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Cancer Recurrence and Survival Associated With Dietary Patterns in Stage III Colon Cancer—Reply
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In Reply: We agree with Dr Chu that other measures of energy expenditure have been shown to be associated with disease-free survival in colon cancer survivors. However, we believe that BMI alone is not a surrogate marker for the potential biological impact of diet and physical activity. In Dignam et al1 (cited by Chu), only patients with class III obesity (BMI  35) experienced an inferior disease-free survival compared with normal weight patients. The hazard ratio for very obese patients was 1.28 (95% confidence interval, 1.04-1.57),1 weaker than the association we found for patients with the highest level of a Western pattern diet (hazard ratio, 3.25; 95% confidence interval, 2.04-5.19). In our study, we adjusted for BMI in all multivariate analyses, and this did not attenuate the relationship. Furthermore, as shown in Table 6 of our article, stratification by BMI ( 25 vs >25) showed a similar association for underweight/normal weight . . . [Full Text of this Article]
Jeffrey Meyerhardt, MD, MPH
jmeyerhardt@partners.org
Charles Fuchs, MD, MPH
Dana-Farber Cancer Institute
Boston, Massachusetts
RELATED LETTER
Cancer Recurrence and Survival Associated With Dietary Patterns in Stage III Colon Cancer
David Z. J. Chu
JAMA. 2007;298(19):2263.
EXTRACT
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RELATED ARTICLE
Association of Dietary Patterns With Cancer Recurrence and Survival in Patients With Stage III Colon Cancer
Jeffrey A. Meyerhardt, Donna Niedzwiecki, Donna Hollis, Leonard B. Saltz, Frank B. Hu, Robert J. Mayer, Heidi Nelson, Renaud Whittom, Alexander Hantel, James Thomas, and Charles S. Fuchs
JAMA. 2007;298(7):754-764.
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