Dietary Calcium Intake and Colorectal Adenoma in Men and Women with Low Calcium Intake

Abstract

Backgrounds/Aims: Calcium is a preventive factor for colorectal cancer, which develops fromcolorectal adenoma. This study aimed to investigate the association between dietary calciumintake and prevalence of colorectal adenoma among Korean adults. Methods: Overall, 612 participants aged ≥ 20 years who underwent gastrointestinal endoscopyat 8 medical centers from 2021 to 2023 were included. Dietary calcium intake was assessedusing a food frequency questionnaire and was energy-adjusted using the residual model. Multivariatelogistic regression models were used to calculate for the odds ratios (ORs) and 95%confidence intervals (CIs). The associations between dietary calcium intake and colorectaladenoma prevalence were also assessed according to the anatomic subsites and adenoma status(advanced or nonadvanced). Results: Among the 612 participants, 269 were diagnosed with colorectal adenoma (170 menand 99 women). With respect to the gender-specific association, low dietary calcium intake wasassociated with higher prevalence of colorectal adenoma among men (ORs [95% CIs]: 2.13 [0.50–9.00] for < 250 mg/d; 3.53 [1.06–11.76], 250 to < 350 mg/d; and 1.84 [0.63–5.35], 350 to < 650mg/d, compared to ≥ 650 mg/d of dietary calcium [p for trend = 0.07]). Similar association wasobserved among women, but neither the association nor trend was statistically significant (p fortrend = 0.59). These inverse associations remained similar for distal colon/rectal adenoma amongwomen and advanced adenoma among men. Conclusions: Low dietary calcium intake was associated with high colorectal adenoma prevalence,particularly among men. Given the limited number of studies among Asian populations,our findings should be replicated in other Asian groups.