B vitamin intakes and incidence of colorectal cancer: Results from the Women's Health Initiative Observational Study cohort

Stefanie Zschäbitz, Ting Yuan David Cheng, Marian L. Neuhouser, Yingye Zheng, Roberta M. Ray, Joshua W. Miller, Xiaoling Song, David R. Maneval, Shirley A A Beresford, Dorothy Lane, James M. Shikany, Cornelia M. Ulrich

Research output: Contribution to journalArticle

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Abstract

Background: The role of one-carbon metabolism nutrients in co-lorectal carcinogenesis is not fully understood. Associations might be modified by mandated folic acid (FA) fortification or alcohol intake. Objective: We investigated associations between intakes of folate, riboflavin, vitamin B-6, and vitamin B-12 and colorectal cancer (CRC) in the Women's Health Initiative Observational Study, stratified by time exposed to FA fortification and alcohol intake. Design: A total of 88,045 postmenopausal women were recruited during 1993-1998; 1003 incident CRC cases were ascertained as of 2009. Quartiles of dietary intakes were compared; HRs and 95% CIs were estimated by Cox proportional hazards models. Results: Dietary and total intakes of vitamin B-6 in quartile 4 compared with quartile 1 (HR: 0.80; 95% CI: 0.66, 0.97 and HR: 0.80; 95% CI: 0.66, 0.99, respectively) and total intakes of ribofla-vin (HR: 0.81; 95% CI: 0.66, 0.99) were associated with reduced risk of CRC overall and of regionally spread disease. In current drinkers who consumed <1 drink (13 g alcohol)/wk, B vitamin intakes were inversely associated with CRC risk (P-interaction < 0.05). Dietary folate intake was positively associated with CRC risk among women who had experienced the initiation of FA fortification for 3 to <9 y (P-interaction < 0.01). Conclusions: Vitamin B-6 and riboflavin intakes from diet and supplements were associated with a decreased risk of CRC in post-menopausal women. Associations of B vitamin intake were particularly strong for regional disease and among women drinkers who consumed alcohol infrequently. Our study provides new evidence that the increased folate intake during the early postfortification period may have been associated with a transient increase in CRC risk.

Original languageEnglish (US)
Pages (from-to)332-343
Number of pages12
JournalAmerican Journal of Clinical Nutrition
Volume97
Issue number2
DOIs
StatePublished - Feb 1 2013

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Vitamin B Complex
Women's Health
Observational Studies
Colorectal Neoplasms
Folic Acid
Incidence
Vitamin B 6
Alcohols
Riboflavin
Vitamin B 12
Proportional Hazards Models
Carcinogenesis
Carbon
Diet
Food

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Zschäbitz, S., Cheng, T. Y. D., Neuhouser, M. L., Zheng, Y., Ray, R. M., Miller, J. W., ... Ulrich, C. M. (2013). B vitamin intakes and incidence of colorectal cancer: Results from the Women's Health Initiative Observational Study cohort. American Journal of Clinical Nutrition, 97(2), 332-343. https://doi.org/10.3945/ajcn.112.034736

B vitamin intakes and incidence of colorectal cancer : Results from the Women's Health Initiative Observational Study cohort. / Zschäbitz, Stefanie; Cheng, Ting Yuan David; Neuhouser, Marian L.; Zheng, Yingye; Ray, Roberta M.; Miller, Joshua W.; Song, Xiaoling; Maneval, David R.; Beresford, Shirley A A; Lane, Dorothy; Shikany, James M.; Ulrich, Cornelia M.

In: American Journal of Clinical Nutrition, Vol. 97, No. 2, 01.02.2013, p. 332-343.

Research output: Contribution to journalArticle

Zschäbitz, S, Cheng, TYD, Neuhouser, ML, Zheng, Y, Ray, RM, Miller, JW, Song, X, Maneval, DR, Beresford, SAA, Lane, D, Shikany, JM & Ulrich, CM 2013, 'B vitamin intakes and incidence of colorectal cancer: Results from the Women's Health Initiative Observational Study cohort', American Journal of Clinical Nutrition, vol. 97, no. 2, pp. 332-343. https://doi.org/10.3945/ajcn.112.034736
Zschäbitz, Stefanie ; Cheng, Ting Yuan David ; Neuhouser, Marian L. ; Zheng, Yingye ; Ray, Roberta M. ; Miller, Joshua W. ; Song, Xiaoling ; Maneval, David R. ; Beresford, Shirley A A ; Lane, Dorothy ; Shikany, James M. ; Ulrich, Cornelia M. / B vitamin intakes and incidence of colorectal cancer : Results from the Women's Health Initiative Observational Study cohort. In: American Journal of Clinical Nutrition. 2013 ; Vol. 97, No. 2. pp. 332-343.
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abstract = "Background: The role of one-carbon metabolism nutrients in co-lorectal carcinogenesis is not fully understood. Associations might be modified by mandated folic acid (FA) fortification or alcohol intake. Objective: We investigated associations between intakes of folate, riboflavin, vitamin B-6, and vitamin B-12 and colorectal cancer (CRC) in the Women's Health Initiative Observational Study, stratified by time exposed to FA fortification and alcohol intake. Design: A total of 88,045 postmenopausal women were recruited during 1993-1998; 1003 incident CRC cases were ascertained as of 2009. Quartiles of dietary intakes were compared; HRs and 95{\%} CIs were estimated by Cox proportional hazards models. Results: Dietary and total intakes of vitamin B-6 in quartile 4 compared with quartile 1 (HR: 0.80; 95{\%} CI: 0.66, 0.97 and HR: 0.80; 95{\%} CI: 0.66, 0.99, respectively) and total intakes of ribofla-vin (HR: 0.81; 95{\%} CI: 0.66, 0.99) were associated with reduced risk of CRC overall and of regionally spread disease. In current drinkers who consumed <1 drink (13 g alcohol)/wk, B vitamin intakes were inversely associated with CRC risk (P-interaction < 0.05). Dietary folate intake was positively associated with CRC risk among women who had experienced the initiation of FA fortification for 3 to <9 y (P-interaction < 0.01). Conclusions: Vitamin B-6 and riboflavin intakes from diet and supplements were associated with a decreased risk of CRC in post-menopausal women. Associations of B vitamin intake were particularly strong for regional disease and among women drinkers who consumed alcohol infrequently. Our study provides new evidence that the increased folate intake during the early postfortification period may have been associated with a transient increase in CRC risk.",
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AU - Zheng, Yingye

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