Re: Br J Cancer 2005 May 9;92(9)

[Guest guest]

Hi Al:

Interesting studies. Thank you. And presumably the benefit of the

whole grains against colon cancer is not derived from the endosperm

(something probably everyone here can agree with!).

So it is either the bran or the germ.

Most probably the bran. Including oat bran, rice bran,

psyllium, ...........etc..

This stuff is really interesting because, for males at least, the

reduction of prostate cancer and colon cancer from major risks to

minor risks must considerably reduce our overall cancer

susceptibility.

Rodney.

--- In , Al Pater <old542000@y...>

wrote:

> Hi All,

>

> Br J Cancer 2005 May 9;92(9) is in and three abstracts for papers

that are

> pdf-available are summarized below.

>

> Medline has yet to assemble the abstracts into the present issue of

the journal.

>

> For the first paper, it may be the more significant report for us.

It was a

> prospective study. Whole grain consumption level was inversely

related

> prospectively with colon cancer. It may be well done and the

results not being

> significant for rectal versus colon cancer appeared to be

significant.

>

> Larsson SC, Giovannucci E, Bergkvist L, Wolk A.

> Whole grain consumption and risk of colorectal cancer: a population-

based cohort of

> 60,000 women.

> Br J Cancer. 2005 Apr 12; [Epub ahead of print]

> PMID: 15827552

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=pubmed & dopt=Abstract & list_uids=15827552

>

> ... follow-up of 14.8 years. High consumption of whole grains was

associated with a

> lower risk of colon cancer, but not of rectal cancer. The

multivariate rate ratio

> (RR) of colon cancer for the top category of whole grain

consumption (>/=4.5

> servings day(-1)) compared with the bottom category (<1.5 servings

day(-1)) was 0.67

> (95% confidence interval (CI), 0.47-0.96; P-value for trend=0.06).

The corresponding

> RR after excluding cases occurring within the first 2 years of

follow-up was 0.65

> (95% CI, 0.45-0.94; P-value for trend=0.04).

>

> ... Dietary assessment

>

> Dietary information was derived from a 67-item food-frequency

questionnaire

> administered at baseline. We asked participants to indicate their

average

> consumption of each food item during the previous 6 months.

Participants could

> choose from eight frequency categories, ranging from never/seldom

to four or more

> times per day. Whole grain foods included hard whole grain rye

bread (such as Wasa

> bread), soft whole grain bread, porridge, and cold breakfast

cereals. Refined grains

> included soft white bread, pasta, rice, pancakes or waffles, and

sweet buns or

> biscuits. We computed nutrient intakes by multiplying the

consumption frequency of

> each food item by the nutrient content of age-specific (<53, 53-65,

66 years)

> portion sizes. Values for nutrients in foods were obtained from the

Swedish National

> Food Administration Database (Bergström et al, 1991). All nutrients

and cereal fibre

> were energy-adjusted using the residual method (Willett and

Stampfer, 1986). In a

> validation study among 129 women randomly selected from the cohort,

Spearman

> correlation coefficients between data from four 1-week diet records

and the

> food-frequency questionnaire were 0.5 for hard whole grain rye

bread, 0.5 for soft

> whole grain bread, 0.6 for porridge, and 0.7 for cold breakfast

cereals.

>

> ... Table 1 Age-standardised baseline characteristics according to

consumption of

> whole grains^a

> ----------------------------------------------

> Categories of whole grain consumption (servings day-1)

> Characteristics <1.5 1.5-2.4 2.5-3.4 3.5-4.4 4.5

> ------------------------------------------

> Median consumption (servings day-1) 1.1 2.0 2.9 3.7 5.0

> Mean age at baseline (years) 52.7 53.3 53.8 54.4 55.4

> Mean body mass index (kg m-2) 25.0 24.8 24.6 24.6 24.2

> Education 12 years (%) 10.0 13.1 13.3 13.3 15.2

>

> Dietary intake

> Cereal fibre (mg day-1)b 7.9 10.7 11.5 12.2 12.7

> Saturated fat (g day-1)b 19.0 17.6 17.5 17.4 16.9

> Calcium (mg day-1)b 699 702 702 693 705

> Fruits (servings day-1) 1.2 1.5 1.6 1.6 1.8

> Vegetables (servings day-1) 1.4 1.7 1.8 1.9 2.1

> Red meat (servings week-1) 2.9 3.0 3.0 3.1 3.1

> ------------------------------------------

> ^a Whole grains include hard whole grain rye bread, soft whole

grain bread,

> porridge, and cold breakfast cereals.

> bNutrients adjusted to the rounded mean energy intake (1350 kcal

day-1) in the

> cohort at baseline.

