ASPO Abstracts
Prebiotic Supplement Use and Colorectal Cancer Risk in the Women’s Health Initiative
Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2019
Abstract Body:
Purpose: Prebiotics are a nondigestible food ingredient that are selectively fermented by intestinal microorganisms and are marketed for promoting the growth of beneficial microorganisms and maintaining bowel health. Prebiotic supplements available over-the-counter may be composed of either soluble or insoluble fiber. While the association between dietary fiber intake and colorectal cancer (CRC) has been studied, the association between prebiotic use and CRC remains unclear. Methods: The association between prebiotic use and CRC risk was studied using data from the Women’s Health Initiative. Self-reported prebiotic use was captured on the current medications or current supplements form completed by participants at enrollment. Cox proportional hazards models were used to estimate the hazard ratio, adjusted for demographic and CRC risk factors, for the relationship between prebiotic use and CRC risk and investigate potential interactions with other CRC risk factors. Results: A total of 3,217 CRC cases occurred during an average 15.4 years of follow-up. Prebiotic supplement users (n= 5,990, 3.7%) were predominately non-Hispanic whites, non-smokers, with a normal body mass index. The majority (87.9%) of prebiotic supplement users did not meet dietary fiber recommendations (≥25g/day) (mean dietary intake= 16.7 ± 7.0 grams). Overall, use of any prebiotic supplement was not associated with CRC risk (HR: 1.07; 95%CI: 0.88-1.31). The type of prebiotic supplement (soluble or insoluble) was also not associated with CRC risk (HR: 1.04; 95%CI: 0.83-1.29, HR: 1.39; 95%CI: 0.82-2.35, respectively). Likelihood ratio tests indicated no significant interactions between prebiotic use and other CRC risk factors. A difference in the direction of association between prebiotic use and CRC risk stratified on current calcium supplement use was observed, but was non-significant (calcium users = HR: 0.87; 95%CI: 0.57-1.35, calcium non-users = HR: 1.15; 95%CI: 0.91-1.45). Conclusion: These results suggest that prebiotic fiber supplements are not associated with CRC risk in post-menopausal women. These data would not support the promotion of prebiotic fiber supplements to reduce CRC risk in post-menopausal women.
Keywords: prebiotic, colorectal cancer, supplements