@article{Kim:2022aa,
	abstract = {BACKGROUND: Plant-based diets assessed by a priori indices are associated with health outcomes. This study investigated the associations between pre-defined indices of plant-based diets and risk of colorectal cancer (CRC) and evaluated whether the association varies by sex, race and ethnicity, and anatomic subsite of tumors. METHODS: A total of 79,952 men and 93,475 women who participated in the Multiethnic Cohort Study were included. Primary outcome was incidence of invasive CRC. Cox models were used to estimate the risk of CRC across quintiles of three plant-based diet scores: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). RESULTS: During a mean follow-up of 19.2 years, 4976 incident CRC were identified. Among men, multivariable-adjusted HR (95% CI) for the highest vs. lowest quintiles was 0.77 (0.67-0.88) for PDI, and 0.80 (0.70-0.91) for hPDI, while no significant association was found for uPDI among men and for all indices among women. In men, the inverse association for PDI was stronger in Japanese American, Native Hawaiian, and White groups than African American or Latino group (P for heterogeneity = 0.01) and for left colon and rectal tumors than right tumors (P for heterogeneity = 0.005), whereas the decreased risk with hPDI was found consistently across racial and ethnic groups and subsites. CONCLUSIONS: Greater adherence to plant-based diets rich in healthy plant foods and low in less healthy plant foods is associated with a reduced risk of CRC in men, but not in women. The strength of the association among men may vary by race and ethnicity and anatomic subsite of tumors.},
	address = {Department of Genetics and Biotechnology, College of Life Sciences, Kyung Hee University, 1732 Deogyeong-daero, Giheung-Gu, Yongin, Gyeonggi-Do, 17104, South Korea. kjhye@khu.ac.kr.; Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA.; Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA.; Department of Population and Public Health Sciences, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.; Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA.; Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA.},
	auid = {ORCID: 0000-0002-3280-7381},
	author = {Kim, Jihye and Boushey, Carol J and Wilkens, Lynne R and Haiman, Christopher A and Le Marchand, Lo{\"\i}c and Park, Song-Yi},
	cois = {The authors declare that they have no competing interests.},
	copyright = {{\copyright}2022. The Author(s).},
	crdt = {2022/11/29 00:04},
	date = {2022 Nov 29},
	date-added = {2023-01-04 20:51:49 +0000},
	date-modified = {2023-01-08 12:09:22 +0000},
	dcom = {20221130},
	dep = {20221129},
	doi = {10.1186/s12916-022-02623-7},
	edat = {2022/11/30 06:00},
	gr = {2021R1A2C1003211/Ministry of Science and ICT, Korea/; U01 CA164973/CA/NCI NIH HHS/United States; U01 CA164973/CA/NCI NIH HHS/United States; R03 CA223890/CA/NCI NIH HHS/United States; R03 CA223890/CA/NCI NIH HHS/United States},
	issn = {1741-7015 (Electronic); 1741-7015 (Linking)},
	jid = {101190723},
	journal = {BMC Med},
	jt = {BMC medicine},
	keywords = {Plant-Based},
	language = {eng},
	lid = {10.1186/s12916-022-02623-7 {$[$}doi{$]$}; 430},
	lr = {20221214},
	mh = {Male; Female; Humans; Cohort Studies; *Ethnicity; Research; Health Status; *Colorectal Neoplasms/epidemiology},
	mhda = {2022/12/01 06:00},
	month = {Nov},
	number = {1},
	oto = {NOTNLM},
	own = {NLM},
	pages = {430},
	phst = {2022/04/03 00:00 {$[$}received{$]$}; 2022/10/21 00:00 {$[$}accepted{$]$}; 2022/11/29 00:04 {$[$}entrez{$]$}; 2022/11/30 06:00 {$[$}pubmed{$]$}; 2022/12/01 06:00 {$[$}medline{$]$}},
	pii = {10.1186/s12916-022-02623-7; 2623},
	pl = {England},
	pmc = {PMC9706862},
	pmid = {36443779},
	pst = {epublish},
	pt = {Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't},
	sb = {IM},
	status = {MEDLINE},
	title = {Plant-based dietary patterns defined by a priori indices and colorectal cancer risk by sex and race/ethnicity: the Multiethnic Cohort Study.},
	url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9706862/pdf/12916_2022_Article_2623.pdf},
	volume = {20},
	year = {2022},
	bdsk-url-1 = {https://doi.org/10.1186/s12916-022-02623-7},
	bdsk-url-2 = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9706862/pdf/12916_2022_Article_2623.pdf}}