Skip to main content

Advertisement

Springer Nature Link
Log in

Is adherence to diet, physical activity, and body weight cancer prevention recommendations associated with colorectal cancer incidence in African American women?

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to evaluate whether adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations was associated with colorectal cancer incidence in the Black Women’s Health Study (BWHS).

Methods

In this ongoing prospective cohort of African American women (analytic cohort n = 49,103), 354 incident colorectal cancers were diagnosed between baseline (1995) and 2011. Adherence scores for seven WCRF/AICR recommendations (adherent = 1 point, non-adherent level 1 = 0.5 points, non-adherent level 2 = 0 points) were created using questionnaire data and summed to an overall adherence score (maximum = 7). Recommendation adherence and colorectal cancer incidence were evaluated using baseline and time-varying data in Cox regression models.

Results

At baseline, 8.5 % of women adhered >4 recommendations. In time-varying analyses, the HR was 0.98 (95 % CI 0.84–1.15) per 0.5 point higher score and 0.51 (95 % CI 0.23–1.10) for adherence to >4 compared to <3 recommendations. Adherence to individual recommendations was not associated with colorectal cancer risk. Results were similar in models that considered baseline exposures only.

Conclusions

Adherence to cancer prevention recommendations was low and not associated with colorectal cancer risk among women in the BWHS. Research in diverse populations is essential to evaluate the validity of existing recommendations, and assess whether there are alternative recommendations that are more beneficial for cancer prevention in specific populations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Explore related subjects

Discover the latest articles and news from researchers in related subjects, suggested using machine learning.

References

  1. Division of Cancer Prevention and Control-United States Centers for Disease Control and Prevention (2015) Colorectal cancer rates by race and ethnicity. http://www.cdc.gov/cancer/colorectal/statistics/race.htm. Accessed 4 Dec 2015

  2. Siegel R, Desantis C, Jemal A (2014) Colorectal cancer statistics, 2014. CA Cancer J Clin 64(2):104–117. doi:10.3322/caac.21220

    Article  PubMed  Google Scholar 

  3. Laiyemo AO, Doubeni C, Pinsky PF, Doria-Rose VP, Bresalier R, Lamerato LE, Crawford ED, Kvale P, Fouad M, Hickey T, Riley T, Weissfeld J, Schoen RE, Marcus PM, Prorok PC, Berg CD (2010) Race and colorectal cancer disparities: health-care utilization vs different cancer susceptibilities. J Natl Cancer Inst 102(8):538–546. doi:10.1093/jnci/djq068

    Article  PubMed  PubMed Central  Google Scholar 

  4. Moghaddam AA, Woodward M, Huxley R (2007) Obesity and risk of colorectal cancer: a meta-analysis of 31 studies with 70,000 events. Cancer Epidemiol Biomark Prev 16(12):2533–2547. doi:10.1158/1055-9965.EPI-07-0708

    Article  Google Scholar 

  5. Robsahm TE, Aagnes B, Hjartaker A, Langseth H, Bray FI, Larsen IK (2013) Body mass index, physical activity, and colorectal cancer by anatomical subsites: a systematic review and meta-analysis of cohort studies. Eur J Cancer Prev 22(6):492–505. doi:10.1097/CEJ.0b013e328360f434

    Article  PubMed  Google Scholar 

  6. World Cancer Research Fund/American Association for Cancer Research (2011) Continuous update project report. Food, Nutrition, Physical Activity, and the Prevention of Colorectal Cancer

  7. Larsson SC, Wolk A (2007) Obesity and colon and rectal cancer risk: a meta-analysis of prospective studies. Am J Clin Nutr 86(3):556–565

    CAS  PubMed  Google Scholar 

  8. Magalhaes B, Peleteiro B, Lunet N (2012) Dietary patterns and colorectal cancer: systematic review and meta-analysis. Eur J Cancer Prev 21(1):15–23. doi:10.1097/CEJ.0b013e3283472241

    Article  CAS  PubMed  Google Scholar 

  9. Cerhan JR, Potter JD, Gilmore JM, Janney CA, Kushi LH, Lazovich D, Anderson KE, Sellers TA, Folsom AR (2004) Adherence to the AICR cancer prevention recommendations and subsequent morbidity and mortality in the Iowa Women’s Health Study cohort. Cancer Epidemiol Biomark Prev 13(7):1114–1120

