Colorectal cancer (CRC) is a high incidence cancer and health problem influenced by many factors emphasizes on the importance of identifying risk factors which can be modified. A dietary approach to stop hypertension (DASH) style promotes a balanced nutrition approach that might have effects on CRC. The aim of this study was to analyze existing evidence on the DASH diet's association with CRC.

Databases, including Scopus, Web of Science, and PubMed, were searched to identify eligible studies up to March 2025. Observational studies investigating the association between adherence to the DASH diet and CRC were included. Effect sizes (ESs) and their confidence intervals (CIs) from fully adjusted models were extracted for the meta-analysis. A random-effects model was employed to calculate the combined ES and assess the relationship between the DASH diet and CRC. The publication bias was assessed using Egger's test and heterogeneity between studies was examined using the I2 statistic.

Fourteen studies were included in this study. Adherence to DASH diet reduced CRC risk (RR = 0.81, 95% CI: 0.73-0.89). Subgroup analyses found consistent effects across cohorts and various factors, with no publication bias. For rectal cancer (RC), adherence to DASH dietary pattern reduced risk of RC (RR = 0.75, 95% CI: 0.66-0.86), particularly in males and cohort studies. Colon cancer risk was also reduced (RR = 0.83, 95% CI: 0.79-0.88), with stronger effects in males and cohort studies. For colorectal adenoma, DASH showed a significant risk reduction (RR = 0.42, 95% CI: 0.22-0.80).

Our results highlight that following the DASH diet has a significant effect on lowering the risk of CRC which aligns with previous research. These findings support recommendation of following the DASH diet pattern reduces the burden of CRC. PROSPERO, registration ID: CRD42024569140.

Colorectal cancer (CRC) is a major global health issue, with rising incidence and mortality rates. Dietary factors, especially whole grains consumption, are critical in determining CRC risk. Understanding CRC deaths and disability-adjusted life years (DALYs) related to low whole grains diets is important for prevention. The purpose of the study is to investigate temporal and geographic trends in CRC deaths and DALYs attributable to diet low in whole grains at the global, regional, and national levels from 1990 to 2021.

The data on CRC burden attributable to diet low in whole grains from 1990 to 2021 were extracted from the Global Burden of Diseases (GBD) 2021 database. We described the CRC burden attributable to diet low in whole grains across various years, genders, age groups (5-year age groups from 25 to 94 years and 95+ years), different Socio-demographic Index (SDI) regions and countries. To illustrate the temporal trends in the burden of CRC, we calculated the estimated annual percentage change (EAPC) from 1990 to 2021.

From 1990 to 2021, the global number of CRC deaths attributable to diet low in whole grains increased from 101,813 (95% UI: 42,588 to 151,170) to 186,257 (95% UI: 76,127 to 284,803), representing a 82.94% growth. Similarly, the number of DALYs increased from 2,540,867 (95% UI: 1,050,794 to 3,754,416) to 4,327,219 (95% UI: 1,754,865 to 6,578,232), representing a 70.30% growth. However, both the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) exhibited a decline, with an EAPC of -0.82 (95% CI: -0.85 to -0.78) and - 0.84 (95% CI: -0.87 to -0.81), respectively. The disease burden is heavier in high SDI and high-middle SDI regions. However, between 1990 and 2021, the only region where both ASMR and ASDR increased was low-middle SDI, while in all other regions, they showed a declining trend. In 2021, East Asia had the highest number of CRC deaths and DALYs attributable to diet low in whole grains at the regional level, followed by Western Europe and High-income North America. Additionally, the burden is greater among males and the elderly. Between 1990 and 2021, the number of CRC deaths attributable to diet low in whole grains rose by 102.13% among males and by 63.20% among females. Generally, both the global age-specific mortality rate and the DALYs rate tend to increase with age. SDI demonstrates a nonlinear "S"-shaped correlation with both ASMR and ASDR of CRC attributable to diet low in whole grains. In 2021, the EAPC in ASMR of CRC attributable to diet low in whole grains was negatively associated with SDI (R = -0.402, p < 0.001), reaching the highest EAPC at approximately SDI of 0.51 and the lowest at 0.85. Similarly, the correlation between EAPC in ASDR and SDI in 2021 exhibited a similar pattern.

Despite a decline in the ASMR and ASDR of CRC attributable to diet low in whole grains from 1990 to 2021 globally, the absolute number of cases continues to increase, with a particularly notable burden observed in High-middle and High SDI regions, as well as among males and the elderly population. It is imperative to intensify efforts in CRC prevention and health education, specifically targeting these high-risk groups to raise public awareness and consumption of whole grains. Furthermore, screening initiatives should be intensified among these demographics to address the elevated risk of CRC mortality due to insufficient whole grains consumption.

The aim of this study is to evaluate if the alignment with the 2020-2025 Dietary Guidelines for Americans (DGA), measured by the Healthy Eating Index 2020 (HEI-2020), is associated with colorectal cancer (CRC) risk in an Italian population.

A multicentric case-control study was carried out in Italy between 1992 and 1996. Cases were 1953 patients (males 58 %, median age = 62 years) admitted to major hospitals with incident, histologically confirmed CRC. Controls were 4154 patients (males 50 %, median age = 58 years) admitted to the same hospitals for acute non-neoplastic conditions. Participants' usual diet before study enrolment was collected using a validated food frequency questionnaire, and the alignment with DGA was assessed using the HEI-2020 score, ranging between 0 (no alignment) and 100 (complete alignment). Odds ratios (ORs) and the corresponding 95 % confidence intervals (CIs) were estimated using multiple logistic regression models including terms for selected socioeconomic, lifestyle factors, and potential confounders.

The HEI-2020 score ranged from 29.4 and 97.0. Subjects in the highest tertile of scores had lower risk of CRC compared to those in the lowest tertile (OR: 0.69, 95 % CI = 0.60-0.80). Similar estimates were found for colon (OR: 0.70, 95 % CI = 0.59 - 0.83) and rectal cancer (OR: 0.69, 95 % CI = 0.56-0.85). The findings were also consistent across strata of different covariates.

Alignment with DGA was inversely associated with CRC risk in an Italian population.

Colorectal cancer (CRC) is the third most common type of cancer worldwide, with Norwegian women having the highest incidence rate of colon cancer in 2022. The consumption of sweet beverages is a suggested modifiable risk factor for CRC; however, current evidence is limited and inconclusive.

To assess the associations between the intake of sugar-sweetened beverages (SSBs), artificially sweetened beverages (ASBs), and juice and the risk of overall and subsite-specific CRC among Norwegian women.

In this prospective cohort study, we included 73,921 participants aged 41-61 years at baseline. Information on sweet beverage consumption was collected using self-reported food frequency questionnaires at two time points between 1998 and 2014. We used Cox proportional hazards models to estimate hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) for the associations between sweet beverage consumption and the risk of overall CRC, proximal colon cancer, distal colon cancer, and rectal cancer.

