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Fruit but not vegetable consumption is beneficial for low prevalence of colorectal polyps in a high-risk population: findings from a Chinese Lanxi Pre-colorectal Cancer Cohort study

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Abstract

Purpose

The available evidence regarding the role of fruit and vegetable consumption in the development of colorectal polyps remains inconclusive, and there is a lack of data on different histopathologic features of polyps. We aimed to evaluate the associations of fruit and vegetable consumption with the prevalence of colorectal polyps and its subtypes in a high-risk population in China.

Methods

We included 6783 Chinese participants aged 40–80 years who were at high risk of colorectal cancer (CRC) in the Lanxi Pre-colorectal Cancer Cohort (LP3C). Dietary information was obtained through a validated food-frequency questionnaire (FFQ), and colonoscopy screening was used to detect colorectal polyps. Dose–response associations of fruit and vegetable intake with the prevalence of polyps were calculated using multivariate-adjusted regression models, which was reported as odds ratios (ORs) with 95% confidence intervals (CIs).

Results

2064 cases of colorectal polyps were ascertained in the LP3C during 2018–2019. Upon multivariable adjustments, including the diet quality, fruit consumption was inversely associated with the prevalence of polyps (P trend = 0.02). Participants in the highest tertile of fruit intake had a 25% lower risk (OR: 0.75; 95% CI 0.62‒0.92) compared to non-consumers, while vegetable consumption had no significant association with polyp prevalence (P trend = 0.86). In terms of colorectal histopathology and multiplicity, higher fruit intake was correlated with 24, 23, and 33% lower prevalence of small polyps (OR: 0.76; 95% CI 0.62‒0.94; P trend = 0.05), single polyp (OR: 0.77; 95% CI 0.62‒0.96; P trend = 0.04), and distal colon polyps (OR: 0.67; 95% CI 0.51‒0.87; P trend = 0.003), respectively.

Conclusions

Fresh fruit is suggested as a protective factor to prevent colorectal polyps in individuals at high risk of CRC, and should be underscored in dietary recommendations, particularly for high-risk populations.

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Data availability

The data that support the findings of this study are available from the last author upon reasonable request.

Abbreviations

BMI:

Body mass index

CI:

Confidence interval

CRC:

Colorectal cancer

FFQ:

Food frequency questionnaire

HCA:

Heterocyclic amine

LP3C:

Lanxi Pre-colorectal Cancer Cohort

MET-h/wk:

Metabolic equivalent task hours per week

OR:

Odds ratio

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Acknowledgements

We thank grants from Lanxi Municipal Government, all participants and staff of the Lanxi Pre-colorectal Cancer Cohort for their contributions and Lanxi Red Cross Hospital for support of project development.

Funding

This research received no external funding.

Author information

Author notes

  1. Shengzhi Wu and Yuqi Wu equally contribute to the work.

Authors and Affiliations

  1. Lanxi Red Cross Hospital, Jinhua, 321000, Zhejiang, China

    Shengzhi Wu, Xiaodong Hu & Jing Zhao

  2. Department of Food Science and Nutrition, Zhejiang Key Laboratory for Agro-Food Processing, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, 310058, Zhejiang, China

    Yuqi Wu, Pan Zhuang & Yu Zhang

  3. Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China

    Fei Wu, Xiaohui Liu, Yin Li, Yang Ao & Jingjing Jiao

  4. Lanxi Hospital of Traditional Chinese Medicine, Jinhua, 321100, Zhejiang, China

    Fuzhen Pan & Weifang Zheng

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  1. Shengzhi Wu
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Contributions

All authors contributed to the study investigation. Writing – Original Draft Preparation, Y.W.; Conceptualization, P.Z., J.J., W.Z., and Y.Z.; Methodology, S.W., Y.W., X.H., and F.W.; Validation, S.W., Y.W., J.Z., F.P., X.L., Y.L., Y.A., and P.Z.; Formal Analysis, S.W. and F.W.; Investigation, Y.W.; Resources, S.W.; Data Curation, F.W. and P.Z.; Writing – Review & Editing, P.Z., J.J., and Y.Z.; Visualization, Y.W.; Supervision, Y.Z.; Project Administration, W.Z. and Y.Z. All authors read and approved the manuscript. The work reported in the paper has been performed by the authors, unless clearly specified in the text.

Corresponding authors

Correspondence to Weifang Zheng or Yu Zhang.

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Conflicts of interest

The authors declare no conflicts of interest.

Ethical approval

The original protocol was approved by the ethical committee of Lanxi Red Cross Hospital, China. The ethical approval number is 20180302.

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Informed consent was obtained from all subjects involved in the study. Written informed consent has been obtained from the patients to publish this paper.

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Not applicable.

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Wu, S., Wu, Y., Hu, X. et al. Fruit but not vegetable consumption is beneficial for low prevalence of colorectal polyps in a high-risk population: findings from a Chinese Lanxi Pre-colorectal Cancer Cohort study. Eur J Nutr (2024). https://doi.org/10.1007/s00394-024-03377-z

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