Table 4.
Associations between energy-adjusted dietary nitrate (NO3-N) and nitrite and meat intakes and incident colon and rectal cancers (N=34,708)
| Colon | Rectum | ||||
|---|---|---|---|---|---|
| N | Cases | HRb, 95% CI | Cases | HRc, 95% CI | |
| Dietary NO3-Na (mg/day) | |||||
| ≤9.80 | 8,676 | 324 | 1.00 (Ref.) | 79 | 1.00 (Ref.) |
| 9.81–13.80 | 8,674 | 324 | 0.98 (0.84, 1.15) | 81 | 1.03 (0.76, 1.41) |
| 13.81–19.29 | 8,685 | 321 | 0.97 (0.83, 1.13) | 71 | 0.91 (0.66, 1.26) |
| >19.29 | 8,673 | 355 | 1.11 (0.94, 1.30) | 94 | 1.27 (0.93, 1.74) |
| p trend | 0.17 | 0.09 | |||
| Continuousd | 1.07 (0.96, 1.20) | 1.15 (0.92, 1.45) | |||
| Dietary Nitrite (mg/day) | |||||
| ≤0.57 | 8,588 | 345 | 1.00 (Ref.) | 93 | 1.00 (Ref.) |
| 0.58–0.65 | 8,655 | 342 | 0.93 (0.80, 1.08) | 74 | 0.75 (0.55, 1.02) |
| 0.66–0.74 | 8,974 | 320 | 0.83 (0.71, 0.97) | 91 | 0.88 (0.65, 1.18) |
| >0.74 | 8,491 | 317 | 0.87 (0.74, 1.02) | 67 | 0.68 (0.49, 0.94) |
| p trend | 0.05 | 0.04 | |||
| Continuous | 0.82 (0.63, 1.07) | 0.66 (0.39, 1.12) | |||
| Plant sources | |||||
| ≤0.32 | 8,225 | 309 | 1.00 (Ref.) | 73 | 1.00 (Ref.) |
| 0.33–0.39 | 9,618 | 368 | 0.97 (0.83, 1.13) | 102 | 1.12 (0.83, 1.52) |
| 0.40–0.48 | 7,889 | 308 | 0.99 (0.85, 1.18) | 75 | 1.00 (0.72, 1.39) |
| >0.48 | 8,976 | 339 | 0.96 (0.81, 1.14) | 75 | 0.86 (0.61, 1.21) |
| p trend | 0.72 | 0.33 | |||
| Continuous | 0.95 (0.79, 1.14) | 0.89 (0.61, 1.30) | |||
| Animal sources | |||||
| ≤0.19 | 9,151 | 361 | 1.00 (Ref.) | 82 | 1.00 (Ref.) |
| 0.20–0.24 | 8,387 | 326 | 0.92 (0.79, 1.08) | 97 | 1.26 (0.94, 1.69) |
| 0.25–0.30 | 8,581 | 345 | 0.94 (0.80, 1.09) | 80 | 1.02 (0.75, 1.38) |
| >0.30 | 8,264 | 292 | 0.82 (0.70, 0.97) | 66 | 0.89 (0.64, 1.23) |
| p trend | 0.03 | 0.11 | |||
| Continuous | 0.87 (0.74, 1.02) | 0.75 (0.55, 1.01) | |||
| Processed meats e | |||||
| 0 | 5,966 | 220 | 1.00 (Ref.) | 58 | 1.00 (Ref.) |
| ≤0.02 | 9,712 | 351 | 0.97 (0.82, 1.15) | 86 | 0.88 (0.63, 1.23) |
| 0.02–0.04 | 9,400 | 392 | 1.11 (0.94, 1.31) | 99 | 1.03 (0.74, 1.43) |
| >0.04 | 9,630 | 361 | 1.03 (0.86, 1.22) | 82 | 0.84 (0.59, 1.19) |
| p trend | |||||
| Continuous | 1.03 (0.99, 1.07) | 0.98 (0.90, 1.05) | |||
| Red meat (g/day) f | |||||
| ≤30.1 | 8,690 | 303 | 1.00 (Ref.) | 70 | 1.00 (Ref.) |
| 30.2–49.1 | 8,679 | 326 | 1.09 (0.93, 1.27) | 86 | 1.24 (0.91, 1.70) |
| 49.2–63.4 | 8,664 | 346 | 1.14 (0.98, 1.34) | 90 | 1.29 (0.94, 1.76) |
| >63.4 | 8,675 | 349 | 1.18 (1.01, 1.37) | 79 | 1.15 (0.83, 1.59) |
| p trend | 0.04 | 0.48 | |||
| Continuous | 1.09 (1.02, 1.16) | 1.08 (0.95, 1.24) | |||
| Processed meat (g/day) f | |||||
| ≤0.74 | 11,565 | 315 | 1.00 (Ref.) | 85 | 1.00 (Ref.) |
| 0.75–2.44 | 6,028 | 338 | 1.08 (0.92, 1.26) | 77 | 0.92 (0.67, 1.25) |
| 2.45–4.59 | 8,794 | 346 | 1.10 (0.94, 1.28) | 84 | 0.99 (0.74, 1.35) |
| >4.59 | 8,321 | 325 | 1.07 (0.91, 1.25) | 79 | 0.97 (0.71, 1.32) |
| p trend | 0.55 | 0.15 | |||
| Continuous | 1.07 (1.00, 1.15) | 0.98 (0.85, 1.12) | |||
a
NO3− converted to NO3-N. Dietary nitrate was derived almost exclusively from plant sources, therefore results are presented only for total dietary nitrate.
b
Models adjusted for age, heme iron, red meat, and mutually adjusted for total dietary nitrate or nitrite.
c
Models adjusted for age and mutually adjusted for total dietary nitrate or nitrite.
d
Per 1-unit change in natural log-transformed value.
e
Not mutually adjusted for nitrate from processed meat sources due to high correlation.
f
Models adjusted for age and total dietary nitrate.