>

> ... Table 2 RR and 95% CI of colorectal cancer according to

consumption of whole

> grains

> ----------------------------------------------------

> Categories of whole grain servings/day---

> <1.5 1.5-2.4 2.5-3.4 3.5-4.4 4.5---P-value for trend

> ---------------------------------------------------

> Colorectal cancer

> All cases

> Number of cases 187 201 191 132 94

> Age-adjusted RR (95% CI) 1.00 0.99 (0.81-1.22) 1.05 (0.85-1.29)

0.97 (0.77-1.22)

> 0.80 (0.62-1.03) 0.14

> Multivariate RR (95% CI)^a 1.00 1.00 (0.81-1.24) 1.05 (0.84-1.30)

0.96 (0.75-1.23)

> 0.80 (0.60-1.06) 0.16

> Excluding cases with follow-up <2 years

> Number of cases 176 187 175 119 84

> Multivariate RR (95% CI)^a 1.00 0.99 (0.80-1.23) 1.02 (0.81-1.29)

0.93 (0.72-1.21)

> 0.76 (0.56-1.03) 0.10

>

> Colon cancer^b

> All cases

> Number of cases 136 135 131 88 57

> Age-adjusted RR (95% CI) 1.00 0.92 (0.72-1.16) 1.00 (0.78-1.28)

0.90 (0.68-1.18)

> 0.67 (0.49-0.91) 0.03

> Multivariate RR (95% CI)^a 1.00 0.94 (0.73-1.21) 1.02 (0.79-1.33)

0.91 (0.67-1.23)

> 0.67 (0.47-0.96) 0.06

> Excluding cases with follow-up <2 years

> Number of cases 129 125 124 79 52

> Multivariate RR (95% CI)^a 1.00 0.91 (0.70-1.18) 1.02 (0.78-1.34)

0.86 (0.63-1.18)

> 0.65 (0.45-0.94) 0.04

>

> Rectal cancer^b

> All cases

> Number of cases 50 66 57 43 36

> Age-adjusted RR (95% CI) 1.00 1.22 (0.84-1.78) 1.14 (0.77-1.68)

1.17 (0.77-1.78)

> 1.16 (0.75-1.80) 0.61

> Multivariate RR (95% CI)^a 1.00 1.17 (0.80-1.72) 1.09 (0.72-1.64)

1.09 (0.69-1.72)

> 1.11 (0.67-1.83) 0.85

> Excluding cases with follow-up <2 years

> Number of cases 46 62 48 39 31

> Multivariate RR (95% CI)^a 1.00 1.21 (0.81-1.81) 1.02 (0.66-1.58)

1.11 (0.69-1.79)

> 1.07 (0.62-1.82) 0.99

> ----------------------------------------------------

> ^a Multivariate RRs were adjusted for age, body mass index

(quartiles), education

> (less than high school, high school, or university), total energy

intake

> (continuous), and quartiles of intakes of saturated fat, calcium,

red meat, fruits,

> and vegetables.

> ^b Six cases diagnosed with both colon and rectal cancer are

excluded from

> subsite-specific analysis.

> RR=rate ratio; CI=confidence interval. ...

>

>

> For the second paper, the title may suffice. Depend on CR, not

fruit or vegetables

> for colorectal cancer prevention. However, pickled vegetables were

among the

> vegetable list.

>

> Tsubono Y, Otani T, Kobayashi M, Yamamoto S, Sobue T, Tsugane S.

> No association between fruit or vegetable consumption and the risk

of colorectal

> cancer in Japan.

> Br J Cancer. 2005 Apr 26; [Epub ahead of print]

> PMID: 15856039

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=pubmed & dopt=Abstract & list_uids=15856039

>

>

> For the third paper, the lower levels of cholesterol in CRONers may

prevent

> testicular cancer, if the study showing the cholesterol-cancer link

is to be brought

> further.

>

> Wirehn AB, Tornberg S, Carstensen J.

> Serum cholesterol and testicular cancer incidence in 45,000 men

followed for 25

> years.

> Br J Cancer. 2005 Apr 12; [Epub ahead of print]

> PMID: 15827555

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=pubmed & dopt=Abstract & list_uids=15827555

>

> In a 25-year follow-up study of 44,864 men with measured serum

cholesterol levels,

> the testicular cancer hazard ratios for the serum cholesterol

categories 5.7-6.9 and

> >/=7.0 mmol l(-1) vs the reference category (<5.7 mmol l(-1)) were

1.3 and 4.5,

> respectively; P-value for trend=0.005. ...

>

> Al Pater, PhD; email: old542000@y...

