Xiao Luo1,2, Jing Sui3,4, Wanshui Yang4,5, Qi Sun2,4, Yanan Ma1,4, Tracey G Simon6,7,8, Geyu Liang3, Jeffrey A Meyerhardt9, Andrew T Chan4,7,8, Edward L Giovannucci2,4,10, Xuehong Zhang4. 1. Department of Health Statistics, School of Public Health, China Medical University, Shenyang, Liaoning, P.R. China. 2. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. 3. Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of public Health, Southeast University, Nanjing, Jiangsu, P.R. China. 4. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. 5. School of Public Health, Anhui Medical University, Hefei, Anhui, P.R. China. 6. Liver Center, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA. 7. Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA. 8. Clinical and Translational Epidemiology Unit (CTEU), Massachusetts General Hospital, Boston, Massachusetts, USA. 9. Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, USA. 10. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Abstract
OBJECTIVES: Adherence to a healthy diet has been associated with a reduced risk of type 2 diabetes (T2D). Hepatocellular carcinoma (HCC) may have overlapping mechanisms with T2D, such as inflammation and insulin resistance. Thus, we examined the association between a previously developed T2D prevention dietary pattern and HCC risk. METHODS: We followed 87,943 women in the Nurses' Health Study and 49,665 men in the Health Professionals Follow-up Study for up to 32 years. The dietary diabetes risk reduction score, which includes dietary glycemic index, cereal fiber, ratio of polyunsaturated to saturated fats, trans fat, sugar-sweetened beverages, nuts, coffee, and red and processed meats, was obtained using validated food frequency questionnaires and updated every 4 years. The Cox proportional hazards regression model was used to calculate multivariable hazard ratios and confidence intervals (95% CIs). RESULTS: During over 1.9 million person-years, a total of 160 incident HCC cases were identified. The dietary diabetes risk reduction score was associated with a lower risk of HCC (top vs bottom quartile; hazard ratio: 0.57, 95% CI: 0.34-0.95; Ptrend = 0.03). All the individual food and beverage items were associated with the risk of HCC in the expected direction, although the association was weaker than the overall dietary pattern. DISCUSSION: Greater adherence to the T2D prevention diet was associated with a lower risk of developing HCC among US men and women. Further studies are needed to confirm and extend our findings.
OBJECTIVES: Adherence to a healthy diet has been associated with a reduced risk of type 2 diabetes (T2D). Hepatocellular carcinoma (HCC) may have overlapping mechanisms with T2D, such as inflammation and insulin resistance. Thus, we examined the association between a previously developed T2D prevention dietary pattern and HCC risk. METHODS: We followed 87,943 women in the Nurses' Health Study and 49,665 men in the Health Professionals Follow-up Study for up to 32 years. The dietary diabetes risk reduction score, which includes dietary glycemic index, cereal fiber, ratio of polyunsaturated to saturated fats, trans fat, sugar-sweetened beverages, nuts, coffee, and red and processed meats, was obtained using validated food frequency questionnaires and updated every 4 years. The Cox proportional hazards regression model was used to calculate multivariable hazard ratios and confidence intervals (95% CIs). RESULTS: During over 1.9 million person-years, a total of 160 incident HCC cases were identified. The dietary diabetes risk reduction score was associated with a lower risk of HCC (top vs bottom quartile; hazard ratio: 0.57, 95% CI: 0.34-0.95; Ptrend = 0.03). All the individual food and beverage items were associated with the risk of HCC in the expected direction, although the association was weaker than the overall dietary pattern. DISCUSSION: Greater adherence to the T2D prevention diet was associated with a lower risk of developing HCC among US men and women. Further studies are needed to confirm and extend our findings.
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Authors: Wanshui Yang; Jing Sui; Longgang Zhao; Yanan Ma; Fred K Tabung; Tracey G Simon; Dong Hoon Lee; Xufen Zeng; Long H Nguyen; Jeffrey A Meyerhardt; Andrew T Chan; Edward L Giovannucci; Xuehong Zhang Journal: Cancer Epidemiol Biomarkers Prev Date: 2021-01-29 Impact factor: 4.090