Partial substitution of red meat or processed meat with plant-based foods and the risk of colorectal cancer

Rilla Tammi, Niina E. Kaartinen, Kennet Harald, Mirkka Maukonen, Heli Tapanainen, Stephanie A. Smith-Warner, Demetrius Albanes, Johan G. Eriksson, Pekka Jousilahti, Seppo Koskinen, Maarit A. Laaksonen, Sanna Heikkinen, Janne Pitkäniemi, Anne Maria Pajari, Satu Männistö

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objectives: 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. Methods: 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. Results: 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; p interaction=0.001). Conclusions: 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.

Original languageEnglish
JournalEuropean Journal of Epidemiology
Number of pages10
ISSN0393-2990
DOIs
Publication statusPublished - 2024
MoE publication typeA1 Journal article-refereed

Fields of Science

  • Epidemiology
  • Fruit
  • Nutrition
  • Sustainability
  • Vegetable
  • Whole grain
  • 3122 Cancers
  • 416 Food Science

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