>

> __________________________________________________

>

[Guest guest]

Nothing in any of these three is inconsistent with the conclusions

of " The China Study " which I have mentioned earlier.

If increased consumption of whole grains results in decreased

consumption of animal protein, this is consistent. Lower cholesterol

would also be consistent with lower consumption of animal protein.

Especially be cautious of the Japanese vegetables-in-the-diet study.

Their vegetable consumption is typically so much higher than ours as

a fraction of total diet, that none of this may overlap the typical

US diet. That is - if the low end of the Japanese range is to eat

only twice as large a fraction of their diet in vegetables than the

average in the US - the study is only studying those who eat many

more vegetables in their diet than the typical US resident.

" The China Study " is critical of the results reported from the

(Framingham?) Nurses Study for similar reasons - because they are

typically consuming even more animal protein than the US average.

Since they (Nurses study and the Japanese one mentioned) are

epidemiological studies, you take whatever the data gives you, but it

does not necessarily cover the whole range of possible overall diet

choices.

Iris

[Guest guest]

Hi Iris:

There is a variety of ways of looking at these data. Another one is

to take a look at the baseline characteristics of the participants

and draw the conclusion that those who go out of their way to eat

large amounts of whole gains - whether they are truly the beneficial

factor or not - are the same people who do many things to try to

preserve their health. So, while it may be the whole grains that

confer the benefit (and if it is I would bet it is the bran), it may

possibly instead be one or several of their other behaviours.

Take a look at the data in Table 1. Those at the top of the whole

grain consumption spectrum, compared with those at the bottom, have

considerably more education, lower BMIs, consume more vegetables,

fruits and fiber, and less saturated fat ........... and,

curiously, eat somewhat more red meat.

I do not have an opinion as to which of these factors, if any, it is

that is responsible for the lower rate of colon cancer. But it

certainly does suggest that taking care about what one eats is

related to a lower colon cancer risk ............ which is good

news for us.

Rodney.

> Nothing in any of these three is inconsistent with the conclusions

> of " The China Study " which I have mentioned earlier.

>

> If increased consumption of whole grains results in decreased

> consumption of animal protein, this is consistent. Lower

cholesterol

> would also be consistent with lower consumption of animal protein.

>

> Especially be cautious of the Japanese vegetables-in-the-diet

study.

> Their vegetable consumption is typically so much higher than ours

as

> a fraction of total diet, that none of this may overlap the typical

> US diet. That is - if the low end of the Japanese range is to eat

> only twice as large a fraction of their diet in vegetables than

the

> average in the US - the study is only studying those who eat many

> more vegetables in their diet than the typical US resident.

>

> " The China Study " is critical of the results reported from the

> (Framingham?) Nurses Study for similar reasons - because they are

> typically consuming even more animal protein than the US average.

> Since they (Nurses study and the Japanese one mentioned) are

> epidemiological studies, you take whatever the data gives you, but

it

> does not necessarily cover the whole range of possible overall diet

> choices.

>

> Iris

[Guest guest]

Hi Al:

It is also interesting that the relative risks for colon cancer seem

to drop off sharply only, really, at the highest intake level. The

relative risk was reported to be a lot lower at the highest 5.0

servings a day than it was at a, fairly large, 3.7 servings. A much

bigger drop than the drop from zero servings to 3.7 servings.

I see that table 2 says that whole grains still appear to be

significant after adjusting for the other beneficial factors. Which

suggests my post questioning whether the whole grains truly were

responsible, may not be valid.

Rodney.

> >

> > If increased consumption of whole grains results in decreased

> > consumption of animal protein, this is consistent. Lower

cholesterol

> > would also be consistent with lower consumption of animal protein.

> >

>

> Hi All,

>

> I disagree.

>

> The original post said:

>

> " ^a Multivariate RRs were adjusted for age, body mass index

(quartiles), education

> (less than high school, high school, or university), total energy

intake

> (continuous), and quartiles of intakes of saturated fat, calcium,

red meat, fruits,

> and vegetables. "

>

> > " The China Study " is critical of the results reported from the

> > (Framingham?) Nurses Study for similar reasons - because they are

> > typically consuming even more animal protein than the US

average.

> > Since they (Nurses study and the Japanese one mentioned) are

> > epidemiological studies, you take whatever the data gives you,

but it

> > does not necessarily cover the whole range of possible overall

diet

> > choices.

>

> It was a well-done 14+ year prospective study. This is good, I

believe. A

> randomized control experiment can not be done.

>

> The nurses were highly health-conscious.

>

> Al Pater, PhD; email: old542000@y...

>

>

>

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