Association Between the Sulfur Microbial Diet and Risk of Colorectal Cancer

Sulfur-metabolizing bacteria that reduce dietary sulfur to hydrogen sulfide have been associated with colorectal cancer (CRC). However, there are limited studies investigating the association between diet and sulfur-metabolizing bacteria in the development of CRC. To develop a dietary score that cor...

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Bibliographic Details
Published in:JAMA network open 2021-11, Vol.4 (11), p.e2134308-e2134308
Main Authors: Wang, Yiqing, Nguyen, Long H, Mehta, Raaj S, Song, Mingyang, Huttenhower, Curtis, Chan, Andrew T
Format: Article
Language:English
Subjects:
Adult
Aged
Bacteria
Caloric Restriction - adverse effects
Colorectal cancer
Colorectal Neoplasms - epidemiology
Colorectal Neoplasms - etiology
Diet
Diet - adverse effects
Diet - methods
Diet Surveys
Diet, Healthy - statistics & numerical data
Feces - microbiology
Feeding Behavior - physiology
Female
Follow-Up Studies
Fruit
Gastroenterology and Hepatology
Humans
Male
Medical personnel
Middle Aged
Nurses
Online Only
Original Investigation
Proportional Hazards Models
Prospective Studies
Red Meat - adverse effects
Risk Factors
Sulfur
Sulfur - metabolism
Sulfur-Reducing Bacteria
Vegetables
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Summary:Sulfur-metabolizing bacteria that reduce dietary sulfur to hydrogen sulfide have been associated with colorectal cancer (CRC). However, there are limited studies investigating the association between diet and sulfur-metabolizing bacteria in the development of CRC. To develop a dietary score that correlates with gut sulfur-metabolizing bacteria and to examine its association with CRC risk. This prospective cohort study included data from the Health Professionals Follow-up Study (1986-2014), Nurses' Health Study (1984-2016), and Nurses' Health Study II (1991-2017). Participants were US male health professionals and female registered nurses who were free of inflammatory bowel disease and cancer at baseline, with a subsample of participants who provided stool samples from 2012 to 2014. Statistical analysis was conducted from September 1, 2020, to June 1, 2021. A dietary pattern, assessed by a food-frequency questionnaire, that most correlated with 43 sulfur-metabolizing bacteria identified through taxonomic and functional profiling of gut metagenome data. Incident CRC. Among 214 797 participants comprising 46 550 men (mean [SD] age at baseline, 54.3 [9.7] years) and 168 247 women (mean [SD] age at baseline, 43.0 [9.2] years), 3217 incident cases of CRC (1.5%) were documented during 5 278 048 person-years of follow-up. The sulfur microbial diet, developed in a subsample of 307 men (mean [SD] age, 70.5 [4.3] years) and 212 women (mean [SD] age, 61.0 [3.8] years), was characterized by high intakes of low-calorie beverages, french fries, red meats, and processed meats and low intakes of fruits, yellow vegetables, whole grains, legumes, leafy vegetables, and cruciferous vegetables. After adjustment for other risk factors, greater adherence to the sulfur microbial diet was associated with an increased risk of CRC, with a hazard ratio (HR) of 1.27 (95% CI, 1.12-1.44) comparing the highest vs the lowest quintile of the diet score (linear trend of diet score quintiles; P 
ISSN:2574-3805
2574-3805
DOI:10.1001/jamanetworkopen.2021.34308