BackgroundIron is an essential micronutrient with differing intake patterns and metabolism between men and women. Epidemiologic evidence on the association of dietary iron and its heme and non-heme components with colorectal cancer (CRC) development is inconclusive.MethodsWe examined baseline dietary questionnaire-assessed intakes of total, heme, and non-heme iron and CRC risk in the EPIC cohort. Sex-specific multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were computed using Cox regression. We modelled substitution of a 1 mg/day of heme iron intake with non-heme iron using the leave one-out method.ResultsOf 450,105 participants (318,680 women) followed for 14.2 +/- 4.0 years, 6162 (3511 women) developed CRC. In men, total iron intake was not associated with CRC risk (highest vs. lowest quintile, HRQ5vs.Q1:0.88; 95%CI:0.73, 1.06). An inverse association was observed for non-heme iron (HRQ5vs.Q1:0.80, 95%CI:0.67, 0.96) whereas heme iron showed a non-significant association (HRQ5vs.Q1:1.10; 95%CI:0.96, 1.27). In women, CRC risk was not associated with intakes of total (HRQ5vs.Q1:1.11, 95%CI:0.94, 1.31), heme (HRQ5vs.Q1:0.95; 95%CI:0.84, 1.07) or non-heme iron (HRQ5vs.Q1:1.03, 95%CI:0.88, 1.20). Substitution of heme with non-heme iron demonstrated lower CRC risk in men (HR:0.94; 95%CI: 0.89, 0.99).ConclusionsOur findings suggest potential sex-specific CRC risk associations for higher iron consumption that may differ by dietary sources.
Dietary intake of total, heme and non-heme iron and the risk of colorectal cancer in a European prospective cohort study / Aglago, Elom K; Cross, Amanda J; Riboli, Elio; Fedirko, Veronika; Hughes, David J; Fournier, Agnes; Jakszyn, Paula; Freisling, Heinz; Gunter, Marc J; Dahm, Christina C; Overvad, Kim; Tjønneland, Anne; Kyrø, Cecilie; Boutron-Ruault, Marie-Christine; Rothwell, Joseph A; Severi, Gianluca; Katzke, Verena; Srour, Bernard; Schulze, Matthias B; Wittenbecher, Clemens; Palli, Domenico; Sieri, Sabina; Pasanisi, Fabrizio; Tumino, Rosario; Ricceri, Fulvio; Bueno-de-Mesquita, Bas; Derksen, Jeroen W G; Skeie, Guri; Jensen, Torill Enget; Lukic, Marko; Sánchez, Maria-Jose; Amiano, Pilar; Colorado-Yohar, Sandra; Barricarte, Aurelio; Ericson, Ulrika; van Guelpen, Bethany; Papier, Keren; Knuppel, Anika; Casagrande, Corinne; Huybrechts, Inge; Heath, Alicia K; Tsilidis, Konstantinos K; Jenab, Mazda. - In: BRITISH JOURNAL OF CANCER. - ISSN 1532-1827. - STAMPA. - 128:(2023), pp. 1529-1540. [10.1038/s41416-023-02164-7]
Dietary intake of total, heme and non-heme iron and the risk of colorectal cancer in a European prospective cohort study
Severi, Gianluca;
2023
Abstract
BackgroundIron is an essential micronutrient with differing intake patterns and metabolism between men and women. Epidemiologic evidence on the association of dietary iron and its heme and non-heme components with colorectal cancer (CRC) development is inconclusive.MethodsWe examined baseline dietary questionnaire-assessed intakes of total, heme, and non-heme iron and CRC risk in the EPIC cohort. Sex-specific multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were computed using Cox regression. We modelled substitution of a 1 mg/day of heme iron intake with non-heme iron using the leave one-out method.ResultsOf 450,105 participants (318,680 women) followed for 14.2 +/- 4.0 years, 6162 (3511 women) developed CRC. In men, total iron intake was not associated with CRC risk (highest vs. lowest quintile, HRQ5vs.Q1:0.88; 95%CI:0.73, 1.06). An inverse association was observed for non-heme iron (HRQ5vs.Q1:0.80, 95%CI:0.67, 0.96) whereas heme iron showed a non-significant association (HRQ5vs.Q1:1.10; 95%CI:0.96, 1.27). In women, CRC risk was not associated with intakes of total (HRQ5vs.Q1:1.11, 95%CI:0.94, 1.31), heme (HRQ5vs.Q1:0.95; 95%CI:0.84, 1.07) or non-heme iron (HRQ5vs.Q1:1.03, 95%CI:0.88, 1.20). Substitution of heme with non-heme iron demonstrated lower CRC risk in men (HR:0.94; 95%CI: 0.89, 0.99).ConclusionsOur findings suggest potential sex-specific CRC risk associations for higher iron consumption that may differ by dietary sources.I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.