Intake of processed meat, but not sodium, is associated with risk of colorectal cancer: Evidence from a large prospective cohort and two-sample Mendelian randomization

Qi Feng, Sunny H Wong, Jie Zheng, Qian Yang, Joseph Jy Sung, Kelvin Kf Tsoi*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Abstract

BACKGROUND & AIMS: Processed meat and high sodium intake are common in Western diet. The objective was to examine their independent effects on the risk of colorectal cancer (CRC).

METHODS: We performed both observational analysis with UK Biobank and genetic analysis with Mendelian randomization (MR). The 24-h urinary sodium (UNa) and reported intake of processed meat were fitted on incident CRC by multivariable Cox proportional hazard model, adjusted for covariates, such as age, gender, family history, etc. Different sodium measures were used for sensitivity analyses. Two-sample MR analyses were performed using summary data from genome-wide association studies of UNa and CRC. Multivariable MR was adjusted for body mass index.

RESULTS: We included 415 524 eligible participants from UK Biobank. During a median follow-up of 11.1 years, 2663 participants were diagnosed with CRC. High intake of processed meat independently increased risk of CRC by 23% (HR 1.23; 95% CI: 1.03 to 1.46), but 24-h UNa was not significantly associated with CRC (HR 0.96; 95% CI: 0.87 to 1.06). Furthermore, MR also showed little evidence for the effect of UNa on CRC (OR 1.02; 95% CI: 0.11 to 9.42). Sensitivity analyses showed consistent results across different measurements of sodium intake.

CONCLUSIONS: Intake of processed meat had an independent effect on the risk of CRC, but the risk was not associated with sodium level. Reduction of processed meat intake may be an effective strategy for CRC prevention, while sodium reduction should still be recommended to achieve other health benefits.

Original languageEnglish
Pages (from-to)4551-4559
Number of pages9
JournalClinical Nutrition
Volume40
Issue number7
Early online date13 Jun 2021
DOIs
Publication statusPublished - 1 Jul 2021

Bibliographical note

Copyright © 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Keywords

  • Sodium intake
  • Urinary sodium
  • Processed meat
  • Colorectal cancer
  • UK Biobank
  • Mendelian randomization

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