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Index-based dietary patterns and risk of lung cancer in the NIH-AARP diet and health study.

Abstract

BACKGROUND/OBJECTIVES

Dietary pattern analysis considers combinations of food intake and may offer a better measure to assess diet-cancer associations than examining individual foods or nutrients. Although tobacco exposure is the major risk factor for lung cancer, few studies have examined whether dietary patterns, based on preexisting dietary guidelines, influence lung cancer risk. After controlling for smoking, we examined associations between four diet quality indices-Healthy Eating Index-2010 (HEI-2010), Alternate Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean Diet score (aMED) and Dietary Approaches to Stop Hypertension (DASH)-and lung cancer risk in the NIH-AARP (National Institutes of Health-American Association of Retired Persons) Diet and Health study.

SUBJECTS/METHODS

Baseline dietary intake was assessed in 460 770 participants. Over a median of 10.5 years of follow-up, 9272 incident lung cancer cases occurred. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and confidence intervals (CIs).

RESULTS

Comparing highest to lowest quintiles, HRs (95% CIs) for lung cancer were as follows: HEI-2010=0.83 (0.77-0.89), AHEI-2010=0.86 (0.80-0.92), aMED=0.85 (0.79-0.91) and DASH=0.84 (0.78-0.90). Among the individual components of the dietary indices, higher consumption of whole grains and fruits was significantly inversely associated with lung cancer risk for several of the diet indices. Total index score analyses stratified by smoking status showed inverse associations with lung cancer for former smokers; however, only HEI-2010 was inversely associated in current smokers and no index score was inversely associated among never smokers.

CONCLUSIONS

Although smoking is the factor most strongly associated with lung cancer, this study adds to a growing body of evidence that diet may have a modest role in reducing lung cancer risk, especially among former smokers.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA. Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.

    ,

    Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. Division of Public Health Sciences, Department of Surgery, School of Medicine, Washington University in St Louis, St Louis, MO, USA.

    ,

    Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.

    ,

    Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA. Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.

    Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.

    Source

    MeSH

    Diet
    Feeding Behavior
    Female
    Fruit
    Humans
    Lung Neoplasms
    Male
    Middle Aged
    Proportional Hazards Models
    Risk Factors
    Smoking
    Whole Grains

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Intramural

    Language

    eng

    PubMed ID

    26264348

    Citation

    Anic, G M., et al. "Index-based Dietary Patterns and Risk of Lung Cancer in the NIH-AARP Diet and Health Study." European Journal of Clinical Nutrition, vol. 70, no. 1, 2016, pp. 123-9.
    Anic GM, Park Y, Subar AF, et al. Index-based dietary patterns and risk of lung cancer in the NIH-AARP diet and health study. Eur J Clin Nutr. 2016;70(1):123-9.
    Anic, G. M., Park, Y., Subar, A. F., Schap, T. E., & Reedy, J. (2016). Index-based dietary patterns and risk of lung cancer in the NIH-AARP diet and health study. European Journal of Clinical Nutrition, 70(1), pp. 123-9. doi:10.1038/ejcn.2015.122.
    Anic GM, et al. Index-based Dietary Patterns and Risk of Lung Cancer in the NIH-AARP Diet and Health Study. Eur J Clin Nutr. 2016;70(1):123-9. PubMed PMID: 26264348.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Index-based dietary patterns and risk of lung cancer in the NIH-AARP diet and health study. AU - Anic,G M, AU - Park,Y, AU - Subar,A F, AU - Schap,T E, AU - Reedy,J, Y1 - 2015/08/12/ PY - 2015/02/10/received PY - 2015/06/02/revised PY - 2015/06/25/accepted PY - 2015/8/13/entrez PY - 2015/8/13/pubmed PY - 2016/10/7/medline SP - 123 EP - 9 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 70 IS - 1 N2 - BACKGROUND/OBJECTIVES: Dietary pattern analysis considers combinations of food intake and may offer a better measure to assess diet-cancer associations than examining individual foods or nutrients. Although tobacco exposure is the major risk factor for lung cancer, few studies have examined whether dietary patterns, based on preexisting dietary guidelines, influence lung cancer risk. After controlling for smoking, we examined associations between four diet quality indices-Healthy Eating Index-2010 (HEI-2010), Alternate Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean Diet score (aMED) and Dietary Approaches to Stop Hypertension (DASH)-and lung cancer risk in the NIH-AARP (National Institutes of Health-American Association of Retired Persons) Diet and Health study. SUBJECTS/METHODS: Baseline dietary intake was assessed in 460 770 participants. Over a median of 10.5 years of follow-up, 9272 incident lung cancer cases occurred. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and confidence intervals (CIs). RESULTS: Comparing highest to lowest quintiles, HRs (95% CIs) for lung cancer were as follows: HEI-2010=0.83 (0.77-0.89), AHEI-2010=0.86 (0.80-0.92), aMED=0.85 (0.79-0.91) and DASH=0.84 (0.78-0.90). Among the individual components of the dietary indices, higher consumption of whole grains and fruits was significantly inversely associated with lung cancer risk for several of the diet indices. Total index score analyses stratified by smoking status showed inverse associations with lung cancer for former smokers; however, only HEI-2010 was inversely associated in current smokers and no index score was inversely associated among never smokers. CONCLUSIONS: Although smoking is the factor most strongly associated with lung cancer, this study adds to a growing body of evidence that diet may have a modest role in reducing lung cancer risk, especially among former smokers. SN - 1476-5640 UR - https://www.unboundmedicine.com/medline/citation/26264348/Index_based_dietary_patterns_and_risk_of_lung_cancer_in_the_NIH_AARP_diet_and_health_study_ L2 - http://dx.doi.org/10.1038/ejcn.2015.122 DB - PRIME DP - Unbound Medicine ER -