Applied nutritional investigationCharacterization of meat consumption and risk of colorectal cancer in Cordoba, Argentina☆
Introduction
Colorectal cancer (CRC) is a major disease in Western populations, and diet may account for approximately 35% of cases.1 In Córdoba, Argentina, the disease represents the third and fifth most common causes of cancer death in women and men, respectively.2 This industrialized, Mediterranean-type city with 1 300 000 inhabitants is in the center of the country. Our previous results showed a significant association of CRC risk with high intakes of saturated fatty acids, cholesterol, and alcoholic beverages (wine, beer, and various types of spirits) and that high consumption of insoluble fibers was associated with a decreased risk.3, 4
Epidemiologic studies on the risk of CRC associated with nutritional factors in Argentina may be valuable because of the country’s ethnic and geographic heterogeneity. The major ethnic streams of the present Argentinean population come from Creole-Spanish (Hispanics), Italian, Arab, and Jewish populations who originally were not heavy meat eaters. Nevertheless, the Argentinian population has traditionally had a high consumption of animal protein and fats obtained mainly from red meat in addition to low fiber and fish intakes. These particular cultural patterns seem to be related to an increased CRC risk.
However, it is not clear whether the mechanisms of increased risk associated with meat intake involve animal fat, cooking methods, meat varieties, or other related factors.5, 6, 7 Different studies have indicated that the risk of developing CRC is greater in populations that consume high levels of red meat and saturated fat6, 8 or processed or cured meats.7, 9 Poultry intake and high consumption of fish have no clear relation with this type of cancer in humans, so no definitive judgment is possible.5, 8, 9, 10
We characterized the meat intake in Córdoba’s adult population and estimated the effect of the consumption of different types of meat in the risk for CRC.
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Materials and methods
The general design of this study has been published elsewhere.3, 4 Briefly, the data were derived from a case-control study of CRC conducted between January 1993 and October 1998 in residents of greater Córdoba.
Cases were patients, 24 to 80 y, with an incidental histologically confirmed primary diagnosis of colorectal adenocarcinomas who had been admitted to the nine largest general hospitals in greater Córdoba. Overall, 287 subjects with CRC (163 men and 124 women; mean age ± standard error:
Meat consumption characterization
Table I lists the characteristics of the study population according to sex, age, body mass index, and social status. As intake distributions were strongly skewed, and the adopted location parameter was the median. Table II shows the median meat consumption and its standard deviations (g/d) according to sex and state of health (case control). For men and women, median intake of all meat types was greater for cases. The main type of meat eaten by the Argentine population is red beef (fatty and
Discussion
Argentina appears to be a convenient study area because red meat is preferentially consumed, whereas fish is seldom eaten. Our previous studies showed that a high frequency of heavily roasted meat was associated with CRC risk.17 Coincidentally, saturated fatty acids and cholesterol seemed increase the risk.3 In the present study, we further characterized meat consumption and risk for CRC by total intake and different types of meat.
Concerning possible selection bias in our work, the catchment
Acknowledgements
The authors are indebted to Paul D. Hobson, PhD, for critical reading of the manuscript; Profs. J. Garibotti, O. Figueroa, P. Ruggieri, R. Martini, J. Brunetto, E. Moreno, M. Adris, C. Olivatto, H. Eynard, G. Jarchum, L. Gramática, M. Cornet, R. Amuchástegui, J. M. Foscarini; C. S. Fabbro, C. B. Oldani, and L. M. Pivetta; and the following institutions: Hospital Nacional de Clínicas, Hospital Misericordia, Hospital Córdoba, Hospital San Roque, Hospital Italiano, Hospital Privado, Clínica Sucre,
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This work was supported in part by CONICOR/Agencia Córdoba Ciencia, CONICET, and SECyT-UNC.