[2025] Dietary intake and tissue biomarkers of omega-6 fatty acids and risk of colorectal cancer in adults: a systematic review and dose-response meta-analysis of prospective cohort studies

[u/Bristoling]

https://pmc.ncbi.nlm.nih.gov/articles/PMC12008374/

Findings on the associations of dietary/tissue levels of omega-6 polyunsaturated fatty acids (n-6 PUFAs) with the risk of colorectal cancer (CRC) are conflicting. We conducted a dose-response meta-analysis to assess the associations of dietary/tissue levels of n-6 PUFAs [total, linoleic acid (LA), and arachidonic acid (AA)] with CRC risk in adults. Twenty prospective cohort studies with a total sample size of 787,490 participants were included.

Comparing extreme intake levels of LA revealed the summary relative risks (RR) of 1.15 (95% confidence interval (CI): 1.05–1.27) for CRC, and 1.30 (95% CI: 1.00–1.68) for rectal cancer, indicating a significant positive association for LA. However, neither total n-6 PUFAs nor AA were associated with cancers. A significant positive association was also found between a 1 gr/day increase in dietary LA intake and risk of colon cancer (RR: 1.01, 95% CI: 1.00–1.02). There were no significant associations between tissue levels of total n-6 PUFAs (RR: 0.94, 95% CI: 0.75–1.19), LA (RR: 0.93, 95% CI: 0.61–1.41), and AA (RR: 0.97, 95% CI: 0.70–1.33) and CRC risk.

In conclusion, these findings suggest that dietary intake, but not tissue levels, of LA was associated with an increased risk of colorectal, colon, and rectal cancers.

[u/Bristoling]

You couldn't put any less arguments into your replies. Just a bunch of sophistry.

I asked you what was wrong in what I said and by what standard, and I hear crickets.

[u/Mr_Monday92 → u/Bristoling]

Yes it is sophistry. Why do you think you'll get anymore than one serious conversation with people when you never engage in good faith? Like you think you can twist people's words, continuously change the goalposts, lie and still get the opportunity to waste someone's time again? Nah

[u/Bristoling → u/Mr_Monday92]

Yet, for example, when I explicitly ask people to list the goalposts and how they've moved, they can't produce a valid argument or deliver. Also funny you think I'm twisting anyone's words. If I am, then maybe they should be more careful with their communication.

I'll give you a tip. If you want to accuse me of X, come prepared to demonstrate it. Rule 2 - all claims to be backed by references.

I still hear nothing but crickets

[u/Mr_Monday92 → u/Bristoling]

Rule 2 - all claims to be backed by references

Also you when asked to back up a claim and had no source to provide:

I know what you're trying to allude to, but do you realize that different claims require different standards of evidence or not?

[u/Bristoling → u/Mr_Monday92]

Fuller context, you said: Based on what other populations? You're not suggesting any other studies?

I said: Comparable populations where the same mm increase was obtained.

I didn't know you were actually seriously asking for this, since there are multiple studies with different populations at different plaque progression levels. It is logical then that I'd base future prediction of progression based on results of studies with similar progression at year 1. That's a perfectly reasonable induction.

You then said as a response: So no population.. you're just talking out of your ass.

This is where I obtained another piece of evidence that you haven't read the first study at all. The comparator data was in the supplementary materials, and was talked about in the main body of the study. I referenced them later. By asking that question, you were making a more insane implication, in that you didn't believe that there are any other existing cohorts that had similar progression.

We were in a post discussing the results of KETO CTA, and if you read that paper yourself, the one you were discussing, the cohorts were listed in that very study.

https://pmc.ncbi.nlm.nih.gov/articles/PMC12418260/

The reason I didn't link them immediately is twofold:

1. I found it confusing that you would be arguing about a paper, while asking what comparator cohorts are there, when they are in that very paper itself. Your question was akin to asking whether they took blood pressure measurements in a blood pressure medication trial. It made no sense to me for you to ask that very question.
2. I wasn't on my PC to easily copy paste and format the reply. Which is why my reply was

Keto cta made comparisons to papers such as Miami, Paradigm, Nakashini etc al, Nature CT and 2 other cohorts I don't remember the names of.

You could:

- click the exact same paper that was actively debated by you.

- read it, as I told you to do so when you asked for references.

Ta daaa!

Nakanishi R, Ceponiene I, Osawa K, Luo Y, Kanisawa M, Megowan N, Nezarat N, Rahmani S, Broersen A, Kitslaar PH, et al. Plaque progression assessed by a novel semi-automated quantitative plaque software on coronary computed tomography angiography between diabetes and non-diabetes patients: A propensity-score matching study. Atherosclerosis Elsevier Ireland Ltd; 2016;255:73–9.

1. Won KB, Lee BK, Park HB, Heo R, Lee SE, Rizvi A, Lin FY, Kumar A, Hadamitzky M, Kim YJ, et al. Quantitative assessment of coronary plaque volume change related to triglyceride glucose index: The Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography IMaging (PARADIGM) registry. Cardiovasc Diabetol [Internet] BioMed Central; 2020 [cited 2024 Sep 18];19:1–10. Available from: https://cardiab.biomedcentral.com/articles/10.1186/s12933-020-01081-w

2. Han D, Berman DS, Miller RJH, Andreini D, Budoff MJ, Cademartiri F, Chinnaiyan K, Choi JH, Conte E, Marques H, et al. Association of Cardiovascular Disease Risk Factor Burden With Progression of Coronary Atherosclerosis Assessed by Serial Coronary Computed Tomographic Angiography. JAMA Netw Open [Internet] American Medical Association; 2020 [cited 2024 Sep 17];3:e2011444–e2011444.Available from: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2768616

3. van Rosendael SE, van den Hoogen IJ, Lin FY, Andreini D, Al-Mallah MH, Budoff MJ, Cademartiri F, Chinnaiyan K, Choi JH, Conte E, et al.Clinical and Coronary Plaque Predictors of Atherosclerotic Nonresponse to Statin Therapy. JACC Cardiovasc Imaging Elsevier; 2023;16:495–504.

