Evidence map›Paper›PMID 33279777›Full record

ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2022

Metabolic Signatures of Healthy Lifestyle Patterns and Colorectal Cancer Risk in a European Cohort.

Joseph A Rothwell, Neil Murphy, Jelena Bešević, Nathalie Kliemann, Mazda Jenab, Pietro Ferrari, David Achaintre, Audrey Gicquiau, Béatrice Vozar, Augustin Scalbert and 36 more

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In one paragraph

Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 2 pooled it
3.6field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.

  1. Pooled it
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  7. Metabolic profile of biodiverse diets in a healthy European cohort.The American journal of clinical nutrition · 2025
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  10. Identifying Metabolomic Mediators of the Physical Activity and Colorectal Cancer Relationship.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

46 authors at 20 institutions in 13 countries.

Joseph A RothwellCentre for Epidemiology and Population Health, U1018, Generations and Health Team, Faculté de Médecine, Université Paris-Saclay, INSERM, Villejuif, France; Gustave Roussy, Villejuif, France; International Agency for Research on Cancer, Lyon, France. Electronic address: joseph.rothwell@inserm.fr.
Neil MurphyInternational Agency for Research on Cancer, Lyon, France.
Jelena BeševićDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
Nathalie KliemannInternational Agency for Research on Cancer, Lyon, France.
Mazda JenabInternational Agency for Research on Cancer, Lyon, France.
Pietro FerrariInternational Agency for Research on Cancer, Lyon, France.
David AchaintreInternational Agency for Research on Cancer, Lyon, France.
Audrey GicquiauInternational Agency for Research on Cancer, Lyon, France.
Béatrice VozarInternational Agency for Research on Cancer, Lyon, France.
Augustin ScalbertInternational Agency for Research on Cancer, Lyon, France.
Inge HuybrechtsInternational Agency for Research on Cancer, Lyon, France.
Heinz FreislingInternational Agency for Research on Cancer, Lyon, France.
Cornelia PrehnDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
Jerzy AdamskiResearch Unit, Molecular Endocrinology and Metabolism, Helmholtz Zentrum München, Neuherberg, Germany; Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Experimental Genetics, School of Life Science Weihenstephan, Technische Universität München, Neuherberg, Germany.
Amanda J CrossDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
Valeria Maria PalaDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
Marie-Christine Boutron-RuaultCentre for Epidemiology and Population Health, U1018, Generations and Health Team, Faculté de Médecine, Université Paris-Saclay, INSERM, Villejuif, France; Gustave Roussy, Villejuif, France.
Christina C DahmDepartment of Public Health, Aarhus University, Aarhus C, Denmark.
Kim OvervadDepartment of Public Health, Aarhus University, Aarhus C, Denmark.
Inger Torhild GramFaculty of Health Sciences, Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.
Torkjel M SandangerFaculty of Health Sciences, Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.
Guri SkeieFaculty of Health Sciences, Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.
Paula JakszynUnit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Barcelona, Spain; Blanquerna School of Health Sciences, Ramon Llull University, Barcelona, Spain.
Kostas K TsilidisDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
Krasimira AleksandrovaNutrition, Immunity and Metabolism Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Potsdam, Germany.
Matthias B SchulzeInstitute of Nutritional Science, University of Potsdam, Potsdam, Germany; Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
David J HughesSchool of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland.
Bethany van GuelpenDepartment of Radiation Sciences, Oncology Unit, Umea University, Umea, Sweden.
Stina BodénDepartment of Radiation Sciences, Oncology Unit, Umea University, Umea, Sweden.
Maria-José SánchezCIBER Epidemiología y Salud Pública, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.
Julie A SchmidtCancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
Verena KatzkeDivision of Cancer Epidemiology, Deutsches Krebsforschungszentrum, Stiftung des Öffentlichen Rechts, Heidelberg, Germany.
Tilman KühnDivision of Cancer Epidemiology, Deutsches Krebsforschungszentrum, Stiftung des Öffentlichen Rechts, Heidelberg, Germany.
Sandra Colorado-YoharDepartment of Epidemiology, Murcia Regional Health Council, Instituto Murciano de Investigatión Biomédica (IMIB)-Arrixaca, Murcia, Spain; CIBER Epidemiología y Salud Pública, Spain; Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia.
Rosario TuminoCancer Registry and Histopathology Department, Provincial Health Authority, Ragusa, Italy.
Bas Bueno-de-MesquitaDepartment for Determinants of Chronic Diseases, National Institute for Public Health and the Environment, BA Bilthoven, The Netherlands.
Paolo VineisDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Italian Institute of Technology, Genova, Italy.
Giovanna MasalaCancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network-Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy.
Salvatore PanicoDipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy.
Anne Kirstine EriksenDanish Cancer Society Research Center, Diet, Genes and Environment, Copenhagen, Denmark.
Anne TjønnelandDanish Cancer Society Research Center, Diet, Genes and Environment, Copenhagen, Denmark.
Dagfinn AuneDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Nutrition, Bjørknes University College, Oslo, Norway; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
Elisabete WeiderpassInternational Agency for Research on Cancer, Lyon, France.
Gianluca SeveriCentre for Epidemiology and Population Health, U1018, Generations and Health Team, Faculté de Médecine, Université Paris-Saclay, INSERM, Villejuif, France; Gustave Roussy, Villejuif, France.
Véronique ChajèsInternational Agency for Research on Cancer, Lyon, France.
Marc J GunterInternational Agency for Research on Cancer, Lyon, France.
Centre international de recherche sur le cancer · FRInstitut Gustave Roussy · FRInserm · FRUiT The Arctic University of Norway · NODanish Cancer Society · DKDKFZ-ZMBH Alliance · DEGerman Institute of Human Nutrition · DEUmeå University · SEUniversity College Dublin · IEAarhus University · DKFederico II University Hospital · ITImperial College London · GBInstituto de Investigación Biosanitaria de Granada · ESInstituto Murciano de Investigación Biosanitaria · ESIstituto per lo Studio e la Prevenzione Oncologica · ITNational Institute for Public Health and the Environment · NLNational University of Singapore · SGOsloMet – Oslo Metropolitan University · NOUniversitat Ramon Llull · ESUniversity of Ioannina · GR

