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Index-based dietary patterns and risk of head and neck cancer in a large prospective study.

Abstract

BACKGROUND

Head and neck cancer (HNC) is the seventh most common cancer worldwide. Although diet has been proposed to play an important role in HNC, few associations with diet have been convincing other than alcohol intake. Studies of dietary patterns that examine overall diets may provide broader insight than studies of individual foods. Little is known about the association between dietary patterns and risk of HNC.

OBJECTIVE

We prospectively evaluated the association between 2 index-based dietary patterns [ie, the Healthy Eating Index-2005 (HEI-2005) and alternate Mediterranean Diet Score (aMED)] and risk of head and neck squamous cell carcinoma.

DESIGN

We included 494,967 participants from the NIH-AARP Diet and Health study (1995-2006). HRs (95% CIs) were estimated by using Cox regression. Scores for the HEI-2005 and aMED were calculated on the basis of diet assessed by using a baseline food-frequency questionnaire. Higher scores reflected adherence to dietary recommendations for healthy eating. Our main outcome was the incidence of HNC, including cancer of the larynx, oral cavity, and orohypopharynx.

RESULTS

A total of 1868 HNC cases were identified during follow-up. Higher HEI-2005 scores were associated with reduced risk of HNC in men [HR: 0.74 (95% CI: 0.61, 0.89) for highest compared with lowest quintiles; P-trend = 0.0008] and women [HR: 0.48; 95% CI: 0.33, 0.70; P-trend < 0.0001]. High aMED scores were also associated with lower HNC risk in men (HR: 0.80; 95% CI: 0.64, 1.01; P-trend = 0.002) and women (HR: 0.42; 95% CI: 0.24, 0.74; P-trend < 0.0001). Associations were similar among subsites. We did not find significant interactions between smoking and alcohol intake and each index on HNC risk.

CONCLUSIONS

HEI-2005 and aMED scores were associated inversely with risk of HNC. Large interventional studies are required to assess the causality before conveying definite public health messages.

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  • Authors+Show Affiliations

    ,

    Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD (W-QL, YP, JWW, AMG, PRT, NDF, and CCA), and AARP, Washington, DC (ARH).

    , , , , , ,

    Source

    MeSH

    Aged
    Cohort Studies
    Diet
    Diet, Mediterranean
    Female
    Follow-Up Studies
    Head and Neck Neoplasms
    Health Promotion
    Humans
    Incidence
    Male
    Middle Aged
    Nutrition Policy
    Patient Compliance
    Proportional Hazards Models
    Surveys and Questionnaires
    United States

    Pub Type(s)

    Clinical Trial
    Journal Article
    Observational Study

    Language

    eng

    PubMed ID

    24401718

    Citation

    Li, Wen-Qing, et al. "Index-based Dietary Patterns and Risk of Head and Neck Cancer in a Large Prospective Study." The American Journal of Clinical Nutrition, vol. 99, no. 3, 2014, pp. 559-66.
    Li WQ, Park Y, Wu JW, et al. Index-based dietary patterns and risk of head and neck cancer in a large prospective study. Am J Clin Nutr. 2014;99(3):559-66.
    Li, W. Q., Park, Y., Wu, J. W., Goldstein, A. M., Taylor, P. R., Hollenbeck, A. R., ... Abnet, C. C. (2014). Index-based dietary patterns and risk of head and neck cancer in a large prospective study. The American Journal of Clinical Nutrition, 99(3), pp. 559-66. doi:10.3945/ajcn.113.073163.
    Li WQ, et al. Index-based Dietary Patterns and Risk of Head and Neck Cancer in a Large Prospective Study. Am J Clin Nutr. 2014;99(3):559-66. PubMed PMID: 24401718.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Index-based dietary patterns and risk of head and neck cancer in a large prospective study. AU - Li,Wen-Qing, AU - Park,Yikyung, AU - Wu,Jennifer W, AU - Goldstein,Alisa M, AU - Taylor,Philip R, AU - Hollenbeck,Albert R, AU - Freedman,Neal D, AU - Abnet,Christian C, Y1 - 2014/01/08/ PY - 2014/1/10/entrez PY - 2014/1/10/pubmed PY - 2014/5/3/medline SP - 559 EP - 66 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 99 IS - 3 N2 - BACKGROUND: Head and neck cancer (HNC) is the seventh most common cancer worldwide. Although diet has been proposed to play an important role in HNC, few associations with diet have been convincing other than alcohol intake. Studies of dietary patterns that examine overall diets may provide broader insight than studies of individual foods. Little is known about the association between dietary patterns and risk of HNC. OBJECTIVE: We prospectively evaluated the association between 2 index-based dietary patterns [ie, the Healthy Eating Index-2005 (HEI-2005) and alternate Mediterranean Diet Score (aMED)] and risk of head and neck squamous cell carcinoma. DESIGN: We included 494,967 participants from the NIH-AARP Diet and Health study (1995-2006). HRs (95% CIs) were estimated by using Cox regression. Scores for the HEI-2005 and aMED were calculated on the basis of diet assessed by using a baseline food-frequency questionnaire. Higher scores reflected adherence to dietary recommendations for healthy eating. Our main outcome was the incidence of HNC, including cancer of the larynx, oral cavity, and orohypopharynx. RESULTS: A total of 1868 HNC cases were identified during follow-up. Higher HEI-2005 scores were associated with reduced risk of HNC in men [HR: 0.74 (95% CI: 0.61, 0.89) for highest compared with lowest quintiles; P-trend = 0.0008] and women [HR: 0.48; 95% CI: 0.33, 0.70; P-trend < 0.0001]. High aMED scores were also associated with lower HNC risk in men (HR: 0.80; 95% CI: 0.64, 1.01; P-trend = 0.002) and women (HR: 0.42; 95% CI: 0.24, 0.74; P-trend < 0.0001). Associations were similar among subsites. We did not find significant interactions between smoking and alcohol intake and each index on HNC risk. CONCLUSIONS: HEI-2005 and aMED scores were associated inversely with risk of HNC. Large interventional studies are required to assess the causality before conveying definite public health messages. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/24401718/Index_based_dietary_patterns_and_risk_of_head_and_neck_cancer_in_a_large_prospective_study_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.113.073163 DB - PRIME DP - Unbound Medicine ER -