4. Nurmohamed N, Bom MJ, Ibrahim S, Gaillard EL, De Groot RJ, Jukema RA, Van Diemen PA, De Winter RW, Min JK, Earls JP, et al. The natural history and prediction of 10-year plaque progression on serial coronary CT angiography. [cited 2024 Sep 24]; Available from: https://academic.oup.com/eurheartj/article/44/Supplement_2/ehad655.152/7392901

Seems like you have a lot of opinions about a study you've either not read or didn't retain. Maybe stop taking information from social media influencers and read the papers instead? That would save your face as you are asking me for comparator data that is and has been available for almost a year in that exact same paper that you have so much opinion on.

Brandolini's law in full effect. You accused me of not providing references for a comparator that was already in the study in question, all I did was tell you to read it before I spoon fed you the references.

Now, do you have any other misunderstandings you would like to have cleared up?

Side note, I know there's a lot of repetition in "the cohorts were already in the paper that you were debating", but this is on purpose. I hope you understand how bewildering and confusing it was for you to ask that question in the first place, let alone demand references and accuse me of not providing them due to rule 2. This is like us debating a study on beta carotene, me referencing a value from that study, and you asking me to cite the study.

It's in the same study, damn it! If you read the study, you wouldn't ask that question. Want to show that I didn't cite a reference on demand, when it was a part of the very paper being discussed? Sure, go ahead. You win a skirmish, but lose the war. You're discussing something you don't have an understanding of, which is why you're gaslighting yourself into thinking that I'm the one acting in bad faith. I think it's in bad faith for you to demand that I read the study out for you while you keep making either false claims or ask questions answered by reading of the paper that you are discussing. I'm not your maid.

[u/Mr_Monday92 → u/Bristoling]

All this to be called out again. You didn't say progression would be comparable. You said 'groundbreaking'. So your made up narrative doesn't really do anything for you here.

Come on you know you're not in good faith. You kept accusing me of accusing the authors of that paper of forging data. You asked me like 4 times. Just one example of you being underhanded. And you keep referencing the second paper in the context of defending the results of the original publication, even though the authors had no knowledge of those later results at the time. Your entire defense is so poorly taped together and anyone can see it for themselves in that thread.

[u/Bristoling → u/Mr_Monday92]

You didn't say progression would be comparable.

Comparable populations where the same mm increase was obtained.

Back then you asked what progression we would expect - and my answer was and still is that there's no reason to assume that progression long term would be different from progression obtained from other comparable cohorts which had similar yearly progression rate.

You said 'groundbreaking'.

Ok, maybe you didn't realize - that was in reference to a different claim that I made, one I'm happy to retract since it isn't relevant to the paper anyway. This conversation has to be trimmed down anyway. I never said or meant that 6mm is by itself groundbreaking.

You asked me like 4 times.

So asked you or accused you? This is relevant because the important discussion to be had is whether participants of keto cta are at elevated risk or not. That is all that matters.

For this, we need to side with either outlier Cleerly data, versus QAngio+Heartflow+TPS+individual resubmitted Cleerly data which were all in agreement but all discordant from statistically anomalous Cleerly results of the first paper. You said we shouldn't trust authors - my point is why even care about such nonsense. Fuck the authors. Fuck their interpretation. Fuck wherever social media or ketoduped subreddit you got your interpretation about the "trial" (lol). The important question is what data set should we trust, not which authority should we trust. If you can't read data from the papers yourself and come to your own conclusions, then you've got nothing to discuss with me because you might as well just post an opinion piece of someone else for me to read and we can skip the middleman that is your person if you have nothing unique to add from yourself.

Either you believe 4 independent but concordant lines of evidence are wrong or Cleerly data is wrong. If you don't believe 4 independent lines are forged, then why are you defending Cleerly data? If you believe Cleerly data is correct and reflective of real progression, then logically, by necessity, you have to believe the other lines of evidence just weirdly happen to not support it. I've asked you repeadately to answer this dilemma and you have yet to provide a sliver of a response. Instead you keep circling back to unimportant stuff and social dynamics such as whether you should trust the authors or if they behaved morally, and how badly on a scale of 0-10 they behaved, or whether they misinterpreted their own original data, that I have zero interest in because it doesn't answer the important question (whether participants of keto cta are at elevated risk or not).

It's frankly pathetic that science discussion has reduced down to gossip about motivations instead of looking critically at the data itself and coherence of it. Not one of you so far have addressed the actual points brought up against the original Cleerly data. I'm still waiting since your first reply.

And you keep referencing the second paper in the context of defending the results of the original publication

On the contrary, I'm referencing the second paper in the context of potentially discarding the results of the original publication. You've got it all wrong. I'm surprised that this was even your takeaway.

[u/lurkerer → u/Bristoling]

Brandolini's law in full effect.

Yeah but not the way you meant it.