The Association Between Different Types of Dietary Carbohydrates and Colorectal Cancer: A Case-Control Study

Mona Jonoush; Soroor Fathi; Naeemeh Hassanpour Ardekanizadeh; Golsa Khalatbari Mohseni; Nazanin Majidi; Seyed Ali Keshavarz; Soheila Shekari; Shiva Nemat Gorgani; Saheb Abbas Torki; Mahtab Sotoudeh; Fatemeh Habibi; Maryam Gholamalizadeh; Atiyeh Alizadeh; Saeid Doaei

doi:10.3389/fnut.2022.898337

The Association Between Different Types of Dietary Carbohydrates and Colorectal Cancer: A Case-Control Study

Front Nutr. 2022 Jul 12:9:898337. doi: 10.3389/fnut.2022.898337. eCollection 2022.

Authors

Affiliations

¹ Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
² Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
³ Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
⁴ Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
⁵ Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran.
⁶ Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
⁷ Department of Nutrition, Faculty of Nutrition Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
⁸ Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁹ Department of Pharmacognosy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
¹⁰ Department of Obstetrics and Gynecology, Reproductive Health Research Center, School of Medicine, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran.

Abstract

Background: Several factors such as genetics and dietary intake are involved in the development of colorectal cancer (CRC). Higher intake of dietary carbohydrates may be associated with an increased risk of CRC. This study aimed to investigate the association between different types of dietary carbohydrates and CRC.

Methods: This hospital-based case-control study was carried out from June 2020 to May 2021 on 480 randomly selected participants including 160 CRC patients and 320 healthy controls aged 35-70 years in Firoozgar hospital, Tehran, Iran. Dietary intake was assessed using Food Frequency Questionnaire (FFQ). Nutritionist IV software was used to determine the intake of calorie and various forms of dietary carbohydrates including total carbohydrate, simple sugar, glucose, fructose, galactose, sucrose, lactose, and maltose.

Results: The average daily intake of calorie, carbohydrates, sugar, glucose, fructose, sucrose, and maltose were significantly higher among CRC cases compared to the controls (All P < 0.05). The logistic regression found significant associations between CRC with dietary intake of carbohydrates (OR = 1.009, CI 95%: 1.003-1.01, P = 0.002), sugar (OR = 1.02, CI 95%: 1.01-1.03, P < 0.001), glucose (OR = 1.06, CI 95%: 1.01-1.11, P = 0.009), fructose (OR = 1.31, CI 95%: 1.19-1.43, P < 0.001), sucrose (OR = 1.19, CI 95%: 1.12.-1.25, P < 0.001), maltose (OR = 9.03, CI 95%: 3.93-20.78, P < 0.001), galactose (OR = 1.31, CI 95%: 1.07-1.6, P = 0.008), and lactose (OR = 1.009, CI 95%: 1.01-1.18, P = 0.02). This association remained significant after adjustment for sex and age (except for galactose and lactose), and additional adjustment for sleep, tobacco, and alcohol level, and further adjustment for calorie intake and body mass index (BMI) (except for glucose).

Conclusions: A positive association was found between CRC and dietary intake of carbohydrates, sugar, fructose, sucrose, and maltose. Following a low-carbohydrate, low-sugar diet may help prevent CRC. Future longitudinal studies are warranted to confirm these findings.

Keywords: carbohydrates; colorectal cancer; dietary intake; mortality; sociodemographic questionnaire.