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Dietary flavonoid, lignan and antioxidant capacity and risk of hepatocellular carcinoma in the European prospective investigation into cancer and nutrition study.
Int J Cancer 2013; 133(10):2429-43IJ

Abstract

Limited epidemiological evidence suggests a protective role for plant foods rich in flavonoids and antioxidants in hepatocellular cancer (HCC) etiology. Our aim was to prospectively investigate the association between dietary intake of flavonoids, lignans and nonenzymatic antioxidant capacity (NEAC) and HCC risk. Data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort including 477,206 subjects (29.8% male) recruited from ten Western European countries, was analyzed. Flavonoid, lignan and NEAC intakes were calculated using a compilation of existing food composition databases linked to dietary information from validated dietary questionnaires. Dietary NEAC was based on ferric reducing antioxidant capacity (FRAP) and total radical-trapping antioxidant parameter (TRAP). Hepatitis B/C status was measured in a nested case-control subset. During a mean follow-up of 11-years, 191 incident HCC cases (66.5% men) were identified. Using Cox regression, multivariable adjusted models showed a borderline nonsignificant association of HCC with total flavonoid intake (highest versus lowest tertile, HR = 0.65, 95% CI: 0.40-1.04; p(trend) = 0.065), but not with lignans. Among flavonoid subclasses, flavanols were inversely associated with HCC risk (HR = 0.62, 95% CI: 0.39-0.99; p(trend) = 0.06). Dietary NEAC was inversely associated with HCC (FRAP: HR 0.50, 95% CI: 0.31-0.81; p(trend) = 0.001; TRAP: HR 0.49, 95% CI: 0.31-0.79; p(trend) = 0.002), but statistical significance was lost after exclusion of the first 2 years of follow-up. This study suggests that higher intake of dietary flavanols and antioxidants may be associated with a reduced HCC risk.

Authors+Show Affiliations

Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23649669

Citation

Zamora-Ros, Raul, et al. "Dietary Flavonoid, Lignan and Antioxidant Capacity and Risk of Hepatocellular Carcinoma in the European Prospective Investigation Into Cancer and Nutrition Study." International Journal of Cancer, vol. 133, no. 10, 2013, pp. 2429-43.
Zamora-Ros R, Fedirko V, Trichopoulou A, et al. Dietary flavonoid, lignan and antioxidant capacity and risk of hepatocellular carcinoma in the European prospective investigation into cancer and nutrition study. Int J Cancer. 2013;133(10):2429-43.
Zamora-Ros, R., Fedirko, V., Trichopoulou, A., González, C. A., Bamia, C., Trepo, E., ... Jenab, M. (2013). Dietary flavonoid, lignan and antioxidant capacity and risk of hepatocellular carcinoma in the European prospective investigation into cancer and nutrition study. International Journal of Cancer, 133(10), pp. 2429-43. doi:10.1002/ijc.28257.
Zamora-Ros R, et al. Dietary Flavonoid, Lignan and Antioxidant Capacity and Risk of Hepatocellular Carcinoma in the European Prospective Investigation Into Cancer and Nutrition Study. Int J Cancer. 2013 Nov 15;133(10):2429-43. PubMed PMID: 23649669.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary flavonoid, lignan and antioxidant capacity and risk of hepatocellular carcinoma in the European prospective investigation into cancer and nutrition study. AU - Zamora-Ros,Raul, AU - Fedirko,Veronika, AU - Trichopoulou,Antonia, AU - González,Carlos A, AU - Bamia,Christina, AU - Trepo,Elisabeth, AU - Nöthlings,Ute, AU - Duarte-Salles,Talita, AU - Serafini,Mauro, AU - Bredsdorff,Lea, AU - Overvad,Kim, AU - Tjønneland,Anne, AU - Halkjaer,Jytte, AU - Fagherazzi,Guy, AU - Perquier,Florence, AU - Boutron-Ruault,Marie-Christine, AU - Katzke,Verena, AU - Lukanova,Annekatrin, AU - Floegel,Anna, AU - Boeing,Heiner, AU - Lagiou,Pagona, AU - Trichopoulos,Dimitrios, AU - Saieva,Calogero, AU - Agnoli,Claudia, AU - Mattiello,Amalia, AU - Tumino,Rosario, AU - Sacerdote,Carlotta, AU - Bueno-de-Mesquita,H Bas, AU - Peeters,Petra H M, AU - Weiderpass,Elisabete, AU - Engeset,Dagrun, AU - Skeie,Guri, AU - Argüelles,Marcial Vicente, AU - Molina-Montes,Esther, AU - Dorronsoro,Miren, AU - Tormo,María José, AU - Ardanaz,Eva, AU - Ericson,Ulrika, AU - Sonestedt,Emily, AU - Sund,Malin, AU - Landberg,Rikard, AU - Khaw,Kay-Tee, AU - Wareham,Nicholas J, AU - Crowe,Francesca L, AU - Riboli,Elio, AU - Jenab,Mazda, Y1 - 2013/06/04/ PY - 2013/02/19/received PY - 2013/04/16/accepted PY - 2013/5/8/entrez PY - 2013/5/8/pubmed PY - 2014/3/7/medline KW - EPIC KW - antioxidant capacity KW - dietary intake KW - flavonoids KW - hepatocellular carcinoma KW - lignans SP - 2429 EP - 43 JF - International journal of cancer JO - Int. J. Cancer VL - 133 IS - 10 N2 - Limited epidemiological evidence suggests a protective role for plant foods rich in flavonoids and antioxidants in hepatocellular cancer (HCC) etiology. Our aim was to prospectively investigate the association between dietary intake of flavonoids, lignans and nonenzymatic antioxidant capacity (NEAC) and HCC risk. Data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort including 477,206 subjects (29.8% male) recruited from ten Western European countries, was analyzed. Flavonoid, lignan and NEAC intakes were calculated using a compilation of existing food composition databases linked to dietary information from validated dietary questionnaires. Dietary NEAC was based on ferric reducing antioxidant capacity (FRAP) and total radical-trapping antioxidant parameter (TRAP). Hepatitis B/C status was measured in a nested case-control subset. During a mean follow-up of 11-years, 191 incident HCC cases (66.5% men) were identified. Using Cox regression, multivariable adjusted models showed a borderline nonsignificant association of HCC with total flavonoid intake (highest versus lowest tertile, HR = 0.65, 95% CI: 0.40-1.04; p(trend) = 0.065), but not with lignans. Among flavonoid subclasses, flavanols were inversely associated with HCC risk (HR = 0.62, 95% CI: 0.39-0.99; p(trend) = 0.06). Dietary NEAC was inversely associated with HCC (FRAP: HR 0.50, 95% CI: 0.31-0.81; p(trend) = 0.001; TRAP: HR 0.49, 95% CI: 0.31-0.79; p(trend) = 0.002), but statistical significance was lost after exclusion of the first 2 years of follow-up. This study suggests that higher intake of dietary flavanols and antioxidants may be associated with a reduced HCC risk. SN - 1097-0215 UR - https://www.unboundmedicine.com/medline/citation/23649669/Dietary_flavonoid_lignan_and_antioxidant_capacity_and_risk_of_hepatocellular_carcinoma_in_the_European_prospective_investigation_into_cancer_and_nutrition_study_ L2 - https://doi.org/10.1002/ijc.28257 DB - PRIME DP - Unbound Medicine ER -