Associations of Evolutionary-Concordance Diet and Lifestyle Pattern Scores with Incident, Sporadic Colorectal Adenoma in a Pooled Case-Control Study

Abstract

Differences in diet and lifestyle relative to those of our Paleolithic-era ancestors may explain current high incidences of chronic diseases, including colorectal cancer (CRC), in Westernized countries. Previously reported evolutionary-concordance diet and lifestyle pattern scores, reflecting closeness of diet and lifestyle patterns to those of Paleolithic-era humans, were associated with lower CRC incidence. Separate and joint associations of the scores with colorectal adenoma among men and women are unknown. To address this, we pooled data from three case-control studies of incident, sporadic colorectal adenomas (n = 771 cases, 1,990 controls), used participants’ responses to food frequency and lifestyle questionnaires to calculate evolutionary-concordance diet and lifestyle pattern scores, and estimated the scores’ associations with adenomas using multivariable unconditional logistic regression. The multivariable-adjusted odds ratios comparing those in the highest relative to the lowest diet and lifestyle score quintiles were 0.84 (95% confidence interval [CI] 0.62, 1.12; P_trend:0.03) and 0.41 (95% CI 0.29, 0.59; P_trend:<0.0001), respectively. The inverse associations were stronger for high-risk adenomas, and among those with both high relative to those with both low diet and lifestyle scores. These results suggest that more evolutionary-concordant diet and lifestyle patterns, separately and jointly, may be associated with lower risk for incident, sporadic colorectal adenoma.

Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2021.2002919 .

Acknowledgments

None.

Disclosure Statement

None of the authors has a conflict of interest to disclose. The findings and conclusions contained within are those of the authors and do not necessarily reflect positions or policies of the National Cancer Institute, the Fullerton Foundation, or the Wilson P. and Anne W. Franklin Foundation. The National Cancer Institute the Fullerton Foundation, and the Wilson P. and Anne W. Franklin Foundation had no influence on the analysis and interpretation of the data, the decision to submit the manuscript for publication, or the writing of the manuscript.

Authors’ Contributions

M. J. Penley: Conceptualization, formal analysis, writing–original draft, writing–review and editing. D.A. Byrd: Participated in formal analysis, writing-review and editing. R.M. Bostick: Conceptualization, supervision, funding acquisition, writing–original draft, writing–review and editing.

Additional information

Funding

This work was supported by the National Cancer Institute of the US National Institutes of Health under grants P01 CA50305 and R01 CA66539, The Fullerton Foundation, and The Anne and Wilson P. Franklin Foundation.