Yin Zhang1,2,3, Mingyang Song3,4,5,6, Andrew T Chan2,5,7,8, Eva S Schernhammer2,3,9, Brian M Wolpin1, Meir J Stampfer2,3,6, Jeffrey A Meyerhardt1, Charles S Fuchs10,11, Susan B Roberts12, Walter C Willett3,6, Frank B Hu2,3,6, Edward L Giovannucci2,3,6, Kimmie Ng1. 1. Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA. 2. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. 3. Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA. 4. Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. 5. Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. 6. Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA. 7. Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA. 8. Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 9. Department of Epidemiology, Center of Public Health, Medical University of Vienna, Vienna, Austria. 10. Department of Medical Oncology, Smilow Cancer Hospital and Yale Cancer Center, New Haven, CT, USA. 11. Department of Medicine, Yale School of Medicine, New Haven, CT, USA. 12. USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
Abstract
BACKGROUND: Unrestrained eating behavior, as a potential proxy for diet frequency, timing, and caloric intake, has been questioned as a plausible risk factor for digestive system cancers, but epidemiological evidence remains sparse. OBJECTIVES: We investigated prospectively the associations between unrestrained eating behavior and digestive system cancer risk. METHODS: Participants in the Nurses' Health Study who were free of cancer and reported dietary information in 1994 were followed for ≤18 y. Cox models were used to estimate HRs and 95% CIs for unrestrained eating (eating anything at any time, no concern with figure change, or both) and risk of digestive system cancers. RESULTS: During follow-up, 2064 digestive system cancer cases were documented among 70,450 eligible participants in analyses of eating anything at any time, In total, 2081 digestive system cancer cases were documented among 72,468 eligible participants in analyses of no concern with figure change. In fully adjusted analyses, women with the behavior of eating anything at any time had a higher risk of overall digestive system cancer (HR: 1.22; 95% CI: 1.10, 1.35), overall gastrointestinal tract cancer ((HR: 1.33; 95% CI: 1.18, 1.50), buccal cavity and pharynx cancer (HR: 1.50; 95% CI: 1.02, 2.21), esophageal cancer (HR: 1.62; 95% CI: 1.01, 2.62), small intestine cancer (HR: 1.92; 95% CI: 1.02,3. 59), and colorectal cancer (HR: 1.20; 95% CI: 1.04, 1.38), and a non-statistically significant increased risk of stomach cancer (HR: 1.54; 95% CI: 0.96,2.48), compared with women without this behavior. No statistically significant association was observed for pancreatic cancer and liver and gallbladder cancer. The combined effect of eating anything at any time and having no concern with figure change was associated with a significantly increased risk of overall digestive system cancer (HR: 1.27; 95% CI: 1.10, 1.46), overall gastrointestinal tract cancer (HR: 1.45; 95% CI: 1.23, 1.71), and colorectal cancer (HR: 1.34; 95% CI: 1.11, 1.63), compared with women exhibiting the opposite. CONCLUSIONS: Unrestrained eating behavior was independently associated with increased risk of gastrointestinal tract cancers. The potential importance of unrestrained eating behavior modification in preventing gastrointestinal tract cancers should be noted.
BACKGROUND: Unrestrained eating behavior, as a potential proxy for diet frequency, timing, and caloric intake, has been questioned as a plausible risk factor for digestive system cancers, but epidemiological evidence remains sparse. OBJECTIVES: We investigated prospectively the associations between unrestrained eating behavior and digestive system cancer risk. METHODS: Participants in the Nurses' Health Study who were free of cancer and reported dietary information in 1994 were followed for ≤18 y. Cox models were used to estimate HRs and 95% CIs for unrestrained eating (eating anything at any time, no concern with figure change, or both) and risk of digestive system cancers. RESULTS: During follow-up, 2064 digestive system cancer cases were documented among 70,450 eligible participants in analyses of eating anything at any time, In total, 2081 digestive system cancer cases were documented among 72,468 eligible participants in analyses of no concern with figure change. In fully adjusted analyses, women with the behavior of eating anything at any time had a higher risk of overall digestive system cancer (HR: 1.22; 95% CI: 1.10, 1.35), overall gastrointestinal tract cancer ((HR: 1.33; 95% CI: 1.18, 1.50), buccal cavity and pharynx cancer (HR: 1.50; 95% CI: 1.02, 2.21), esophageal cancer (HR: 1.62; 95% CI: 1.01, 2.62), small intestine cancer (HR: 1.92; 95% CI: 1.02,3. 59), and colorectal cancer (HR: 1.20; 95% CI: 1.04, 1.38), and a non-statistically significant increased risk of stomach cancer (HR: 1.54; 95% CI: 0.96,2.48), compared with women without this behavior. No statistically significant association was observed for pancreatic cancer and liver and gallbladder cancer. The combined effect of eating anything at any time and having no concern with figure change was associated with a significantly increased risk of overall digestive system cancer (HR: 1.27; 95% CI: 1.10, 1.46), overall gastrointestinal tract cancer (HR: 1.45; 95% CI: 1.23, 1.71), and colorectal cancer (HR: 1.34; 95% CI: 1.11, 1.63), compared with women exhibiting the opposite. CONCLUSIONS: Unrestrained eating behavior was independently associated with increased risk of gastrointestinal tract cancers. The potential importance of unrestrained eating behavior modification in preventing gastrointestinal tract cancers should be noted.
Authors: Martine M Perrigue; Elizabeth D Kantor; Theresa A Hastert; Ruth Patterson; John D Potter; Marian L Neuhouser; Emily White Journal: Cancer Causes Control Date: 2013-09-21 Impact factor: 2.506
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Authors: Yin Zhang; Mingyang Song; Chen Yuan; Andrew T Chan; Eva S Schernhammer; Brian M Wolpin; Meir J Stampfer; Jeffrey A Meyerhardt; Charles S Fuchs; Susan B Roberts; Eric B Rimm; Walter C Willett; Frank B Hu; Edward L Giovannucci; Kimmie Ng Journal: Clin Nutr Date: 2021-09-17 Impact factor: 7.324