During a mean follow-up time of 16.5 years from baseline, 1,187 women were diagnosed with CRC. Compared to no consumption, juice consumption was inversely associated with overall CRC risk (HR≥ 7 glasses/wk = 0.81, 95% CI: 0.67-0.98; p-trend = 0.025), colon cancer (HR≥ 7 glasses/wk = 0.73, 95% CI: 0.58-0.94; p-trend = 0.015) and proximal colon cancer (HR≥ 7 glasses/wk = 0.71, 95% CI: 0.52-0.99; p-trend = 0.065) after adjusting for age, education, and diabetes status at baseline. No associations were observed between juice consumption and distal colon cancer or rectal cancer risk, or between the intake of SSBs or ASBs and CRC.

We observed no substantial association between the intake of SSBs or ASBs and the risk of CRC or cancer in colorectal subsites in our cohort of Norwegian women. Conversely, our results indicate that juice consumption is associated with a reduced risk of CRC, particularly in the colon. These results warrant further investigation in larger cohorts with power to detect possible differences in cancer risk across colorectal subsites, especially as patterns of sweet beverage consumption are changing.

Colon and rectum cancer (CRC) poses a significant public health challenge, and diets high in processed meat have been identified as key risk factors. This study aims to assess the burden of CRC attributable to processed meat consumption in China from 1990 to 2021, focusing on mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs).

Data were obtained from the Global Burden of Disease (GBD) study for CRC attributable to processed meat consumption in China from 1990 to 2021. The analysis included age-standardized rates for deaths, DALYs, YLDs, and YLLs, alongside age-period-cohort (APC) and decomposition analyses to examine temporal trends and contributing factors. Joinpoint regression was used to detect significant changes in trends.

The burden of CRC attributable to processed meat consumption in China increased significantly between 1990 and 2021. In 2021, males exhibited higher mortality and DALY rates than females, particularly in older age groups. The age-standardized death rate rose from 0.23 to 0.32 per 100,000, and DALYs increased from 5.83 to 8.57 per 100,000. Joinpoint analysis revealed steep rises in DALYs and YLLs, especially during 2007-2011. APC analysis showed that older cohorts consistently exhibited higher death rates, while more recent cohorts displayed lower mortality. Decomposition analysis indicated that population growth and epidemiological changes drove the rise in mortality, with aging contributing to a reduction in deaths. These factors had a more pronounced impact on males.

The study highlights the growing burden of CRC linked to processed meat consumption in China over three decades, with significant gender differences and strong cohort effects. The findings call for targeted interventions to reduce processed meat consumption and mitigate CRC risk.

Given the heightened focus on high-risk populations, this study aimed to provide insights into early susceptibility and preventive strategies for colorectal cancer (CRC) by focusing on high-risk populations. In this research, fecal samples from 1,647 individuals across three discovery cohorts and nine external validation cohorts were sequenced using whole-genome metagenomic sequencing. A prediction model based on random forest was constructed using the nine external cohorts and independently validated with the three discovery cohorts. A disease probability (POD) model based on microbial biomarkers was developed to assess CRC risk. We found that the gut microbiome composition of CRC relatives differed from that of controls, with enrichment of species such as Fusobacterium and Bacteroides and a reduction in beneficial genera like Coprococcus and Roseburia. Additionally, dietary red meat intake emerged as a risk factor. The POD model indicated an elevated risk of CRC in unaffected relatives. The findings suggest that the POD for CRC may be increased in unaffected relatives or individuals living in shared environments, although this difference did not reach statistical significance. Our study introduces a novel framework for assessing the risk of colorectal cancer in ostensibly healthy individuals.

Colorectal cancer (CRC) is a malignant tumor that originates from the epithelial cells of the colon and rectum. Global epidemiological data shows that in 2020, the incidence and mortality rate of CRC ranked third and second, respectively, posing a serious threat to people's health and lives. The factors influencing CRC are numerous and can be broadly categorized as modifiable and non-modifiable based on whether they can be managed or intervened upon. Non-modifiable factors include age, gender, family history, among others. Among the modifiable factors, dietary habits and behavioral practices are the main intervention measures that people can take to prevent CRC. Numerous studies indicate that a high intake of red and processed meats, fats, as well as habits such as smoking, alcohol consumption, and prolonged sitting, increase the risk of developing CRC. Conversely, consuming ample vegetables, fruits, high dietary fiber, and engaging in moderate regular exercise may reduce the risk of CRC. This article primarily discusses the impact of dietary habits and behavioral practices on the occurrence and development of CRC, along with possible mechanisms, laying the foundation and providing direction for the prevention and control of CRC occurrence and development.

Colorectal cancer (CRC) is a prevalent and lethal malignancy. This study examines differences in clinical and prognostic characteristics of CRC between patients under 50 years and those aged 50 and above, treated at a reference hospital in Southern Brazil.

A retrospective cohort study was conducted, analyzing data from the Cancer Hospital Registry in Porto Alegre, RS. Patients diagnosed with colon or rectal adenocarcinoma between January 2013 and December 2017 were included. Variables analyzed included family history, alcoholism, smoking status, clinical staging, tumor laterality, clinical presentation, CEA levels at diagnosis, adjuvant chemotherapy, and neutrophil-to-lymphocyte ratio.

The study cohort included 1,121 patients, with 85% aged 50 years or older, and 15% younger than 50 years. Significant differences were observed in smoking status and clinical presentation, with younger patients presenting with a higher prevalence of obstruction/subocclusion at diagnosis, which may reflect differences in clinical presentation due to delayed diagnosis.

Age and lifestyle factors, particularly smoking, significantly influenced the clinical presentation and management of colorectal cancer. These findings underscore the importance of targeted prevention strategies and personalized treatment approaches for younger CRC patients.

Background: Prebiotics are non-digestible dietary compounds, defined as substrates that are utilised by host microorganisms conferring a health benefit. Although fructo-oligosaccharides (FOSs) and galacto-oligosaccharides (GOSs) are among the most studied prebiotics and support intestinal normobiosis, comprehensive data on their content in foods remain limited. Objectives: The objective was to quantify the content of FOSs (kestose, nystose, and 1 F-β-fructofuranosylnystose) and GOSs (raffinose and stachyose) in 35 foods, including fruit and nuts, legumes, and cereals. We also estimated the intakes of prebiotics in an Italian population. Methods: We analysed the prebiotic content in foods using high-performance anion-exchange chromatography with pulsed amperometric detection (HPAEC-PAD). We estimated the prebiotic intake of 100 healthy controls from a case-control study on colorectal cancer conducted in Italy between 2017 and 2019. We used dietary information collected through a food frequency questionnaire and the prebiotic data quantified in this and a previous study. Results: FOSs were mostly detected in cereal products, with wheat bran and whole-meal rye flour containing the highest amount (around 0.7 g/100 g each). GOSs were most abundant in legumes, especially in dried soy products (around 4.0 g/100 g each). Mean daily intake was 0.236 g for total FOSs and 0.371 g for total GOSs. Wheat bran, raspberries, chestnuts, walnuts, raisins, soy milk, and soy yoghurt overall accounted for 3.9% of kestose, 1.2% of nystose, 0% of 1F-β-fructofuranosylnystose, 15.5% of raffinose, and 8.3% of stachyose total intakes. Conclusions: The present study enables the development of a comprehensive database on prebiotic content in foods through a consistent analytical method. This makes prebiotic intake assessments more accurate than previously available data and facilitates future epidemiological studies investigating their potential effects on health.

