This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Bobe, G. Articles by Lanza, E. PubMed PubMed Citation Articles by Bobe, G. Articles by Lanza, E.

Dietary Flavonoids and Colorectal Adenoma Recurrence in the Polyp Prevention Trial

¹ Laboratory of Cancer Prevention, Center for Cancer Research; ² Cancer Prevention Fellowship Program, Office of Preventive, ³ Epidemiology and Genetics Research Program, Division of Cancer Control and Populations Science; ⁴ Biometric Research Branch, Division of Cancer Treatment and Diagnosis; and ⁵ Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda/Frederick, Maryland; ⁶ Information Management Services, Inc., Rockville, Maryland; ⁷ University of Utah, Salt Lake City, Utah; ⁸ Kaiser Foundation Research Institute, Oakland, California; ⁹ Ohio State Cancer Center, Columbus, Ohio; ¹⁰ Edward Hines, Jr., Hospital, Veterans Affairs Medical Center, Hines, Illinois; ¹¹ Walter Reed Army Medical Center, Washington, District of Columbia; ¹² Arizona Cancer Center, University of Arizona, Tucson, Arizona; ¹³ Daston Communications, Chapel Hill, North Carolina; and ¹⁴ Roswell Park Cancer Institute, Buffalo, New York

Requests for reprints: Gerd Bobe, Laboratory of Cancer Prevention, National Cancer Institute-Frederick, Room 110, Building 576, Frederick, MD 21702-1201. Phone: 301-846-6015; Fax: 301-846-6907. E-mail: gb246f{at}nih.gov

Two recent case-control studies suggested that some flavonoid subgroups may play a role in preventing colorectal cancer. Previous prospective cohort studies generally reported no association; however, only a small subset of flavonoids was evaluated and partial flavonoid databases were used. We used the newly constructed U.S. Department of Agriculture flavonoid database to examine the association between consumption of total flavonoids, 6 flavonoid subgroups, and 29 individual flavonoids with adenomatous polyp recurrence in the Polyp Prevention Trial. The Polyp Prevention Trial was a randomized dietary intervention trial, which examined the effectiveness of a low-fat, high-fiber, high-fruit, and high-vegetable diet on adenoma recurrence. Intakes of flavonoids were estimated from a food frequency questionnaire. Multivariate logistic regression models (adjusted for age, body mass index, sex, regular non–steroidal anti-inflammatory use, and dietary fiber intake) were used to estimate odds ratios and 95% confidence intervals for both any and advanced adenoma recurrence within quartiles of energy-adjusted flavonoid intake (baseline, during the trial, and change during the trial). Total flavonoid intake was not associated with any or advanced adenoma recurrence. However, high intake of flavonols, which are at greater concentrations in beans, onions, apples, and tea, was associated with decreased risk of advanced adenoma recurrence (4th versus 1st quartile during the trial; odds ratio, 0.24; 95% confidence interval, 0.11, 0.53; P_trend = 0.0006). Similar inverse associations were observed to a smaller extent for isoflavonoids, the flavonol kaempferol, and the isoflavonoids genistein and formononetin. Our data suggest that a flavonol-rich diet may decrease the risk of advanced adenoma recurrence. (Cancer Epidemiol Biomarkers Prev 2008;17(6):1344–53)