    Google Scholar 

  10. Romaguera D, Vergnaud AC, Peeters PH, van Gils CH, Chan DS, Ferrari P, Romieu I, Jenab M, Slimani N, Clavel-Chapelon F, Fagherazzi G, Perquier F, Kaaks R, Teucher B, Boeing H, von Rusten A, Tjonneland A, Olsen A, Dahm CC, Overvad K, Quiros JR, Gonzalez CA, Sanchez MJ, Navarro C, Barricarte A, Dorronsoro M, Khaw KT, Wareham NJ, Crowe FL, Key TJ, Trichopoulou A, Lagiou P, Bamia C, Masala G, Vineis P, Tumino R, Sieri S, Panico S, May AM, Bueno-de-Mesquita HB, Buchner FL, Wirfalt E, Manjer J, Johansson I, Hallmans G, Skeie G, Benjaminsen Borch K, Parr CL, Riboli E, Norat T (2012) Is concordance with World Cancer Research Fund/American Institute for Cancer Research guidelines for cancer prevention related to subsequent risk of cancer? Results from the EPIC study. Am J Clin Nutr 96(1):150–163. doi:10.3945/ajcn.111.031674

    Article  CAS  PubMed  Google Scholar 

  11. Makarem N, Lin Y, Bandera EV, Jacques PF, Parekh N (2015) Concordance with World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guidelines for cancer prevention and obesity-related cancer risk in the Framingham Offspring cohort (1991–2008). Cancer Causes Control 26(2):277–286. doi:10.1007/s10552-014-0509-9

    Article  PubMed  Google Scholar 

  12. Thomson CA, McCullough ML, Wertheim BC, Chlebowski RT, Martinez ME, Stefanick ML, Rohan TE, Manson JE, Tindle HA, Ockene J, Vitolins MZ, Wactawski-Wende J, Sarto GE, Lane DS, Neuhouser ML (2014) Nutrition and physical activity cancer prevention guidelines, cancer risk, and mortality in the women’s health initiative. Cancer Prev Res 7(1):42–53. doi:10.1158/1940-6207.CAPR-13-0258

    Article  Google Scholar 

  13. Kabat GC, Matthews CE, Kamensky V, Hollenbeck AR, Rohan TE (2015) Adherence to cancer prevention guidelines and cancer incidence, cancer mortality, and total mortality: a prospective cohort study. Am J Clin Nutr 101(3):558–569. doi:10.3945/ajcn.114.094854

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Catsburg C, Miller AB, Rohan TE (2014) Adherence to cancer prevention guidelines and risk of breast cancer. Int J Cancer. doi:10.1002/ijc.28887

    Google Scholar 

  15. Hastert TA, Beresford SA, Patterson RE, Kristal AR, White E (2013) Adherence to WCRF/AICR cancer prevention recommendations and risk of postmenopausal breast cancer. Cancer Epidemiol Biomark Prev. doi:10.1158/1055-9965.EPI-13-0210

    Google Scholar 

  16. World Cancer Research Fund/American Association for Cancer Research (2015) Recommendations for cancer prevention. http://www.aicr.org/reduce-your-cancer-risk/recommendations-for-cancer-prevention/. Accessed 11 Dec 2015

  17. Wei EK, Giovannucci E, Wu K, Rosner B, Fuchs CS, Willett WC, Colditz GA (2004) Comparison of risk factors for colon and rectal cancer. Int J Cancer 108(3):433–442. doi:10.1002/ijc.11540

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Kirkpatrick SI, Dodd KW, Reedy J, Krebs-Smith SM (2012) Income and race/ethnicity are associated with adherence to food-based dietary guidance among US adults and children. Journal of the Academy of Nutrition and Dietetics 112(5):624e626–635e626. doi:10.1016/j.jand.2011.11.012

    Google Scholar 

  19. Marshall SJ, Jones DA, Ainsworth BE, Reis JP, Levy SS, Macera CA (2007) Race/ethnicity, social class, and leisure-time physical inactivity. Med Sci Sports Exerc 39(1):44–51. doi:10.1249/01.mss.0000239401.16381.37

    Article  PubMed  Google Scholar 

  20. Neighbors CJ, Marquez DX, Marcus BH (2008) Leisure-time physical activity disparities among Hispanic subgroups in the United States. Am J Public Health 98(8):1460–1464. doi:10.2105/AJPH.2006.096982

    Article  PubMed  PubMed Central  Google Scholar 

  21. U.S. Center for Disease Control (2014) Facts about physical activity. http://www.cdc.gov/physicalactivity/data/facts.html. Accessed 11 Apr 2014

  22. Rosenberg L, Adams-Campbell L, Palmer JR (1995) The Black Women’s Health Study: a follow-up study for causes and preventions of illness. J Am Med Womens Assoc 50(2):56–58

    CAS  PubMed  Google Scholar 

  23. Carter-Nolan PL, Adams-Campbell LL, Makambi K, Lewis S, Palmer JR, Rosenberg L (2006) Validation of physical activity instruments: Black Women’s Health Study. Ethn Dis 16(4):943–947