Dietary guidelines play a key role in promoting health and preventing chronic diseases. The Nordic Nutrition Recommendations (NNR) 2023 provide updated recommendations for healthy eating relevant for the Nordic and Baltic countries, but the potential benefits have yet to be quantified.

This study aimed to project the population health benefits, specifically, potential gains in life expectancy in Nordic and Baltic countries resulting from long-term dietary changes from current dietary patterns within each country to NNR2023.

For this population-based mathematical model, using the Food4HealthyLife 2.0 calculator, data were obtained from meta-analyses on associations between each food group and mortality, and background mortality data were derived from the Global Burden of Disease study. Standard life-table methods were used, accounting for the correlation between 14 food groups and the anticipated time delay between dietary changes and health effects.

For 40-y-old females and males, projected life expectancy gains were from 1.8 and 2.1 y in Finland to 3.4 and 4.1 y, respectively, in Lithuania, changing to feasible NNR2023. Correspondingly, when changing to full-potential NNR2023, gains ranged from 4.4 and 5.0 y in Finland to 6.1 and 7.3 y, respectively, in Lithuania. The largest gains in life expectancy were linked to consuming more legumes (18%), nuts (17%), whole grains (12%), and less processed meat (14%) and added sugars (13%).

Adopting dietary patterns in line with the NNR2023 is associated with considerable gains in life expectancy in the Nordic and Baltic countries. The study contributes to the evidence base to support policy measures to achieve NNR2023.

Fiscal policies can provide important incentives for encouraging the dietary changes needed to achieve global policy targets. Across Europe, the foods relevant to health and the environment often incur reduced but non-zero value-added tax (VAT) rates at about half the maximum rates, which allows for providing both incentives and disincentives. Integrating economic, health and environmental modelling, we show that reforming VAT rates on foods, including increasing rates on meat and dairy, and reducing VAT rates on fruits and vegetables can improve diets and result in health, environmental and economic benefits in most European countries. The health improvements were primarily driven by reductions in VAT rates on fruits and vegetables, whereas most of the environmental and revenue benefits were driven by increased rates on meat and dairy. Our findings suggest that differentiating VAT rates based on health and environmental considerations can support changes towards healthier and more sustainable diets in Europe.

To provide estimates and trends for burdens of early-onset colorectal cancer (EOCRC) from 1990 to 2021 at the global, regional, and national levels, and to provide projections of EOCRC burden through 2030.

A trend analysis based on the Global Burden of Diseases 2021. The joinpoint regression model was used to analyze the temporal trends on EOCRC burden by calculating the corresponding average annual percent changes (AAPCs). A decomposition analysis was used to understand the drivers of the changes in EOCRC burden. The relationship between socio-demographic index (SDI) and disease burden was assessed by the concentration index of inequality. In addition, we constructed a Bayesian age-period-cohort model to predict the burden of EOCRC worldwide from 2022 to 2030.

Globally, the burden of EOCRC increased significantly between 1990 and 2021, with the incidence rising from 5.43/100000 to 6.13/100000 (AAPC = 0.39), and the prevalence increasing from 29.65/100000 to 38.86/100000 (AAPC = 0.87). Over the same period, the death rate decreased from 2.98/100000 to 2.30/100000 (AAPC = - 0.84), whereas the disability-adjusted life-year (DALY) decreased from 148.46/100000 to 115.42/100000 (AAPC = - 0.82). In 2021, East Asia and China had the highest burden of EOCRC regionally and nationally. Decomposition analysis indicated the increase in EOCRC burden was mainly driven by population growth. The concentration index revealed that high-SDI countries had a greater burden of EOCRC than low-SDI countries. The global incidence and prevalence of EOCRC will rise continuously from 2022 to 2030.

Between 1990 and 2021, the incidence and prevalence of EOCRC have escalated, whereas the death rate and DALY rate have declined. The burden varied with sex, SDI, and geographical locations. Given the rising trend of EOCRC burden, coordinated efforts are needed to reduce the burden posed by this malignancy.

Colorectal cancer (CRC) is the third most commonly diagnosed cancer in the United States (U.S.). Mississippi has the highest rate of CRC incidence in the U.S. and has large populations of black and white individuals, allowing for studies of racial disparities.

We conducted an ecological study using the county as the unit of analysis. CRC incidence data at the county level for black and white populations in Mississippi, covering the years 2003 to 2020, were retrieved from the Mississippi Cancer Registry. Age-adjusted incidence rate differences and their corresponding 95% confidence intervals (CIs) were then calculated for these groups. Getis-Ord Gi* hot and cold spot analysis of CRC incidence rate racial disparities was performed using ArcGIS Pro. We used global ordinary least square regression and geographically weighted regression (MGWR version 2.2) to identify factors associated with racial differences in CRC incidence rates.

Age-adjusted CRC incidence rate in the black population (median = 58.12/100,000 population) and in the white population (median = 46.44/100,000 population) varied by geographical area. Statistically significant racial differences in CRC incidence rates were identified in 28 counties, all of which showed higher incidence rates among the black population compared to the white population. No hot spots were detected, indicating that there were no spatial clusters of areas with pronounced racial disparities. As a post hoc analysis, after considering multicollinearity and a directed acyclic graph, a parsimonious multiple regression model showed an association (β = 0.93, 95% CI: 0.25, 1.62) indicating that a 1% increase in food insecurity was associated with a 0.93/100,000 differential increase in the black-white CRC incidence rate. Geographically weighted regression did not reveal any local patterns in this association.

Black-white racial disparities in CRC incidence were found in 28 counties in Mississippi. The county-level percentage of food insecurity emerged as a possible predictor of the observed black-white racial disparities in CRC incidence rates. Individual-level studies are needed to clarify whether food insecurity is a driver of these disparities or a marker of systemic disadvantage in these counties.

Early-onset colorectal cancer (EO-CRC) is becoming increasingly concerning due to its impact on individuals under 50 years old. We explored the burden of EO-CRC to provide information for planning effective management and prevention strategies.

We conducted secondary analyses to assess the burden of EO-CRC using data from GBD 2021.

The incidence, prevalence, deaths, disability-adjusted life years (DALYs) and their rates across 204 countries and territories were obtained from GBD 2021 database. The estimated annual percentage change (EAPC) calculation was used to assess temporal trends in these metrics. Additionally, we reported the proportion of DALYs attributable to risk factors and projected future disease burden till 2050.

The global number of new EO-CRC cases increased from 107,310 in 1990 to 211,890 in 2021. Both age-standardized incidence rate (ASIR) and prevalence rate (ASPR) of EO-CRC showed overall increases over the study period (ASIR: EAPC = 0.96 (0.9-1.02), ASPR: EAPC = 1.5 (1.44-1.55)). However, a decline in ASIR and ASPR was observed in 2020 and 2021. Males consistently showed higher EO-CRC indicators compared to females. Furthermore, projections indicated that deaths and DALYs cases are likely to fluctuate but generally increase by 2050, reaching 85,602 and 4,283,093, respectively.

