Dietary energy density is positively associated with risk of pancreatic cancer in urban Shanghai Chinese.

Regular consumption of energy-dense foods predisposes to obesity and type 2 diabetes, both of which are suggested risk factors for pancreatic cancer. The aim of this study was to investigate whether energy density of foods is an independent risk factor for pancreatic cancer. In this population-based case-control study in urban Shanghai, 908 patients with pancreatic cancer and 1067 normal controls, aged 35-79 y, were recruited. The energy density for overall diet was calculated from food-frequency questionnaire data. Energy density (adjusted for age, sex, and total energy intake) was significantly higher in cases (6.08 ± 0.04 kJ/g) than in controls (5.91 ± 0.04 kJ/g) (P = 0.003). Energy density was positively associated with pancreatic cancer risk (OR: 1.16 per unit increase; 95% CI: 1.07, 1.27; P < 0.001). In adjusted analysis, the risk of pancreatic cancer was 72% greater (OR: 1.72; 95% CI: 1.25, 2.35; P = 0.001) in the highest quintile of energy density compared with the lowest quintile. In this case-control study, dietary energy density is positively associated with risk of pancreatic cancer. This association should be further investigated in prospective studies.