(P30-26-26) Trends in Colorectal Cancer-Related Dietary Exposures Among U.S. Young Adults: NHANES 2011–March 2020

Objectives: Colorectal cancer (CRC) incidence is rising among young adults. CRC-related dietary risks - low fiber, calcium, and dairy, high red and processed meat, and alcohol intakes - are not well characterized in young adults.

We aimed to examine trends in CRC-related dietary exposures among U.S. young adults (18–25 years) from 2011 to March 2020.

Methods: We analyzed NHANES data from 2011 to March 2020. Dietary exposures include fiber (g/day), calcium (mg/day), dairy (cup eq/day), whole grains (oz eq/day), alcohol (number of drinks/drinking day), red meat (oz eq/day), and processed meat (oz eq/day). Nutrient intakes were derived from 24-hour dietary recalls, food group equivalents from the Food Patterns Equivalents Database, and alcohol from the alcohol use questionnaire. Only participants with one or more reliable recalls were included. Averages of two recalls were used where appropriate. Weighted means (standard error [SE]) were estimated. We tested overall differences (Wald F-tests), linear trend (weighted cycle midyear regression (2011.5–2018.5)), and differences between 2011–12 and 2017–March 2020. Analyses were repeated for consumers (intake >0).

Results: These analyses included 3512 participants (2011–12 [n=845], 2013–14 [n=856], 2015-16 [n=731], and 2017–March 2020 [n=1080]), with a weighted mean (SE) age of 21.66 (0.06) years, and 48.6% females. Significant declines were observed for alcohol (p=0.001), fiber (p=0.002), calcium (p < 0.001), and dairy (p < 0.001). Trends showed declines in alcohol (−0.18 [-0.26, -0.09] ± 0.04; p< 0.001), fiber (−0.21 [-0.37, -0.05] ± 0.08; p=0.012), calcium (−19.75 [-27.78, -11.73] ± 4.09; p< 0.001), and dairy (−0.07 [-0.09, -0.04] ± 0.01; p< 0.001). Early vs late contrasts showed marked declines from 2011–12 to 2017–March 2020 in alcohol (−1.30 [-1.94, -0.67] ± 0.33; p< 0.001), fiber (−2.02 [-3.19, -0.85] ± 0.60; p=0.002), calcium (−136.83 [-197.09, -76.57] ± 30.74; p< 0.001), and dairy (−0.41 [-0.60, -0.22] ± 0.10; p< 0.001). Other exposures showed no significant changes. Results were similar for consumers.

Conclusions: From 2011 to 2020, U.S. young adults experienced significant declines in multiple dietary exposures—including fiber, calcium, and dairy intakes—highlighting overall worsening patterns relevant to CRC prevention. Continued surveillance and targeted interventions are warranted.

Funding Sources: N/A