The global impact of EO-CRC has increased significantly from 1990 to 2021, revealing notable variations across SDI regions, countries, age groups, and sexes. Besides, deaths and DALYs are predicted to rise by 2050. These results highlight the importance of implementing measures to address the growing burden of EO-CRC globally.

Food systems are essential for the achievement of the United Nations Sustainable Development Goals in China. Here, using an integrated assessment modelling framework that considers country-specific pathways and covers 18 indicators, we find that most social and environmental targets for the Chinese food system under current trends are not aligned with the United Nations Agenda 2030. We further quantify the impacts of multiple measures, revealing potential trade-offs in pursuing strategies aimed at public health, environmental sustainability and livelihood improvement in isolation. Among the individual packages of measures, a shift towards healthy diets exhibits the lowest level of trade-offs, leading to improvements in nutrition, health, environment and livelihoods. In contrast, focusing efforts on climate change mitigation and ecological conservation, or promoting faster socioeconomic development alone, have trade-offs between social and environmental outcomes. These trade-offs could be minimized by bundling all three aspects of measures.

Background and Objectives: This study examined factors influencing the onset and progression of colorectal tumors, including patients' epidemiological data, tumor location (right-sided, left-sided, and rectal), histomorphology, perineural or intraneural invasion, lymph node status, immune reactions, mismatch repair (MMR) status, and commonly observed mutations. Our primary goal was to evaluate their predictive and prognostic value and interactions. Materials and Methods: We analyzed a retrospective cohort of 100 patients with colorectal adenocarcinoma diagnosed between 2020 and 2023, using formalin-fixed paraffin-embedded (FFPE) tumor blocks. The methods included routine H&E microscopy, immunohistochemistry, Next-Generation Sequencing (NGS), and subsequent statistical analysis. Results: The findings showed a median diagnosis age of 70 years, with no gender-specific tumor localization. Right-sided tumors were prevalent, especially among patients with a defective MMR (dMMR), which represented 89% of dMMR cases. MMR status significantly correlated with tumor localization. We observed significant relationships between tumor grade, lymphovascular invasion, and overall tumor stage. Higher tumor grades and stages correlated with increased lymphovascular invasion and lymph node involvement. Interestingly, tumor budding did not correlate with lymph node metastasis but was significantly associated with higher tumor grades. Most BRAF mutations were found in right-sided tumors, indicating a significant correlation with this localization. Conclusions: This study focuses on the diversity of colorectal cancer (CRC) by examining how genetic and histological characteristics vary based on tumor location or other tumor variables.

Because bread can contain potential carcinogens such as acrylamide, and is widely consumed, we conducted a systematic review and meta-analysis to determine whether bread consumption is associated with increased cancer risk. PubMed and Medline databases were searched up to 1 March 2024, for studies that provided hazard ratios (HRs) (or similar) for bread consumption and cancer incidence or mortality. Only prospective cohort studies were included. We used the Preferred Reporting Items of Systematic reviews and Meta-Analyses checklist. Meta-analysis was performed with Cochrane's RevMan 5.4.1 software using a DerSimonian-Laird random-effects model. Heterogeneity was assessed with Cochrane's Q (χ2) and I 2 statistics, and publication bias was assessed with Egger's test. Twenty-four publications met inclusion criteria, including 1,887,074 adults, and were included in the systematic review. Ten publications that provided HRs were included in the meta-analysis for highest compared with lowest intakes, and an additional 7 publications that provided mortality or incident rate ratios or relative risks were included in supplemental meta-analyses. Of 108 reported HRs (or similar), 97 (79%) were either not statistically significant (n = 86) or indicated lower cancer risk (n = 11) associated with the highest intakes of bread. The meta-analysis indicated that bread intake was not associated with site-specific cancer risk [HR: 1.01; 95% confidence interval (CI): 0.89, 1.14; P = 0.92; 8 publications] or total cancer mortality (HR: 0.90; 95% CI: 0.73, 1.11; P = 0.32; 2 publications). Supplemental meta-analyses using all risk estimates in addition to HRs confirmed these findings. Whole-grain bread was associated with a lower site-specific cancer risk, mainly because of reduced colorectal cancer risk. Results of the systematic review and meta-analysis indicate that bread consumption is not associated with increased site-specific cancer risk, whereas high whole-grain/nonwhite bread consumption is associated with lower total cancer mortality and colorectal cancer risk. This study was registered at Clinical Trials Registry of PROSPERO as registration number CRD42023414156.

Sub-optimal food choices contribute to the risk of multiple non-communicable diseases (NCDs) which can be mitigated by improving diet quality. Food consumption patterns may partly account for variation of NCD risks in population subgroups in China. This study aimed to evaluate the risk of diet-related NCDs of observed Chinese diets, and to assess the potential reduction in NCD risks by adhering to certain diet recommendations.

Dose-response meta-analyses were used to derive relative risks between three diet-related NCDs and consumption of 15 food groups. 24-h dietary recall data of 12,809 adults from the 2011 China Health and Nutrition Survey were used to estimate the diet-related summed risks (SRs) of NCDs. Twelve Chinese provinces were aggregated into five regions, and stratified by age, gender, overweight status, education, income, and urbanicity. The Chinese Dietary Guideline-2016 (CDG-2016) and the EAT-Lancet diet were used as recommended diets.

Associations between SRs and gender, age, educational level, income level, and urbanicity were observed. No association was found between SRs and overweight status. Both diet recommendations have lower SRs compared to observed diets among all regions. The food groups that contributed most to the variation of the SRs of diet-related NCDs in China were high consumption of red meat and refined grains, and low consumption of whole grains, fruits, and legumes.

To address the heterogeneity in diet-related NCD risks, focusing on region-specific dietary practical is imperative for Chinese population, in order to propose tailored guidance to adhere to diet recommendations.

Building on the evidence for multifaceted effects of different nutrients, foods and dietary patterns is a new priority for nutrition science. This review aims to describe the causal pathways and biological mechanisms that elucidate the associations between different nutrition exposures (nutrients, foods and dietary patterns) and health outcomes.

A scoping review was conducted in two stages: 1) review of nutrition science textbooks; and 2) a review of reviews of empirical literature using a systematic approach to elucidate causal pathways and biological mechanisms for nutrition exposures and health outcomes. Reviews were eligible for inclusion if they reported biological mechanistic pathways between exposures and outcomes of interest among free-living healthy adults and/or children. Causal pathways within and between the exposures and the outcomes were identified and summarised visually.

A total of seven core textbooks and 1,934 reviews of relevant empirical literature were included. The complexity of the causal pathways and the number of biological mechanisms progressively increases as the nutrition exposure changes from nutrients to foods to dietary patterns. The biological mechanisms demonstrate that associations with beneficial or adverse health outcomes are determined by the contrasting chemical composition and physical structure of the different types and forms of nutrition exposures, and that contextual factors (e.g., food processing) can influence these chemical and physical factors for food and dietary pattern exposures.

