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Prospective study of alcohol consumption and the risk of colorectal cancer before and after folic acid fortification in the United States.

ABSTRACT: To evaluate the influence of alcohol consumption on the risk of colorectal cancer according to folic acid fortification period in the United States.We evaluated the association between alcohol consumption and colorectal cancer by fortification period (before 1998 vs. after 1998) in 2 prospective cohort studies, the Nurses' Health Study (NHS) of women and the Health Professionals Follow-up Study (HPFS) of men, in which 2793 cases of invasive colorectal cancer were documented.Alcohol consumption was associated with an increased risk of colorectal cancer. Among nonusers of multivitamins and/or folic acid supplements, the pooled multivariate relative risk for ?30 g/d drinkers versus nondrinkers was 1.36 (95% confidence interval [95% CI], 1.09-1.70; P for trend, 0.02). The effect of alcohol consumption was slightly stronger in the prefolic acid fortification period (1980 NHS/1986 HPFS-1998) than in the postfortification period (1998-2008); the pooled multivariate relative risks for ?30 g/d drinkers versus nondrinkers were 1.31 (95% CI, 1.00-1.71; P for trend, 0.10) in the prefortification period and 1.07 (95% CI, 0.69-1.65; P for trend, 0.67) in the postfortification period.Folic acid fortification may attenuate the adverse effect of high alcohol consumption on the risk of colorectal cancer.

SUBMITTER: Nan H

PROVIDER: S-EPMC3749268 | biostudies-literature | 2013 Sep

REPOSITORIES: biostudies-literature

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Prospective study of alcohol consumption and the risk of colorectal cancer before and after folic acid fortification in the United States.

Nan Hongmei H Lee Jung Eun JE Rimm Eric B EB Fuchs Charles S CS Giovannucci Edward L EL Cho Eunyoung E

Annals of epidemiology 20130529 9

<h4>Purpose</h4>To evaluate the influence of alcohol consumption on the risk of colorectal cancer according to folic acid fortification period in the United States.<h4>Methods</h4>We evaluated the association between alcohol consumption and colorectal cancer by fortification period (before 1998 vs. after 1998) in 2 prospective cohort studies, the Nurses' Health Study (NHS) of women and the Health Professionals Follow-up Study (HPFS) of men, in which 2793 cases of invasive colorectal cancer were ...[more]

PMID: 23726821

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Project description:BackgroundThe US CDC and the Institute of Medicine recommend that women capable of becoming pregnant consume ≥400 µg synthetic folic acid/d to prevent neural tube defects (NTDs). The United States has 3 sources of folic acid: fortified enriched cereal grain products (ECGPs), fortified ready-to-eat (RTE) cereals, and dietary supplements.ObjectiveOur objectives were as follows: 1) to estimate the usual daily folic acid intake and distributions of red blood cell (RBC) folate concentrations among women consuming folic acid from different sources; 2) to assess the usual daily total folic acid intake associated with optimal RBC folate concentrations for NTD prevention; 3) to predict NTD prevalence; and 4) to estimate the number of preventable folate-sensitive NTDs.DesignNHANES data (2007-2012) for nonpregnant women of reproductive age (12-49 y) were used to estimate usual daily intakes of synthetic folic acid and natural food folate. We applied existing models of the relation between RBC folate concentrations and NTD risk to predict NTD prevalence.ResultsBased on the distribution of overall RBC folate concentrations (4783 women), the predicted NTD prevalence was 7.3/10,000 live births [95% uncertainty interval (UI): 5.5-9.4/10,000 live births]. Women consuming folic acid from ECGPs as their only source had lower usual daily total folic acid intakes (median: 115 µg/d; IQR: 79-156 µg/d), lower RBC folate concentrations (median: 881 nmol/L; IQR: 704-1108 nmol/L), and higher predicted NTD prevalence (8.5/10,000 live births; 95% UI: 6.4-10.8/10,000 live births) compared with women consuming additional folic acid from diet or supplements. If women who currently consume folic acid from ECGPs only (48% of women) consumed additional folic acid sources, 345 (95% UI: 0-821) to 701 (95% UI: 242-1189) additional NTDs/y could be prevented.ConclusionsThis analysis supports current recommendations and does not indicate any need for higher intakes of folic acid to achieve optimal NTD prevention. Ensuring 400 µg/d intake of folic acid prior to pregnancy has the potential to increase the number of babies born without an NTD.

Dataset Information

Prospective study of alcohol consumption and the risk of colorectal cancer before and after folic acid fortification in the United States.

Publications

Prospective study of alcohol consumption and the risk of colorectal cancer before and after folic acid fortification in the United States.

Similar Datasets

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