Federica Turati1, Dimitrios Trichopoulos2, Jerry Polesel3, Francesca Bravi4, Marta Rossi5, Renato Talamini3, Silvia Franceschi6, Maurizio Montella7, Antonia Trichopoulou8, Carlo La Vecchia9, Pagona Lagiou10. 1. IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Dipartimento di Epidemiologia, Milan, Italy. 2. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. 3. S.O.C. Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, IRCCS, Aviano (PN), Italy. 4. IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Dipartimento di Epidemiologia, Milan, Italy; Struttura Complessa di Statistica Medica, Biometria e Bioinformatica, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. 5. IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Dipartimento di Epidemiologia, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. 6. International Agency for Research on Cancer, Lyon Cedex, France. 7. Dipartimento di Epidemiologia, 'Fondazione G. Pascale', Istituto Nazionale Tumori, Naples, Italy. 8. Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece. 9. IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Dipartimento di Epidemiologia, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. Electronic address: carlo.lavecchia@marionegri.it. 10. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA; Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece.
Abstract
BACKGROUND & AIMS: Hepatocellular carcinoma (HCC) has a very poor prognosis and any effort to identify additional risk factors, besides those already established, would be important for the prevention of the disease. Data on the role of diet on HCC risk are still controversial. METHODS: We have evaluated the association of adherence to the Mediterranean diet with HCC risk, as well as the interaction of this dietary pattern with chronic hepatitis infection, by combining two case-control studies undertaken in Italy and Greece, including overall 518 cases of HCC and 772 controls. Adherence to the traditional Mediterranean diet was assessed through the Mediterranean diet score (MDS), which ranges between 0 (lowest adherence) and 9 (highest adherence). Odds ratios (OR) for HCC were obtained through multiple logistic regression models, controlling for potentially confounding factors, including chronic infection with hepatitis B/C viruses. RESULTS: Compared to MDS of 0-3, the ORs for HCC were 0.66 (95% confidence interval (CI), 0.41-1.04) for MDS equal to 4 and 0.51 (95% CI, 0.34-0.75) for MDS ⩾ 5, with a significant trend (p<0.001). The detrimental effect of poor adherence to Mediterranean diet on HCC risk was disproportionally high among those chronically infected with hepatitis B and/or C viruses, with a suggestion of super-additive interaction, albeit statistically non-significant. CONCLUSIONS: Closer adherence to the Mediterranean diet appears to be protective against HCC. Our results also point to potential benefits from adhering to a Mediterranean dietary pattern for patients chronically infected with hepatitis viruses.
BACKGROUND & AIMS:Hepatocellular carcinoma (HCC) has a very poor prognosis and any effort to identify additional risk factors, besides those already established, would be important for the prevention of the disease. Data on the role of diet on HCC risk are still controversial. METHODS: We have evaluated the association of adherence to the Mediterranean diet with HCC risk, as well as the interaction of this dietary pattern with chronic hepatitis infection, by combining two case-control studies undertaken in Italy and Greece, including overall 518 cases of HCC and 772 controls. Adherence to the traditional Mediterranean diet was assessed through the Mediterranean diet score (MDS), which ranges between 0 (lowest adherence) and 9 (highest adherence). Odds ratios (OR) for HCC were obtained through multiple logistic regression models, controlling for potentially confounding factors, including chronic infection with hepatitis B/C viruses. RESULTS: Compared to MDS of 0-3, the ORs for HCC were 0.66 (95% confidence interval (CI), 0.41-1.04) for MDS equal to 4 and 0.51 (95% CI, 0.34-0.75) for MDS ⩾ 5, with a significant trend (p<0.001). The detrimental effect of poor adherence to Mediterranean diet on HCC risk was disproportionally high among those chronically infected with hepatitis B and/or C viruses, with a suggestion of super-additive interaction, albeit statistically non-significant. CONCLUSIONS: Closer adherence to the Mediterranean diet appears to be protective against HCC. Our results also point to potential benefits from adhering to a Mediterranean dietary pattern for patients chronically infected with hepatitis viruses.
Authors: Wen-Qing Li; Yikyung Park; Katherine A McGlynn; Albert R Hollenbeck; Philip R Taylor; Alisa M Goldstein; Neal D Freedman Journal: Hepatology Date: 2014-05-20 Impact factor: 17.425
Authors: Simone M McCoy; Katrina L Campbell; Annie-Claude M Lassemillante; Matthew P Wallen; Jonathan Fawcett; Maree Jarrett; Graeme A Macdonald; Ingrid J Hickman Journal: Hepatobiliary Surg Nutr Date: 2017-10 Impact factor: 7.293