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  • Response to Letter to the Editor
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Reply to Dr Arasaradnam

European Journal of Clinical Nutrition volume 64, page 1502 (2010)Cite this article

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We appreciate the comments by Dr Arasaradnam on our article (Kim et al., 2009) published in the European Journal of Clinical Nutrition.

We acknowledge that the true protective effect of folate on the risk of colorectal cancer should be reconsidered after accounting for the effect of fiber. When we reanalyzed the data by adding the fiber intake to the final mode, we found no statistical significance in the association of folate with colorectal cancer risks (odds ratio: 0.61, 95% confidence interval: 0.34–1.08) on comparing the highest quartile with the lowest of dietary folate. Although there was obviously the attenuation of effect of folate after further adjustment for fiber, we also observed widening of confidence intervals, indicating collinearity between these two nutrients. The Spearman correlation coefficient between folate and fiber was 0.93 in this data. A possible reason for this collinearity could be that the foods that provide folate and fiber mainly consist of fruits and vegetables. In the observational study such as ours, it may not be possible to see the independent effect of each nutrient when one is highly correlated with the other.

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References

  • Kim J, Kim J, Kim DH, Lee BH, Kang SH, Lee HJ et al. (2009). Folate intake and the risk of colorectal cancer in a Korean population. Eur J Clin Nutr 63, 1057–1064.

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Authors and Affiliations

  1. Cancer Epidemiology Branch, National Cancer Research Institute, National Cancer Center, Goyang, South Korea

    J Kim

  2. Department of Social and Preventive Medicine, Hallym University College of Medicine, Kangwon-Do, South Korea

    D H Kim

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  1. J Kim
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  2. D H Kim
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Correspondence to D H Kim.

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The authors declare no conflict of interest.

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Kim, J., Kim, D. Reply to Dr Arasaradnam. Eur J Clin Nutr 64, 1502 (2010). https://doi.org/10.1038/ejcn.2010.191

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