This review provides models that can guide future research, and has several implications for the generation and interpretation of the nutrition evidence, and its synthesis and translation to inform nutrition guidelines and policies.

Practicing a diverse diet may reduce chronic disease risk, but clear evidence is scarce and previous diet diversity measures rarely captured diet quality. We investigated the effect of the Healthy Food Diversity (HFD)-Index on incident type 2 diabetes (T2D), myocardial infarction (MI) and stroke among a middle-aged German population. The EPIC-Potsdam study recruited 27,548 participants from 1994 to 1998. Semiquantitative food frequency questionnaire was used to calculate the HFD-Index. Longitudinal associations of HFD-Index and verified incident diseases were investigated by multiple-adjusted Cox proportional hazards regression models. Among 26,591 participants (mean age 50.5 years, 60% women), 1537, 376 and 412 developed T2D, MI and stroke, respectively, over an average follow-up of 10.6 years. There was no association between HFD-Index and incident T2D or MI. Higher compared to lower HFD-Index was inversely associated with incident stroke in men [HR (95% CI): 0.80 (0.70, 0.92)], but positively associated with incident stroke in women [1.20 (1.01, 1.42)]. Although there was no clear association between HFD-Index and T2D or MI incidence, we found a beneficial association in men and a harmful association in women for incident stroke. We emphasised the need for further investigations on combining diet diversity and diet quality in relation to health outcomes.

The contribution of suboptimal diets to gastrointestinal (GI) cancer incidence globally remains unquantified, and we aimed to evaluate it.

Comprehensive meta-analyses and rigorous evidence-grading assessment identified the associations between suboptimal diets and 6 GI cancers and their subtypes. A comparative risk assessment model was used to estimate the proportional attributable burden and attributable rate of GI cancers to suboptimal diets by using the corroborative association estimates. In addition, correlation assessments with the Sociodemographic Index were carried out.

In 2018, 21.5% (95% uncertainty interval, 19.1%-24.5%) of incident GI cancer cases globally were attributable to suboptimal diets, maintaining a relatively stable proportion since 1990 (22.4%; 19.7%-25.6%), whereas the absolute diet-attributable cases doubled from 580,862 (510,658-664,076) in 1990 to 1,039,877 (923,482-1,187,244) in 2018. Excessive processed meat consumption (5.9%; 4.2%-7.9%), insufficient fruit intake (4.8%; 3.8%-5.9%), and insufficient whole grain intake (3.6%; 2.8%-5.1%) were the most significant dietary risk factors in 2018, a shift from 1990 when the third major concern was insufficient nonstarchy vegetable intake. In addition, Central and Eastern Europe and Central Asia experienced the highest attributable burden across regions in both 1990 (31.6%; 27.0%-37.4%) and 2018 (31.6%; 27.3%-36.5%), and a positive correlation (P < .001) between the Sociodemographic Index and the attributable GI cancer incidence was observed.

Although the proportional attributable GI incidence remains relatively stable, the doubling of absolute cases from 1990 to 2018, along with the discrepancies among urbanicity and countries/regions, informs dietary priorities and more targeted preventive measures.

Avocado intake has been associated with improvements in diet quality. Whether this response is because of avocado intake, per se, or combined with a food and/or nutrient displacement (D) has yet to be determined.

This secondary analysis, conducted using dietary data from the Habitual Diet and Avocado Trial, sought to assess the effect of consuming a large avocado (168 g, 281 kcal) daily in the avocado-supplemented diet (AD) group compared with the habitual diet (HD) group on food and nutrient D.

Using data from 3 unannounced telephone 24-h dietary recalls conducted during the 6-mo intervention period, food intake data were evaluated for 898 participants, aged 25-87 y, and a BMI range of 20.5-60.3 kg/m2. The food group distribution, energy, and nutrient intake of the AD group (n = 436) were calculated and compared with those of the HD group (n = 462).

The AD group had a higher daily intake of energy (159 ± 575 kcal) (P < 0.001), potassium (3193 ± 817 mg compared with 2419 ± 843 mg) (P < 0.005), fiber (30 ± 8 g compared with 19 ± 9 g) (P < 0.05), and a lower daily intake of animal protein (49 ± 33 g compared with 55 ± 24 g) (P = 0.02) compared with the HD group. Partial D with an avocado was observed for energy (43%), total fat (23%), and carbohydrate (87%), indicating a lower intake of these nutrients from non-avocado sources in the AD group. Food group analysis revealed a lower consumption of animal-derived protein from red meat, processed meats, poultry, and fish in the AD group, with no significant differences observed in dairy and egg intake between groups.

Incorporating 1 avocado daily led to favorable modifications in the dietary composition of participants, including an increase in potassium and fiber intake, which can improve diet quality.This trial was registered at https://clinicaltrials.gov as NCT03528031.

Background & aims: Although previous observational studies have suggested an association between whole grain consumption (including breakfast cereals) and a reduced risk of death, no study has explored in detail the association between consumption of cereal with or without added sweeteners and death. We therefore aimed to evaluate the association between unsweetened, sugar-sweetened, and artificially sweetened cereals and all-cause and cause-specific mortality. Methods: We conducted a prospective cohort study of 186 419 UK Biobank participants who met the inclusion criteria for this study. Participants with baseline demographic, lifestyle, dietary, and clinical data were recruited from 2006 to 2010 and followed up until 2023. The intake of unsweetened, sugar-sweetened, or artificially sweetened cereals was estimated through repeated 24 hour dietary recalls. The non-linear relationships between daily dosage of cereal and all-cause, cancer-specific, and cardiovascular disease (CVD)-specific mortality were calculated using a restricted cubic spline curve. Hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality were calculated using Cox regression models. Results: During a median follow-up of 13.6 years, 11 351 all-cause deaths were recorded, including 6176 cancer deaths and 2126 CVD deaths. Cox regression models with restricted cubic splines showed a non-linear association between unsweetened cereals and all-cause and cancer-specific mortality. Compared with non-consumers, consumers of different amounts of unsweetened cereals (0 to 0.5, 0.5 to 1.5, and >1.5 bowls per day) had lower risks of all-cause mortality in the multivariate Cox models, with respective HRs of 0.89 (95%CI: 0.84-0.95), 0.90 (95%CI: 0.86-0.94), and 0.89 (95%CI: 0.82-0.97). However, no association was observed between consumption of sugar or artificially sweetened cereals and the risk of mortality. When cereals were divided into those with or without dried fruit, the findings were consistent with our primary results. Conclusions: Moderate consumption of unsweetened cereals was associated with a reduced risk of all-cause mortality, suggesting caution in consuming cereals with added sugar or artificial sweeteners.

Colorectal adenomas are recognized as precursors to colorectal cancer through the adenoma-carcinoma sequence. Identifying modifiable dietary factors that may inhibit cancer progression is critical, but epidemiologic studies in Asian populations are scarce.

