A Case-Control Study Examining the Association of Fiber, Fruit, and Vegetable Intake and the Risk of Colorectal Cancer in a Palestinian Population

Hania M Taha; Alexander N Slade; Betty Schwartz; Anna E Arthur

doi:10.3390/ijerph19127181

A Case-Control Study Examining the Association of Fiber, Fruit, and Vegetable Intake and the Risk of Colorectal Cancer in a Palestinian Population

Int J Environ Res Public Health. 2022 Jun 11;19(12):7181. doi: 10.3390/ijerph19127181.

Authors

Hania M Taha^{1

2}, Alexander N Slade³, Betty Schwartz⁴, Anna E Arthur^{1

5}

Affiliations

¹ Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
² Augusta Victoria Hospital, The Lutheran World Federation, East Jerusalem 91191, Palestine.
³ Department of Radiation Oncology, Stony Brook University School of Medicine, Stony Brook, NY 11794, USA.
⁴ Robert H. Smith Faculty of Agriculture, Food, and Environment, Hebrew University of Jerusalem, Rehovot 761001, Israel.
⁵ Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS 66160, USA.

Abstract

While there is an association between Western diets and the incidence of colorectal cancer (CRC), this dietary association has remained unexplored in Palestine. The aim of this study was to examine how fiber and fruit and vegetable (FV) intakes are associated with CRC risk among Palestinian adults. We recruited 528 Palestinians between 2014 and 2016. We identified 118 patients who received CRC treatment at Augusta Victoria Hospital, East Jerusalem. We additionally identified 410 controls who consisted of community-based Palestinians without cancer. All participants completed a survey on demographics and a validated dietary intake food screener. Multivariable logistic regression models tested associations between fiber and FV intakes (categorized into quartiles) with CRC risk. After adjusting for significant covariates (age, sex, education, physical activity, smoking status, BMI, IBD, and family history of CRC), as fibers increased across increasing quartiles, the CRC risk significantly decreased (OR = 0.36, 95% CI: 0.15-0.86, p-trend = 0.02). After adjusting for age and sex, as FV intake increased, the CRC risk significantly decreased (OR = 0.34, 95% CI: 0.15-0.75, p-trend = 0.009). Consumption of fiber-rich foods was inversely associated with CRC risk. Understanding this relationship among Palestinians is essential in order to develop targeted, culturally relevant strategies that may potentially alleviate the burden of CRC.

Keywords: Palestinian population; case–control study; colorectal cancer; dietary fiber; dietary prevention; eating habits; fruits and vegetables.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Arabs
Case-Control Studies
Colorectal Neoplasms* / epidemiology
Diet / adverse effects
Dietary Fiber
Fruit*
Humans
Risk Factors
Vegetables

Substances

Dietary Fiber

Grants and funding

This research was funded by The Pears Family Charitable Foundation Project GB-CHC-1009195, from the Robert H. Smith Faculty of Agriculture, Hebrew University of Jerusalem and H.M.T was funded by USDA-NIFA Hatch Project 1011487.