{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T10:51:57Z","timestamp":1791888717047,"version":"4.3.4"},"reference-count":58,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T00:00:00Z","timestamp":1658880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Alcala de Henares and Autonomous community of Madrid","award":["CM\/JIN\/2019-042"],"award-info":[{"award-number":["CM\/JIN\/2019-042"]}]},{"name":"International Agency for Research on Cancer (IARC)","award":["CM\/JIN\/2019-042"],"award-info":[{"award-number":["CM\/JIN\/2019-042"]}]},{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London","award":["CM\/JIN\/2019-042"],"award-info":[{"award-number":["CM\/JIN\/2019-042"]}]},{"name":"NIHR Imperial Biomedical Research Centre (BRC)","award":["CM\/JIN\/2019-042"],"award-info":[{"award-number":["CM\/JIN\/2019-042"]}]},{"name":"Health Research Fund (FIS)\u2014Instituto de Salud Carlos III (ISCIII)","award":["CM\/JIN\/2019-042"],"award-info":[{"award-number":["CM\/JIN\/2019-042"]}]},{"name":"Regional Governments of Andaluc\u00eda, Asturias, Basque Country, Murcia and Navarra","award":["CM\/JIN\/2019-042"],"award-info":[{"award-number":["CM\/JIN\/2019-042"]}]},{"name":"Catalan Institute of Oncology\u2014ICO (Spain)","award":["CM\/JIN\/2019-042"],"award-info":[{"award-number":["CM\/JIN\/2019-042"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>The aim of this study was to explore the association between three previously identified dietary patterns (Western, Prudent, and Mediterranean) and colorectal cancer (CRC) risk by sex and cancer subtype. The Spanish cohort of the European Prospective Investigation into Cancer and Nutrition study provided dietary and epidemiological information from 15,629 men and 25,808 women recruited between 1992 and 1996. Among them, 568 CRC cases and 3289 deaths were identified during a median follow-up of 16.98 years. The associations between adherence to the three dietary patterns and CRC risk (overall, by sex, and by tumour location: proximal and distal colon and rectum) were investigated by fitting multivariate Cox proportional hazards regression models stratified by study centre and age. Possible heterogeneity of the effects by sex and follow-up time (1\u201310 vs. \u226510 years) was also explored. While no clear effect of the Prudent dietary pattern on CRC risk was found, a suggestive detrimental effect of the Western dietary pattern was observed, especially during the first 10 years of follow-up (HR1SD-increase (95% CI): 1.17 (0.99\u20131.37)), among females (HR1SD-increase (95% CI): 1.31 (1.06\u20131.61)), and for rectal cancer (HR1SD-increase (95% CI): 1.38 (1.03\u20131.84)). In addition, high adherence to the Mediterranean pattern seemed to protect against CRC, especially when restricting the analyses to the first 10 years of follow-up (HR1SD-increase (95% CI): 0.84 (0.73\u20130.98)), among males (HR1SD-increase (95% CI): 0.80 (0.65\u20130.98)), and specifically against distal colon cancer (HR1SD-increase (95% CI): 0.81 (0.63\u20131.03)). In conclusion, low adherence to the Western diet and high adherence to the Mediterranean dietary pattern could prevent CRC, especially distal colon and rectal cancer.<\/jats:p>","DOI":"10.3390\/nu14153085","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T03:21:16Z","timestamp":1658978476000},"page":"3085","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Adherence to the Western, Prudent and Mediterranean Dietary Patterns and Colorectal Cancer Risk: Findings from the Spanish Cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain)"],"prefix":"10.3390","volume":"14","author":[{"given":"Adela","family":"Castell\u00f3","sequence":"first","affiliation":[{"name":"Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain"},{"name":"School of Medicine, University of Alcal\u00e1, 28871 Alcal\u00e1 de Henares, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9972-9779","authenticated-orcid":false,"given":"Miguel","family":"Rodr\u00edguez-Barranco","sequence":"additional","affiliation":[{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain"},{"name":"Andalusian School of Public Health, 18011 Granada, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria ibs. GRANADA, 18012 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nerea","family":"Fern\u00e1ndez de Larrea","sequence":"additional","affiliation":[{"name":"Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Jakszyn","sequence":"additional","affiliation":[{"name":"Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L\u2019Hospitalet de Llobregat, 08908 Barcelona, Spain"},{"name":"Facultat de Ci\u00e8ncies de la Salut Blanquerna, Universitat Ramon LLul, 08021 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0226-5358","authenticated-orcid":false,"given":"Ane","family":"Dorronsoro","sequence":"additional","affiliation":[{"name":"Sub-Directorate for Public Health and Addictions of Gipuzkoa, Ministry of Health of the Basque Government, 20013 San Sebastian, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Amiano","sequence":"additional","affiliation":[{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain"},{"name":"Sub-Directorate for Public Health and Addictions of Gipuzkoa, Ministry of Health of the Basque Government, 20013 San Sebastian, Spain"},{"name":"Epidemiology of Chronic and Communicable Diseases Group, Biodonostia Health Research Institute, 20014 San Sebastian, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda-Dolores","family":"Chirlaque","sequence":"additional","affiliation":[{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain"},{"name":"Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, 30008 Murcia, Spain"},{"name":"Social-Health Department, Murcia University, 30008 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Colorado-Yohar","sequence":"additional","affiliation":[{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain"},{"name":"Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, 30008 Murcia, Spain"},{"name":"Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medell\u00edn 050010, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9242-6364","authenticated-orcid":false,"given":"Marcela","family":"Guevara","sequence":"additional","affiliation":[{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain"},{"name":"Navarra Public Health Institute, 31003 Pamplona, Spain"},{"name":"Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conchi","family":"Moreno-Iribas","sequence":"additional","affiliation":[{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain"},{"name":"Navarra Public Health Institute, 31003 Pamplona, Spain"},{"name":"Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Poll\u00e1n","sequence":"additional","affiliation":[{"name":"Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4817-0757","authenticated-orcid":false,"given":"Mar\u00eda-Jos\u00e9","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain"},{"name":"Andalusian School of Public Health, 18011 Granada, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria ibs. GRANADA, 18012 Granada, Spain"},{"name":"Department of Preventive Medicine and Public Health, University of Granada, 18071 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","first-page":"89","article-title":"Epidemiology of colorectal cancer: Incidence, mortality, survival, and risk factors","volume":"14","author":"Rawla","year":"2019","journal-title":"Prz. Gastroenterol."},{"key":"ref_3","unstructured":"World Cancer Research Fund\/American Institute for Cancer Research (2022, March 23). Continuous Update Project Expert Report 2018. 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