This study explored the impact of fish and meat intake on colorectal adenoma risk among Koreans. The study enrolled asymptomatic adults who visited Seoul National University Hospital Healthcare System Gangnam Center for health check-ups from May to December 2011. All participants underwent screening colonoscopy and completed a validated food frequency questionnaire. The study included 536 adenoma patients, 135 high-risk adenoma patients and 1,122 adenoma-free controls. Using multivariate logistic regression, we calculated odds ratios (ORs) and 95% confidence intervals (CIs) for fish and meat intake related to colorectal adenoma status, significant at p < 0.05.

The intake of total fish, meat, red meat, chicken or processed meat showed no clear association with the prevalence of colorectal adenoma after adjusting for age, education, smoking status, alcohol intake, physical activity, body mass index, metabolic syndrome, colorectal cancer family history, total energy intake, and total fruit and vegetable intake. However, higher fish intake was associated with lower odds of high-risk colorectal adenoma, with a significant trend observed across quartiles (P for trend = 0.04). This trend was more pronounced among men than women (P for trend = 0.01).

In conclusion, we observed a significant inverse association between high fish intake and the prevalence of high-risk adenoma, but there were no clear associations between red and processed meat or chicken in the Korean population.

The available evidence regarding the role of fruit and vegetable consumption in the development of colorectal polyps remains inconclusive, and there is a lack of data on different histopathologic features of polyps. We aimed to evaluate the associations of fruit and vegetable consumption with the prevalence of colorectal polyps and its subtypes in a high-risk population in China.

We included 6783 Chinese participants aged 40-80 years who were at high risk of colorectal cancer (CRC) in the Lanxi Pre-colorectal Cancer Cohort (LP3C). Dietary information was obtained through a validated food-frequency questionnaire (FFQ), and colonoscopy screening was used to detect colorectal polyps. Dose-response associations of fruit and vegetable intake with the prevalence of polyps were calculated using multivariate-adjusted regression models, which was reported as odds ratios (ORs) with 95% confidence intervals (CIs).

2064 cases of colorectal polyps were ascertained in the LP3C during 2018-2019. Upon multivariable adjustments, including the diet quality, fruit consumption was inversely associated with the prevalence of polyps (P trend = 0.02). Participants in the highest tertile of fruit intake had a 25% lower risk (OR: 0.75; 95% CI 0.62‒0.92) compared to non-consumers, while vegetable consumption had no significant association with polyp prevalence (P trend = 0.86). In terms of colorectal histopathology and multiplicity, higher fruit intake was correlated with 24, 23, and 33% lower prevalence of small polyps (OR: 0.76; 95% CI 0.62‒0.94; P trend = 0.05), single polyp (OR: 0.77; 95% CI 0.62‒0.96; P trend = 0.04), and distal colon polyps (OR: 0.67; 95% CI 0.51‒0.87; P trend = 0.003), respectively.

Fresh fruit is suggested as a protective factor to prevent colorectal polyps in individuals at high risk of CRC, and should be underscored in dietary recommendations, particularly for high-risk populations.

Determining the effect of dietary factors on cancer is a crucial issue when accounting for the effect of other major risks, such as smoking and drinking.

A total of 15,563 adults from the Korean National Cancer Center Community Cohort were analyzed to determine and to compare the effect of dietary factors on stomach and colorectal cancer in overall and in the subgroup of non-smokers (or urinary cotinine concentrations <5 ng/mg) and non-drinkers with Cox proportional-hazard models.

During the mean follow-up (13.7 years), 469 and 299 cases of stomach and colorectal cancer were identified, respectively. The preventive effect of vegetable, fish, and soybean/tofu intake on colorectal cancer was found in women after adjustment for smoking, drinking, BMI, and sociodemographic factors. In the subgroup analysis of non-smokers and non-drinkers, the effect on colorectal cancer was increased in women (≥1 time/week vs. almost never, vegetables: hazard ratio (HR) 0.30, 95% confidence interval (CI) 0.13-0.69; fish: HR 0.46, 95% CI 0.26-0.83), and the fresh fish intake effect on stomach cancer was newly identified in men (HR 0.36, 95% CI 0.15-0.86). These effects were more pronounced and additionally shown in other dietary factors such as soybean or tofu in women and vegetables and fish in men, when subjects with <5 ng/mg urinary cotinine concentrations applied.

The protective effect of healthy eating on the risk of stomach and colorectal cancer were different by smoking and drinking status. Rigorous control of smoking and drinking effects is necessary when measuring the effect of dietary factors on cancer, properly.

The influence of sugar intake on the risk of colorectal cancer (CRC) remains controversial, and there is a need to investigate the heterogeneity of effects among racial and ethnic groups.

To examine the association of intake of simple sugars and their food sources with CRC risk according to race/ethnicity in a multiethnic cohort study.

We analyzed data from 192,651 participants who participated in the Multiethnic Cohort Study comprising African American, Japanese American, Latino, Native Hawaiian, and White older adults living in Hawaii and California with an average follow-up of 19 y. Intakes of total and specific types of sugars and sugary foods were estimated from a quantitative food frequency questionnaire completed by the participants in 1993-1996. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for CRC risk according to quintiles (Q) of sugar and food intakes using Cox models adjusted for potential confounders.

As of December 2017, 4403 incident CRC cases were identified. Among all participants, multivariable-adjusted CRC HRs for Q2, Q3, Q4, and Q5 compared with Q1 for total sugars were 1.03 (95% CI: 0.94, 1.13), 1.05 (95% CI: 0.96, 1.16), 1.12 (95% CI: 1.01, 1.24), and 1.13 (95% CI: 1.01, 1.27), respectively. A similar positive association was observed for total fructose, glucose, fructose, and maltose but not for added sugars and sugary foods. The increased risk appeared to be limited to colon cancer and to be strongest among younger participants (i.e., 45-54 y at baseline); an association with CRC was observed for sugar-sweetened beverages in the latter group. Among racial and ethnic groups, increased risk of CRC was most apparent in Latinos.

In this diverse cohort, intakes of total sugar, total fructose, glucose, fructose, and maltose were associated with an increased risk of CRC, and the association was strongest for colon cancer, younger participants, and Latinos.

The benefit of adherence to a plant-based diet concerning colorectal cancer (CRC) has not been investigated among Middle Eastern population. This study aimed to investigate how adherence to a plant-based diet influences the risk of CRC in this understudied population.

This case-control study was conducted in the CRC surgery departments of general hospitals in Tehran, Iran. A total of 71 individuals with newly diagnosed CRC (cases) and 142 controls subjects free of cancer and acute illness were concurrently recruited from the same hospital. Dietary information was collected using a semi-quantitative 168-item food frequency questionnaire. Dietary patterns were characterized using the plant-based diet index (PDI), unhealthy plant-based diet index (uPDI) and healthy plant-based diet index (hPDI). Multivariate logistic regression was employed to assess the association between these dietary patterns and the risk of CRC.

After adjusting the potential confounders, the risk of CRC was significantly lower in the highest tertile of hPDI compared to the lowest tertile (odds ratio (OR) = 0.21; 95% confidence interval (CI): 0.07-0.56, representing 79% risk reduction). Conversely, the risk of CRC was significantly higher in the highest tertile of uPDI compared to the lowest tertile (OR = 6.76; 95% CI: 2.41-18.94). PDI was no significant associated with the risk of CRC.

