Dietary polyamine intake and colorectal cancer risk in postmenopausal women

• Published in: The American journal of clinical nutrition 2015-08, Vol.102 (2), p.411-419
• Main Authors: Vargas, Ashley J, Ashbeck, Erin L, Wertheim, Betsy C, Wallace, Robert B, Neuhouser, Marian L, Thomson, Cynthia A, Thompson, Patricia A
• Format: Article
• Language: English
• Subjects: Aged; Aging; Body Mass Index; Cancer; Cell growth; Cohort Studies; Colorectal cancer; Colorectal Neoplasms - epidemiology; Colorectal Neoplasms - etiology; Colorectal Neoplasms - mortality; Colorectal Neoplasms - prevention & control; Diet - adverse effects; Dietary Fiber - administration & dosage; Dietary Fiber - therapeutic use; Female; Humans; Incidence; Longitudinal Studies; Menopause; Middle Aged; Mortality; Nutrition Policy; Overweight - etiology; Overweight - physiopathology; Overweight - prevention & control; Patient Compliance; Polyamines - administration & dosage; Polyamines - adverse effects; Polyamines - therapeutic use; Postmenopause; Proportional Hazards Models; Regression analysis; Risk Factors; United States - epidemiology
• ISSN: 0002-9165; 1938-3207
• DOI: 10.3945/ajcn.114.103895

Putrescine, spermidine, and spermine (i.e., polyamines) are small cationic amines synthesized by cells or acquired from the diet or gut bacteria. Polyamines are required for both normal and colorectal cancer (CRC) cell growth. We investigated the association between dietary polyamines and risk of CRC incidence and mortality. The study was a prospective analysis in 87,602 postmenopausal women in the Women's Health Initiative Observational Study. Multivariate Cox regression was used to calculate HRs and 95% CIs. Total dietary polyamine intake (mean ± SD: 289.2 ± 127.4 μmol/d) was not positively associated with CRC in fully adjusted models. Instead, intake ≥179.67 μmol/d was associated with reduced risk of CRC [HR (95% CI): 0.82 (0.68, 1.00), 0.81 (0.66, 0.99), 0.91 (0.74, 1.12), and 0.80 (0.62, 1.02) for quintiles 2-5, respectively, compared with quintile 1]. Reduced risk was not significant across all quintiles. Polyamines were not significantly associated with CRC-specific mortality in fully adjusted models. When stratified by risk factors for CRC, only body mass index (BMI) and fiber intake significantly modified the association between polyamine intake and CRC. In women with BMI (in kg/m²) ≤25 or fiber consumption above the median, polyamine intake was associated with significantly lower risk of CRC. No positive association between dietary polyamines and CRC or CRC-specific mortality risk in women was observed. Instead, a protective effect of dietary polyamines was suggested in women with some CRC risk-lowering behaviors in particular. These results are consistent with emerging evidence that exogenous polyamines may be beneficial in colon health and warrant additional study.