    PubMed  Google Scholar 

  24. National Cancer Institute (2005) Diet*Calc analysis program, version 1.4.3. National Cancer Institute, Applied Research Program. http://appliedresearch.cancer.gov/DHQ/dietcalc/. Accessed 29 Apr 2015

  25. Kumanyika SK, Mauger D, Mitchell DC, Phillips B, Smiciklas-Wright H, Palmer JR (2003) Relative validity of food frequency questionnaire nutrient estimates in the Black Women’s Health Study. Ann Epidemiol 13(2):111–118

    Article  PubMed  Google Scholar 

  26. Inoue-Choi M, Lazovich D, Prizment AE, Robien K (2013) Adherence to the World Cancer Research Fund/American Institute for Cancer Research recommendations for cancer prevention is associated with better health-related quality of life among elderly female cancer survivors. J Clin Oncol 31(14):1758–1766. doi:10.1200/JCO.2012.45.4462

    Article  PubMed  PubMed Central  Google Scholar 

  27. Inoue-Choi M, Robien K, Lazovich D (2013) Adherence to the WCRF/AICR guidelines for cancer prevention is associated with lower mortality among older female cancer survivors. Cancer Epidemiol Biomark Prev 22(5):792–802. doi:10.1158/1055-9965.EPI-13-0054

    Article  Google Scholar 

  28. U.S. Department of Agriculture and U.S. Department of Health and Human Services (2010) Dietary guidelines for Americans. 7th edn. U.S. Goverment Printing Office, Washington, DC

  29. Andersen PK, Gill RD (1982) Cox regression-model for counting-processes—a large sample study. Ann Stat 10(4):1100–1120. doi:10.1214/Aos/1176345976

    Article  Google Scholar 

  30. Vergnaud AC, Romaguera D, Peeters PH, van Gils CH, Chan DS, Romieu I, Freisling H, Ferrari P, Clavel-Chapelon F, Fagherazzi G, Dartois L, Li K, Tikk K, Bergmann MM, Boeing H, Tjonneland A, Olsen A, Overvad K, Dahm CC, Redondo ML, Agudo A, Sanchez MJ, Amiano P, Chirlaque MD, Ardanaz E, Khaw KT, Wareham NJ, Crowe F, Trichopoulou A, Orfanos P, Trichopoulos D, Masala G, Sieri S, Tumino R, Vineis P, Panico S, Bueno-de-Mesquita HB, Ros MM, May A, Wirfalt E, Sonestedt E, Johansson I, Hallmans G, Lund E, Weiderpass E, Parr CL, Riboli E, Norat T (2013) Adherence to the World Cancer Research Fund/American Institute for Cancer Research guidelines and risk of death in Europe: results from the European Prospective Investigation into Nutrition and Cancer cohort study 1,4. Am J Clin Nutr 97(5):1107–1120. doi:10.3945/ajcn.112.049569

    Article  CAS  PubMed  Google Scholar 

  31. Makambi KH, Agurs-Collins T, Bright-Gbebry M, Rosenberg L, Palmer JR, Adams-Campbell LL (2011) Dietary patterns and the risk of colorectal adenomas: the Black Women’s Health Study. Cancer Epidemiol Biomark Prev 20(5):818–825. doi:10.1158/1055-9965.EPI-10-1213

    Article  Google Scholar 

  32. Satia JA, Tseng M, Galanko JA, Martin C, Sandler RS (2009) Dietary patterns and colon cancer risk in Whites and African Americans in the North Carolina Colon Cancer Study. Nutr Cancer 61(2):179–193. doi:10.1080/01635580802419806

    Article  PubMed  PubMed Central  Google Scholar 

  33. Satia-Abouta J, Galanko JA, Martin CF, Ammerman A, Sandler RS (2004) Food groups and colon cancer risk in African-Americans and Caucasians. Int J Cancer 109(5):728–736. doi:10.1002/ijc.20044

    Article  CAS  PubMed  Google Scholar 

  34. Satia-Abouta J, Galanko JA, Potter JD, Ammerman A, Martin CF, Sandler RS, North Carolina Colon Cancer S (2003) Associations of total energy and macronutrients with colon cancer risk in African Americans and Whites: results from the North Carolina colon cancer study. Am J Epidemiol 158(10):951–962

    Article  PubMed  Google Scholar 

  35. Williams CD, Satia JA, Adair LS, Stevens J, Galanko J, Keku TO, Sandler RS (2009) Dietary patterns, food groups, and rectal cancer risk in Whites and African-Americans. Cancer Epidemiol Biomark Prev 18(5):1552–1561. doi:10.1158/1055-9965.EPI-08-1146