This study found that higher scores on the hPDI was significantly associated with a decrease risk of CRC, while greater adherence to the uPDI contributed to a significantly increase risk.

Cancer is one of the leading causes of death worldwide, with over 10 million fatalities annually. While tumors can be surgically removed and treated with chemotherapy, radiotherapy, immunotherapy, hormonal therapy, or combined therapies, current treatments often result in toxic side effects in normal tissue. Therefore, researchers are actively seeking ways to selectively eliminate cancerous cells, minimizing the toxic side effects in normal tissue. Caseins and its derivatives have shown promising anti-cancer potential, demonstrating antitumor and cytotoxic effects on cells from various tumor types without causing harm to normal cells. Collectively, these data reveals advancements in the study of caseins and their derivative peptides, particularly providing a comprehensive understanding of the molecular mechanism of action in cancer therapy. These mechanisms occur through various signaling pathways, including (i) the increase of interferon-associated STAT1 signaling, (ii) the suppression of stemness-related markers such as CD44, (iii) the attenuation of the STAT3/HIF1-α signaling, (iv) the down-expression of uPAR and PAI-1, (v) the loss of mitochondrial membrane potential and reduced intracellular ATP production, (vi) the increase of caspase-3 activity, and (vii) the suppression of TLR4/NF-кB signaling. Therefore, we conclude that casein could be an effective adjuvant for cancer treatment.

Colorectal cancer (CRC) is the third leading cancer in incidence and the second leading cancer in mortality worldwide. There is growing scientific evidence to support the crucial role of the gut microbiota in the development of CRC. The gut microbiota is the complex community of microorganisms that inhabit the host gut in a symbiotic relationship. Diet plays a crucial role in modulating the risk of CRC, with a high intake of red and processed meat being a risk factor for the development of CRC. The production of metabolites derived from protein fermentation by the gut microbiota is considered a crucial element in the interaction between red and processed meat consumption and the development of CRC. This paper examines several metabolites derived from the bacterial fermentation of proteins associated with an increased risk of CRC. These metabolites include ammonia, polyamines, trimethylamine N-oxide (TMAO), N-nitroso compounds (NOC), hydrogen sulphide (H2S), phenolic compounds (p-cresol) and indole compounds (indolimines). These compounds are depicted and reviewed for their association with CRC risk, possible mechanisms promoting carcinogenesis and their relationship with the gut microbiota. Additionally, this paper analyses the evidence related to the role of red and processed meat intake and CRC risk and the factors and pathways involved in bacterial proteolytic fermentation in the large intestine.

The incidence rate of cancer is increasing year by year due to the aging of the population, unhealthy living, and eating habits. At present, surgery and medication are still the main treatments for cancer, without paying attention to the impact of individual differences in health management on cancer. However, increasing evidence suggests that individual psychological status, dietary habits, and exercise frequency are closely related to the risk and prognosis of cancer. The reminder to humanity is that the medical concept of the unified treatment plan is insufficient in cancer treatment, and a personalized treatment plan may become a breakthrough point. On this basis, the concept of "Humanistic Health Management" (HHM) is proposed. This concept is a healthcare plan that focuses on self-health management, providing an accurate and comprehensive evaluation of individual lifestyle habits, psychology, and health status, and developing personalized and targeted comprehensive cancer prevention and treatment plans. This review will provide a detailed explanation of the relationship between psychological status, dietary, and exercise habits, and the regulatory mechanisms of cancer. Intended to emphasize the importance of HHM concept in cancer prevention and better prognostic efficacy, providing new ideas for the new generation of cancer treatment.

Previous studies on whole grain consumption had inconsistent findings and lacked quantitative assessments of evidence quality. Therefore, we aimed to summarize updated findings using the Burden of Proof analysis (BPRF) to investigate the relationship of whole grain consumption on type 2 diabetes (T2D), colorectal cancer (CRC), stroke, and ischemic heart disease (IHD).

We conducted a literature search in the Medline and Web of Science up to June 12, 2023, to identify related cohort studies and systematic reviews. The mean RR (relative risk) curve and uncertainty intervals (UIs), BPRF function, risk-outcome score (ROS), and the theoretical minimum risk exposure level (TMREL) were estimated to evaluate the level of four risk-outcome pairs.

In total, 27 prospective cohorts were included in our analysis. Consuming whole grain at the range of TMREL (118.5-148.1 g per day) was associated with lower risks: T2D (declined by 37.3%, 95% UI: 5.8 to 59.5), CRC (declined by 17.3%, 6.5 to 27.7), stroke (declined by 21.8%, 7.3 to 35.1), and IHD (declined by 36.9%, 7.1 to 58.0). For all outcomes except stroke, we observed a non-linear, monotonic decrease as whole grain consumption increased; For stroke, it followed a J-shaped curve (the greatest decline in the risk of stroke at consuming 100 g whole grain for a day). The relationships between whole grain consumption and four diseases are all two-star pairs (ROS: 0.087, 0.068, 0.062, 0.095 for T2D, CRC, stroke, and IHD, respectively).

Consuming 100 g of whole grains per day offers broad protective benefits. However, exceeding this threshold may diminish the protective effects against stroke. Our findings endorse replacing refined grains with whole grains as the main source of daily carbohydrates. REGISTRY AND REGISTRY NUMBER FOR SYSTEMATIC REVIEWS OR META-ANALYSES: We have registered our research in PROSPERO, and the identifier of our meta-analyses is CRD42023447345.

Diabetes has been associated with colorectal cancer. We evaluated whether adherence to a diabetes risk reduction diet (DRRD) can favorably influence the risk of colorectal cancer.

Data came from a multicentric Italian case-control study including 1,953 histologically confirmed colorectal cancer cases and 4,154 hospital controls admitted for acute nonneoplastic diseases. Diet was assessed through a validated and reproducible food frequency questionnaire. The DRRD score was computed assigning higher values for higher consumption of cereal fiber, fruit, coffee, nuts and a higher polyunsaturated/saturated fats ratio and for lower glycemic index and lower consumption of red/processed meat and sweetened beverages and fruit juices. The ORs and the corresponding 95% confidence intervals (CI) of colorectal cancer according to the DRRD score were obtained using logistic regression models adjusting for total energy intake and other major confounders.

The DRRD was inversely related to colorectal cancer risk. The ORs of colorectal cancer were 0.77 (95% CI, 0.67-0.89) for the third versus first score tertile (Ptrend < 0.001) and 0.92 (95% CI, 0.87-0.96) for a 3-point increment in the score. Inverse associations were observed for colon and rectal cancers and were consistent in strata of sex, age, and other major covariates.

A higher adherence to a DRRD was inversely associated with colorectal cancer risk.

Given the high incidence and mortality rates of colorectal cancer, adherence to a DRRD can have relevant prevention and public health implications.

