A Mediterranean Diet for Colon Cancer Prevention: Epidemiological and animal studies indicate that the major components of the traditional Cretan-Mediterranean diet have great promise for the prevention of colorectal cancer while improving overall health. Relative to the American diet, the Mediterranean diet is lower in n-6 fatty acids, polyunsaturated fats, and red meat while intakes of plant-based foods and monounsaturated fats are higher. The hypothesis behind this proposal is that adherence to a Mediterranean type of diet will result in a decrease in n-6 fatty acids and increased n-3 and n-9 fatty acids in human colonic mucosa. This, together with other aspects of the diet such as increased intakes of phytochemicals in fruits and vegetables, is expected to modulate eicosanoid metabolism in normal colorectal mucosa to its anticarcinogenic state resulting in lower colonic proliferation. We will recruit 120 study participants who are at increased risk of colorectal cancer. Subjects will be randomized to a modified Mediterranean diet or a Healthy People 2010 diet for 6 months. The Mediterranean diet will be designed to decrease polyunsaturated fat intake and to increase intakes of monounsaturated fats, fruits and vegetables. These dietary changes are expected to not only decrease pro-inflammatory mediators and increase anti-inflammatory mediators, but to also change the types of eicosanoids that are produced from cyclooxygenases and lipoxygenases. Our pilot testing of this novel exchange list diet indicates that subjects can make very large dietary changes. Dietary intake data, blood samples and biopsies of normal mucosa from flexible sigmoidoscopy will be analyzed before and after intervention, and changes from baseline will be compared in the 2 diet arms. The specific endpoints are fatty acids and carotenoids in blood and mucosa, the types and levels of inflammatory mediators in the mucosa, and proliferation in the mucosa. We expect that the Healthy People 2010 diet will result in minimal changes relative to the Mediterranean diet. Increasing our understanding of the effects of dietary changes on human mucosa is fundamental to evaluating the potential of diet in colorectal cancer prevention. Such data would also validate the use of these biomarkers as screen for other dietary and/or pharmaceutical-based interventions aimed at slowing or reversing carcinogenesis. If beneficial effects can be demonstrated in mucosal biomarkers of colorectal cancer risk (prostaglandin E2, other eicosanoids, proliferation), such data may be used to justify a larger, prospective intervention with disease endpoints and more detailed dietary studies.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
3R01CA120381-03S1
Application #
7846930
Study Section
Chemo/Dietary Prevention Study Section (CDP)
Program Officer
Emenaker, Nancy J
Project Start
2007-01-01
Project End
2010-09-30
Budget Start
2009-06-01
Budget End
2010-09-30
Support Year
3
Fiscal Year
2009
Total Cost
$38,112
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Family Medicine
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Wilson, Matthew J; Sen, Ananda; Bridges, Dave et al. (2018) Higher baseline expression of the PTGS2 gene and greater decreases in total colonic fatty acid content predict greater decreases in colonic prostaglandin-E2 concentrations after dietary supplementation with ?-3 fatty acids. Prostaglandins Leukot Essent Fatty Acids 139:14-19
Djuric, Zora; Bassis, Christine M; Plegue, Melissa A et al. (2018) Colonic Mucosal Bacteria Are Associated with Inter-Individual Variability in Serum Carotenoid Concentrations. J Acad Nutr Diet 118:606-616.e3
Sidahmed, ElKhansa; Sen, Ananda; Ren, Jianwei et al. (2016) Colonic Saturated Fatty Acid Concentrations and Expression of COX-1, but not Diet, Predict Prostaglandin E2 in Normal Human Colon Tissue. Nutr Cancer 68:1192-201
Umoh, Faith I; Kato, Ikuko; Ren, Jianwei et al. (2016) Markers of systemic exposures to products of intestinal bacteria in a dietary intervention study. Eur J Nutr 55:793-798
Djuric, Zora; Turgeon, D Kim; Ren, Jianwei et al. (2015) Effects of a Mediterranean Diet Intervention on Anti- and Pro-Inflammatory Eicosanoids, Epithelial Proliferation, and Nuclear Morphology in Biopsies of Normal Colon Tissue. Nutr Cancer 67:721-9
Li, Yiting; Sen, Ananda; Ren, Jianwei et al. (2015) Effects of vitamin E from supplements and diet on colonic ?- and ?-tocopherol concentrations in persons at increased colon cancer risk. Nutr Cancer 67:73-81
Sidahmed, E; Cornellier, M L; Ren, J et al. (2014) Development of exchange lists for Mediterranean and Healthy Eating diets: implementation in an intervention trial. J Hum Nutr Diet 27:413-25
Porenta, Shannon R; Ko, Yi-An; Gruber, Stephen B et al. (2013) Interaction of fatty acid genotype and diet on changes in colonic fatty acids in a Mediterranean diet intervention study. Cancer Prev Res (Phila) 6:1212-21
Kato, Ikuko; Boleij, Annemarie; Kortman, Guus A M et al. (2013) Partial associations of dietary iron, smoking and intestinal bacteria with colorectal cancer risk. Nutr Cancer 65:169-77
Ren, Jianwei; Mozurkewich, Ellen L; Sen, Ananda et al. (2013) Total Serum Fatty Acid Analysis by GC-MS: Assay Validation and Serum Sample Stability. Curr Pharm Anal 9:331-339

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