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Dietary Flavonoid Intake Reduces the Risk of Head and Neck but Not Esophageal or Gastric Cancer in US Men and Women.
J Nutr 2017; 147(9):1729-1738JN

Abstract

Background:

Flavonoids are bioactive polyphenolic compounds found in fruits, vegetables, and beverages of plant origin. Previous studies have shown that flavonoid intake reduces the risk of certain cancers; however, few studies to date have examined associations of flavonoids with upper gastrointestinal cancers or used prospective cohorts.

Objective:

Our study examined the association between intake of flavonoids (anthocyanidins, flavan-3-ols, flavanones, flavones, flavonols, and isoflavones) and risk of head and neck, esophageal, and gastric cancers.

Methods:

The NIH-AARP Diet and Health Study is a prospective cohort study that consists of 469,008 participants. Over a mean 12-y follow-up, 2453 head and neck (including 1078 oral cavity, 424 pharyngeal, and 817 laryngeal), 1165 esophageal (890 adenocarcinoma and 275 squamous cell carcinoma), and 1297 gastric (625 cardia and 672 noncardia) cancer cases were identified. We used Cox proportional hazards regression models to estimate HRs and CIs for the associations between flavonoid intake assessed at study baseline and cancer outcomes. For 56 hypotheses examined, P-trend values were adjusted using the Benjamini-Hochberg (BH) procedure for false discovery rate control.

Results:

The highest quintile of total flavonoid intake was associated with a 24% lower risk of head and neck cancer (HR: 0.76; 95% CI: 0.66, 0.86; BH-adjusted 95% CI: 0.63, 0.91; P-trend = 0.02) compared with the lowest quintile. Notably, anthocyanidins were associated with a 28% lower risk of head and neck cancer (HR: 0.72; 95% CI: 0.62, 0.82; BH-adjusted 95% CI: 0.59, 0.87; P-trend = 0.0005), and flavanones were associated with a 22% lower risk of head and neck cancer (HR: 0.78; 95% CI: 0.68, 0.89; BH-adjusted 95% CI: 0.64, 0.94; P-trend: 0.02). No associations between flavonoid intake and risk of esophageal or gastric cancers were found.

Conclusions:

Our results indicate that flavonoid intake is associated with lower head and neck cancer risk. These associations suggest a protective effect of dietary flavonoids on head and neck cancer risk, and thus potential as a risk reduction strategy.

Authors+Show Affiliations

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA. Divisions of Cancer Epidemiology and Genetics and.Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD.Divisions of Cancer Epidemiology and Genetics and.Divisions of Cancer Epidemiology and Genetics and.Information Management Services, Rockville, MD.Westat, Rockville, MD; and.Divisions of Cancer Epidemiology and Genetics and.Divisions of Cancer Epidemiology and Genetics and. Department of Statistics and Operations Research, Tel Aviv University, Tel Aviv-Yafo, Israel.Divisions of Cancer Epidemiology and Genetics and.Divisions of Cancer Epidemiology and Genetics and.Divisions of Cancer Epidemiology and Genetics and jessica.petrick@nih.gov.

Pub Type(s)