Observational studies of foods and health are susceptible to bias, particularly from confounding between diet and other lifestyle factors. Common methods for deriving dose-response meta-analysis (DRMA) may contribute to biased or overly certain risk estimates. We used DRMA models to evaluate the empirical evidence for colorectal cancer (CRC) association with unprocessed red meat (RM) and processed meats (PM), and the consistency of this association for low and high consumers under different modeling assumptions. Using the Global Burden of Disease project's systematic reviews as a start, we compiled a data set of studies of PM with 29 cohorts contributing 23,522,676 person-years and of 23 cohorts for RM totaling 17,259,839 person-years. We fitted DRMA models to lower consumers only [consumption < United States median of PM (21 g/d) or RM (56 g/d)] and compared them with DRMA models using all consumers. To investigate impacts of model selection, we compared classical DRMA models against an empirical model for both lower consumers only and for all consumers. Finally, we assessed if the type of reference consumer (nonconsumer or mixed consumer/nonconsumer) influenced a meta-analysis of the lowest consumption arm. We found no significant association with consumption of 50 g/d RM using an empirical fit with lower consumption (relative risk [RR] 0.93 (0.8-1.02) or all consumption levels (1.04 (0.99-1.10)), while classical models showed RRs as high as 1.09 (1.00-1.18) at 50g/day. PM consumption of 20 g/d was not associated with CRC (1.01 (0.87-1.18)) when using lower consumer data, regardless of model choice. Using all consumption data resulted in association with CRC at 20g/day of PM for the empirical models (1.07 (1.02-1.12)) and with as little as 1g/day for classical models. The empirical DRMA showed nonlinear, nonmonotonic relationships for PM and RM. Nonconsumer reference groups did not affect RM (P = 0.056) or PM (P = 0.937) association with CRC in lowest consumption arms. In conclusion, classical DRMA model assumptions and inclusion of higher consumption levels influence the association between CRC and low RM and PM consumption. Furthermore, a no-risk limit of 0 g/d consumption of RM and PM is inconsistent with the evidence.

Dietary guidelines recommend limiting red meat intake because it has been amply associated with increased cancer mortality, particularly in patients with liver conditions, such as metabolic dysfunction-associated fatty liver disease (MASLD). MASLD is the leading cause of liver dysfunction in the world today, and no specific treatment other than lifestyle correction has yet been established. The aim of this study was to explore the protective role of leafy vegetables when associated with high red meat consumption.

The study cohort included 1646 participants assessed during the fourth recall of the MICOL study, subdivided into two groups based on red meat intake (≤50 g/die vs. >50 g/die), in order to conduct a cancer mortality analysis. The prevalence of subjects that consumed >50 g/die was only 15.73%. Leafy vegetable intake was categorized based on median g/die consumption, and it was combined with red meat intake.

This is the first study to demonstrate that the consumption of about 30 g/die of leafy vegetables reduces the risk of mortality. A strong association with mortality was observed in subjects with MASLD, and the protective role of vegetables was demonstrated.

Colorectal cancer (CRC) is the third most common cancer and the second most common cause of cancer mortality worldwide. There are disparities in the epidemiology of CRC across different populations, most probably due to differences in exposure to lifestyle and environmental factors related to CRC. Prevention is the most effective method for controlling CRC. Primary prevention includes determining and avoiding modifiable risk factors (e.g., alcohol consumption, smoking, and dietary factors) as well as increasing protective factors (e.g., physical activity, aspirin). Further studies, especially randomized, controlled trials, are needed to clarify the association between CRC incidence and exposure to different risk factors or protective factors. Detection and removal of precancerous colorectal lesions is also an effective strategy for controlling CRC. Multiple factors, both at the individual and community levels (e.g., patient preferences, availability of screening modalities, costs, benefits, and adverse events), should be taken into account in designing and implementing CRC screening programs. Health policymakers should consider the best decision in identifying the starting age and selection of the most effective screening strategies for the target population. This review aims to present updated evidence on the epidemiology, risk factors, and prevention of CRC.

A growing number of studies have suggested the involvement of long non-coding RNAs as the key players in not just the initiation and progression of the tumor microenvironment, but also in chemotherapy tolerance. In the present study, generated 5-FU-resistant SW480/DR cells were analyzed via cDNA microarray for its aberrant lncRNAs and mRNAs expression in comparison with the 5-FU-susceptible SW480/DS cells. Among the 126 lncRNAs described, lncRNAs GNAS-AS1, MIR205HG, and LOC102723721 have been identified to be significantly upregulated, while lncRNs lnc-RP11-597K23.2.1-2, LOC100507639, and CCDC144NL-AS1 have been found to be significantly downregulated. In the meantime, bioinformatic analysis through gene ontology studies of aberrantly expressed mRNAs revealed "regulated exocytosis", among others, as the biological process most impacted in SW480/DR cells. To investigate, exosome purification was then carried out and its characterization were validated via transmission electron microscopy and nanoparticle tracking analysis. Interestingly, it was determined that the 5-FU-resistant SW480/DR cells secretes significantly higher concentration of extracellular vesicles, particularly, exosomes when compared to the 5-FU-susceptible SW480/DS cells. Based on the lncRNA-mRNA interaction network analysis generated, lncRNA GNAS-AS1 and MIR205HG have been identified to be potentially involved in the incidence of 5-FU resistance in SW480 colon cancer cells through promoting increased release of exosomes into the intercellular matrix. Our study hopes not only to provide insights on the list of involved candidate lncRNAs, but also to elucidate the role exosomes play in the initiation and development of 5-FU chemotherapy resistance in colon cancer cells.

Shifting from animal-based to plant-based diets could reduce colorectal cancer (CRC) incidence. Currently, the impacts of these dietary shifts on CRC risk are ill-defined. Therefore, we examined partial substitutions of red or processed meat with whole grains, vegetables, fruits or a combination of these in relation to CRC risk in Finnish adults.

We pooled five Finnish cohorts, resulting in 43 788 participants aged ≥ 25 years (79% men). Diet was assessed by validated food frequency questionnaires at study enrolment. We modelled partial substitutions of red (100 g/week) or processed meat (50 g/week) with corresponding amounts of plant-based foods. Cohort-specific hazard ratios (HR) for CRC were calculated using Cox proportional hazards models and pooled together using random-effects models. Adjustments included age, sex, energy intake and other relevant confounders.

During the median follow-up of 28.8 years, 1124 CRCs were diagnosed. We observed small risk reductions when red meat was substituted with vegetables (HR 0.97, 95% CI 0.95 - 0.99), fruits (0.97, 0.94 - 0.99), or whole grains, vegetables and fruits combined (0.97, 0.95 - 0.99). For processed meat, these substitutions yielded 1% risk reductions. Substituting red or processed meat with whole grains was associated with a decreased CRC risk only in participants with < median whole grain intake (0.92, 0.86 - 0.98; 0.96, 0.93 - 0.99, respectively; pinteraction=0.001).

Even small, easily implemented substitutions of red or processed meat with whole grains, vegetables or fruits could lower CRC risk in a population with high meat consumption. These findings broaden our insight into dietary modifications that could foster CRC primary prevention.