Wismayer Richard, Kiwanuka Julius, Wabinga Henry, Odida Michael
Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda.
Department of Surgery, Faculty of Health Sciences, Equator University for Science and Technology, Masaka, Uganda.
BMC Nutr. 2024 Jun 19;10(1):88. doi: 10.1186/s40795-024-00894-2.
Low-income countries in East Africa have a lower incidence of colorectal cancer (CRC) than high-income countries; however, the incidence has steadily increased in the last few decades. In Uganda, the extent to which genetic and environmental factors, particularly dietary factors, contribute to the aetiology of CRC is unclear. Therefore, the objective of our study was to determine the relationship between dietary factors and CRC in Uganda.
We conducted a case-control study and recruited 128 cases and 256 controls, matched for age (± 5 years) and sex. Data regarding the frequency of consumption of the dietary factors were obtained from all the participants using an interview-based questionnaire. The potential dietary risk factors and protective factors evaluated included the type and frequency of meat consumed and the type and frequency of high-fibre foods consumed. The frequency was either 4 or more times/week, 2-3 times/week, once/week or never. Conditional logistic regression analyses were used to determine the odds ratios associated with the different risk and protective factors.
The median age (IQR) for the case participants was 55.5 (43-67.5) years, and that of the control participants was 54 (42-65) years. The male-to-female ratio was 1:1 for all the participants. Factors significantly associated with CRC cases included:- the consumption of boiled beef 2-3 times/week (aOR:3.24; 95% CI: 1.08-9.69; p < 0.035). Consumption of high-fibre foods, including:- millet for ≥ 4 times/week (aOR: 0.23; 95% CI: 0.09-0.62; p = 0.003)), spinach for ≥ 4 times/week (aOR:0.32; 95% CI: 0.11-0.97; p = 0.043), and potatoes 2-3 times/week (aOR: 0.30; 95% CI: 0.09-0.97; p = 0.044), were protective against CRC. Boiled cassava showed a tendency to reduce the likelihood of CRC when consumed ≥ 4 times/week (aOR:0.38; 95% CI: 0.12-1.18) however this did not reach statistical significance (p = 0.093).
The consumption of boiled beef increases the risk of CRC, while the intake of high-fibre foods may reduce the risk of CRC among Ugandans. We recommend nutritional educational programmes to increase public awareness regarding the protective role of a high-fibre diet and to limit the intake of cooked meat in our Ugandan population.
东非的低收入国家结直肠癌（CRC）发病率低于高收入国家；然而，在过去几十年中发病率一直在稳步上升。在乌干达，基因和环境因素，特别是饮食因素，在结直肠癌病因中所起作用的程度尚不清楚。因此，我们研究的目的是确定乌干达饮食因素与结直肠癌之间的关系。
我们进行了一项病例对照研究，招募了128例病例和256名对照，年龄（±5岁）和性别相匹配。使用基于访谈的问卷从所有参与者那里获取有关饮食因素消费频率的数据。评估的潜在饮食风险因素和保护因素包括所食用肉类的类型和频率以及高纤维食物的类型和频率。频率为每周4次或更多次、每周2 - 3次、每周1次或从不。使用条件逻辑回归分析来确定与不同风险和保护因素相关的优势比。
病例参与者的年龄中位数（IQR）为55.5（43 - 67.5）岁，对照参与者为54（42 - 65）岁。所有参与者的男女比例为1:1。与结直肠癌病例显著相关的因素包括：每周食用2 - 3次煮牛肉（调整后优势比：3.24；95%置信区间：1.08 - 9.69；p < 0.035）。高纤维食物的摄入，包括：每周食用小米≥4次（调整后优势比：0.23；95%置信区间：0.09 - 0.62；p = 0.003），每周食用菠菜≥4次（调整后优势比：0.32；95%置信区间：0.11 - 0.97；p = 0.043），以及每周食用土豆2 - 3次（调整后优势比：0.
