Dietary intake of flavonoid subclasses and risk of colorectal cancer: evidence from population studies

Objective: To systematically evaluate the relationship between flavonoids intake and colorectal cancer risk by conducting a meta-analysis. Results: Our meta-analysis included 18 studies involving 16,917 colorectal cancer cases in 559,486 participants in relations to flavonoids intake during six to twenty-six years of follow-up. Our results indicated that specific flavonoid subclasses, such as procyanidins (OR = 0.75; 95% CI, 0.66-0.86) and isoflavones (OR = 0.87; 95% CI, 0.78-0.98), showed protective effects against colorectal cancer risk. There was no enough evidence indicating that increased consumption of total flavonoids were significantly associated with reduced risk of colorectal cancer (OR = 0.94, 95% CI, 0.81-1.09). There was no publication bias across studies. Methods: We performed a systematic search of PubMed, Web of Science and the Cochrane Library databases for relevant articles before December 2015. A random-effects model was used to estimate summary odds ratios and 95% confidence intervals (CIs) for associations between flavonoids and colorectal cancer risk. We assessed heterogeneity among studies by the Cochran Q and I-2 statistics. Conclusions: Our meta-analysis provides comprehensive evidence and partly supported the hypothesis that higher habitual intake of foods rich in procyanidins and isoflavones may potentially decrease colorectal cancer incidence. More prospective studies are warranted to verify this protective association.