    Article  CAS  Google Scholar 

  36. Rosenberg L, Boggs D, Wise LA, Palmer JR, Roltsch MH, Makambi KH, Adams-Campbell LL (2006) A follow-up study of physical activity and incidence of colorectal polyps in African-American women. Cancer Epidemiol Biomark Prev 15(8):1438–1442

    Article  Google Scholar 

  37. Wise LA, Rosenberg L, Palmer JR, Adams-Campbell LL (2008) Anthropometric risk factors for colorectal polyps in African-American women. Obesity 16(4):859–868. doi:10.1038/oby.2007.139

    Article  PubMed  Google Scholar 

  38. Collins LC, McNair LD (2002) Minority women and alcohol use. Alcohol Res Health 26(4):251–256

  39. Heo M, Faith MS, Pietrobelli A, Heymsfield SB (2012) Percentage of body fat cutoffs by sex, age, and race-ethnicity in the US adult population from NHANES 1999–2004. Am J Clin Nutr 95(3):594–602. doi:10.3945/ajcn.111.025171

    Article  CAS  PubMed  Google Scholar 

  40. Rahman M, Temple JR, Breitkopf CR, Berenson AB (2009) Racial differences in body fat distribution among reproductive-aged women. Metabolism 58(9):1329–1337. doi:10.1016/j.metabol.2009.04.017

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Krishnan S, Rosenberg L, Djousse L, Cupples LA, Palmer JR (2007) Overall and central obesity and risk of type 2 diabetes in U.S. black women. Obesity 15(7):1860–1866. doi:10.1038/oby.2007.220

    Article  PubMed  Google Scholar 

  42. Krishnan S, Rosenberg L, Singer M, Hu FB, Djousse L, Cupples LA, Palmer JR (2007) Glycemic index, glycemic load, and cereal fiber intake and risk of type 2 diabetes in US black women. Arch Intern Med 167(21):2304–2309. doi:10.1001/archinte.167.21.2304

    Article  PubMed  Google Scholar 

  43. Boggs DA, Palmer JR, Spiegelman D, Stampfer MJ, Adams-Campbell LL, Rosenberg L (2011) Dietary patterns and 14-y weight gain in African American women. Am J Clin Nutr 94(1):86–94. doi:10.3945/ajcn.111.013482

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Rosenberg L, Kipping-Ruane KL, Boggs DA, Palmer JR (2013) Physical activity and the incidence of obesity in young African-American women. Am J Prev Med 45(3):262–268. doi:10.1016/j.amepre.2013.04.016

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

S.J.O.N., L.L.A., L.R., and J.P. designed research; S.J.O.N. and J.Y. analyzed data; S.J.O.N., C.D., and L.R. wrote the paper; S.J.O.N. and L.R. had primary responsibility for final content. All authors read and approved the final manuscript. This work was supported by National Cancer Institute grants R01 CA058420 (L. Rosenberg) and UM1 CA164974 (L. Rosenberg). S.J.O.N. is supported by 5T32CA009686-19 (PI: A. Riegel). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. Data on breast cancer pathology were obtained from several state cancer registries (AZ, CA, CO, CT, DE, DC, FL, GA, IL, IN, KY, LA, MD, MA, MI, NJ, NY, NC, OK, PA, SC, TN, TX, VA), and results reported do not necessarily represent their views. The authors are grateful to the participants and staff of the BWHS. This study was done in compliance with ethical standards with approval from the Institutional Review Board of Boston University Medical Center and informed consent was obtained from all participants.

Author information

Authors and Affiliations

  1. Lombardi Comprehensive Cancer Center, Georgetown University, 1000 New Jersey Ave SE, Washington, DC, 20003, USA

    Sarah J. O. Nomura, Chiranjeev Dash & Lucile L. Adams-Campbell

  2. Slone Epidemiology Center, Boston University, 1010 Commonwealth Avenue, Boston, MA, 02215, USA

    Lynn Rosenberg, Jeffrey Yu & Julie R. Palmer

Authors
  1. Sarah J. O. Nomura
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Chiranjeev Dash
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Lynn Rosenberg
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Jeffrey Yu
    View author publications

    You can also search for this author inPubMed Google Scholar

  5. Julie R. Palmer
    View author publications

    You can also search for this author inPubMed Google Scholar

  6. Lucile L. Adams-Campbell
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Sarah J. O. Nomura.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nomura, S.J.O., Dash, C., Rosenberg, L. et al. Is adherence to diet, physical activity, and body weight cancer prevention recommendations associated with colorectal cancer incidence in African American women?. Cancer Causes Control 27, 869–879 (2016). https://doi.org/10.1007/s10552-016-0760-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-016-0760-3

Keywords