Gastroenterology

Gastroenterology

Volume 122, Issue 7, June 2002, Pages 1784-1792
Gastroenterology

Clinical Research
Diet and colorectal cancer: An investigation of the lectin/galactose hypothesis,☆☆

https://doi.org/10.1053/gast.2002.33659Get rights and content

Abstract

Background & Aims: Mucosal expression of terminal unsubstituted galactose is increased in colon cancer and precancer and allows interaction with mitogenic galactose-binding lectins of dietary or microbial origin. This study tests the hypothesis that galactose, which is variably plentiful in fruit and vegetable but not cereal fibers, might prevent cancer by binding and inhibiting such lectins. Methods: Colorectal cancer cases (512) and controls (512) were matched for age, sex, primary care practitioner, and postal code. A 160-item food-frequency questionnaire was used to estimate their usual pre-illness (6 months previous) diet, aspirin intake, and exercise. Results: Neither cereal fiber nor fruit and vegetable fiber were protective when assessed by univariate analysis, whereas dietary fiber galactose content showed a dose-related protective effect (odds ratio [OR] highest quartile/lowest quartile, 0.67; confidence interval [CI], 0.47–0.95) that remained protective when adjusted for energy, red meat, alcohol, calcium, protein and fat intake, regular aspirin usage, and exercise. Intake of nonlegume green vegetables, assessed because of the high lectin content of legumes, was also protective (OR, 0.54; CI, 0.35–0.81), but this was not independent of galactose. Protective effects of exercise and regular daily aspirin consumption and harmful effects of high energy consumption and high red meat intake were confirmed. Conclusions: The protective effect of fruit and vegetable fibers may be related to their galactose content. This provides further evidence that the association between diet and colon cancer is mediated via specific food components and may explain the discrepant results of studies addressing the protective effects of fiber.

GASTROENTEROLOGY 2002;122:1784-1792

Section snippets

Study population

Histologically confirmed colorectal cancer cases who resided within the Liverpool postal area were identified from the monthly notifications to the Merseyside and Cheshire Cancer Registry. These include all cases diagnosed by the histopathology departments serving all Health Service and private hospitals in the counties of Merseyside and Cheshire. The population covered by this study includes 1,276,092 people residing in 62 postal codes (Office of Census and Population Studies data). The

Results

Five hundred twelve cases and 512 matched controls were interviewed with an age range of 36–100 years and a median age of 67 years. Fifty-seven percent were men and 78% of cases had cancer affecting the left colon or rectum (Table 1).

. Demographic data of colorectal cancer cases studied

Age (yr)35–4445–5455–6465–7475–8485–94>95
All cases (M/F)2/219/548/39115/8383/5923/331/0
Left-sided and rectal (M/F)2/217/241/3191/6668/4318/181/0
Right-sided (M/F)0/02/37/824/1715/165/150/0
Dietary intakes for each

Discussion

This study shows dose-related protective effects against colon cancer for consumption of dietary NSP galactose and nonlegume green vegetables, whereas total fiber consumption, assessed as nonstarch polysaccharide, showed no significant effect. This provides further support for the hypothesis that the protective effect of fruit and vegetable consumption may be mediated via specific components such as galactose and isothiocyanates rather than simply via fiber content.

The protective effect of

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    Address requests for reprints to: Professor Jonathan Rhodes, Department of Medicine, University of Liverpool, Duncan Building, Daulby Street, Liverpool L69 3 GA, England. e-mail: [email protected]; fax: (44) 151-706-5802.

    ☆☆

    Supported by grant NWCR311, “Dietary consumption of peanuts, galactose-containing fruit and vegetable fibre and risk of colorectal cancer: a case control study,” from the North West of England Cancer Research Fund and by Medical Research Council Co-operative grant GR990432.

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