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

Language

eng

PubMed ID

28724656

Citation

Sun, Lucy, et al. "Dietary Flavonoid Intake Reduces the Risk of Head and Neck but Not Esophageal or Gastric Cancer in US Men and Women." The Journal of Nutrition, vol. 147, no. 9, 2017, pp. 1729-1738.
Sun L, Subar AF, Bosire C, et al. Dietary Flavonoid Intake Reduces the Risk of Head and Neck but Not Esophageal or Gastric Cancer in US Men and Women. J Nutr. 2017;147(9):1729-1738.
Sun, L., Subar, A. F., Bosire, C., Dawsey, S. M., Kahle, L. L., Zimmerman, T. P., ... Petrick, J. L. (2017). Dietary Flavonoid Intake Reduces the Risk of Head and Neck but Not Esophageal or Gastric Cancer in US Men and Women. The Journal of Nutrition, 147(9), pp. 1729-1738. doi:10.3945/jn.117.251579.
Sun L, et al. Dietary Flavonoid Intake Reduces the Risk of Head and Neck but Not Esophageal or Gastric Cancer in US Men and Women. J Nutr. 2017;147(9):1729-1738. PubMed PMID: 28724656.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary Flavonoid Intake Reduces the Risk of Head and Neck but Not Esophageal or Gastric Cancer in US Men and Women. AU - Sun,Lucy, AU - Subar,Amy F, AU - Bosire,Claire, AU - Dawsey,Sanford M, AU - Kahle,Lisa L, AU - Zimmerman,Thea P, AU - Abnet,Christian C, AU - Heller,Ruth, AU - Graubard,Barry I, AU - Cook,Michael B, AU - Petrick,Jessica L, Y1 - 2017/07/19/ PY - 2017/03/17/received PY - 2017/04/02/revised PY - 2017/06/14/accepted PY - 2017/7/21/pubmed PY - 2017/9/14/medline PY - 2017/7/21/entrez KW - epidemiology KW - esophageal cancer KW - flavonoids KW - food-frequency questionnaire KW - gastric cancer KW - head and neck cancer SP - 1729 EP - 1738 JF - The Journal of nutrition JO - J. Nutr. VL - 147 IS - 9 N2 - Background: Flavonoids are bioactive polyphenolic compounds found in fruits, vegetables, and beverages of plant origin. Previous studies have shown that flavonoid intake reduces the risk of certain cancers; however, few studies to date have examined associations of flavonoids with upper gastrointestinal cancers or used prospective cohorts.Objective: Our study examined the association between intake of flavonoids (anthocyanidins, flavan-3-ols, flavanones, flavones, flavonols, and isoflavones) and risk of head and neck, esophageal, and gastric cancers.Methods: The NIH-AARP Diet and Health Study is a prospective cohort study that consists of 469,008 participants. Over a mean 12-y follow-up, 2453 head and neck (including 1078 oral cavity, 424 pharyngeal, and 817 laryngeal), 1165 esophageal (890 adenocarcinoma and 275 squamous cell carcinoma), and 1297 gastric (625 cardia and 672 noncardia) cancer cases were identified. We used Cox proportional hazards regression models to estimate HRs and CIs for the associations between flavonoid intake assessed at study baseline and cancer outcomes. For 56 hypotheses examined, P-trend values were adjusted using the Benjamini-Hochberg (BH) procedure for false discovery rate control.Results: The highest quintile of total flavonoid intake was associated with a 24% lower risk of head and neck cancer (HR: 0.76; 95% CI: 0.66, 0.86; BH-adjusted 95% CI: 0.63, 0.91; P-trend = 0.02) compared with the lowest quintile. Notably, anthocyanidins were associated with a 28% lower risk of head and neck cancer (HR: 0.72; 95% CI: 0.62, 0.82; BH-adjusted 95% CI: 0.59, 0.87; P-trend = 0.0005), and flavanones were associated with a 22% lower risk of head and neck cancer (HR: 0.78; 95% CI: 0.68, 0.89; BH-adjusted 95% CI: 0.64, 0.94; P-trend: 0.02). No associations between flavonoid intake and risk of esophageal or gastric cancers were found.Conclusions: Our results indicate that flavonoid intake is associated with lower head and neck cancer risk. These associations suggest a protective effect of dietary flavonoids on head and neck cancer risk, and thus potential as a risk reduction strategy. SN - 1541-6100 UR - https://www.unboundmedicine.com/medline/citation/28724656/Dietary_Flavonoid_Intake_Reduces_the_Risk_of_Head_and_Neck_but_Not_Esophageal_or_Gastric_Cancer_in_US_Men_and_Women_ L2 - https://academic.oup.com/jn/article-lookup/doi/10.3945/jn.117.251579 DB - PRIME DP - Unbound Medicine ER -