We observed a statistically significant positive association between the Western pattern and colon cancer and a suggestion of an inverse association with the prudent pattern. These results are in agreement with previous studies that used dietary patterns to predict colon cancer risk.12,13 In a case-control study in 1998, Slattery et al12 used factor analysis and identified several dietary patterns. The components of the Western and prudent diet in that study and their associations with colon cancer were similar to the Western and prudent patterns in our analysis. The Western pattern identified by Slattery et al was characterized by higher intakes of processed and red meats, eggs, fast food meats, butter, coffee, and potatoes. Women at the top quintile of this pattern had an odds ratio for colon cancer risk of 1.49 (95% CI, 1.05-2.12) compared with the bottom quintile. The prudent pattern identified was characterized by higher intakes of fruits, vegetables, legumes, and fish. Comparing top with bottom quintile, the odds ratio for colon cancer was 0.73 (95% CI, 0.55-0.97) among women. Similar dietary patterns were identified in a Swedish cohort of women.32 The
"healthy" pattern was characterized by higher intakes of fruits and vegetables, low-fat dairy products, whole grains, cereals, and eggs, and the "Western" pattern characterized by higher intakes of meats, refined grains, soda, and potatoes. However, neither pattern was significantly associated with colorectal cancer risk. In a case-control study by Randall et al,13 somewhat different dietary patterns, probably owing to different groupings of foods, were generated separately for men and women. In men, the "traditional" pattern (characterized by items such as beef, cakes, potatoes, and cabbage), "snack" pattern (characterized by desserts, sweets, and hamburger), and the "high-fat" pattern (characterized by items such as alcohol, eggs, and processed meats) were positively associated with colon cancer risk (odds ratios ranged from 1.26-1.32). In women, the "salad" pattern (characterized by salad vegetables),
"light" pattern (characterized by items such as fish, hard cheese, yogurt, and broccoli), and the "whole grain" pattern (characterized by whole grain products, nuts, and dried fruits) were inversely associated with colon cancer risk (odds ratios ranged from 0.67-0.80).