Funding

Cancer Research UK 25004Medical Research Council 1000143Medical Research Council MR/M012190/1World Health Organization 001
6 · The paper itself

Abstract

BACKGROUND &

aimsColorectal cancer risk can be lowered by adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guidelines. We derived metabolic signatures of adherence to these guidelines and tested their associations with colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition cohort.

methodsScores reflecting adherence to the WCRF/AICR recommendations (scale, 1-5) were calculated from participant data on weight maintenance, physical activity, diet, and alcohol among a discovery set of 5738 cancer-free European Prospective Investigation into Cancer and Nutrition participants with metabolomics data. Partial least-squares regression was used to derive fatty acid and endogenous metabolite signatures of the WCRF/AICR score in this group. In an independent set of 1608 colorectal cancer cases and matched controls, odds ratios (ORs) and 95% CIs were calculated for colorectal cancer risk per unit increase in WCRF/AICR score and per the corresponding change in metabolic signatures using multivariable conditional logistic regression.

resultsHigher WCRF/AICR scores were characterized by metabolic signatures of increased odd-chain fatty acids, serine, glycine, and specific phosphatidylcholines. Signatures were inversely associated more strongly with colorectal cancer risk (fatty acids: OR, 0.51 per unit increase; 95% CI, 0.29-0.90; endogenous metabolites: OR, 0.62 per unit change; 95% CI, 0.50-0.78) than the WCRF/AICR score (OR, 0.93 per unit change; 95% CI, 0.86-1.00) overall. Signature associations were stronger in male compared with female participants.

conclusionsMetabolite profiles reflecting adherence to WCRF/AICR guidelines and additional lifestyle or biological risk factors were associated with colorectal cancer. Measuring a specific panel of metabolites representative of a healthy or unhealthy lifestyle may identify strata of the population at higher risk of colorectal cancer.

Indexed as

Colorectal NeoplasmsHealthy LifestyleCohort StudiesDietFatty AcidsFemaleHumansMaleProspective StudiesRisk FactorsFatty AcidsColorectal NeoplasmRisk FactorsTargeted MetabolomicsWorld Cancer Research Fund/American Institute for Cancer Research Recommendations

Identifiers

PMID33279777
PMCPMC9049188
OpenAlexW3106797839

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.