.; Ramírez Sabio, J.B.; Estruch, R.; Ros, E.; Fitó, M.; Alonso-Gómez, A.M.; Fiol, M.; Lapetra, J.; Serra-Majem, L.; Pintó, X.; Ruiz-Canela, M.; Corella, D.; Castañer, O.; Macías-González, M.; Salas-Salvadó, J. Association between the 2018 WCRF/AICR and the Low-Risk Lifestyle Scores with Colorectal Cancer Risk in the Predimed Study. J. Clin. Med. 2020, 9, 1215.
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