The association of the dietary inflammatory potential with risk of overall and site-specific cancers: a community-based longitudinal study in the UK Biobank - 01/04/24

Doi : 10.1016/j.jnha.2024.100225 
Jiaxin Liang a, b, c, 1, Rongrong Yang d, 1, Huiying Da a, b, c, Jiao Wang a, b, c, Maiwulamujiang Maimaitiyiming a, b, c, Xiuying Qi a, b, c, , Michelle M. Dunk e, 2, Weili Xu a, b, c, e, , 2
a Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China 
b Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China 
c Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China 
d Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin, China 
e Aging Research Center, Department of Neurobiology, Health Care Sciences and Society Karolinska Institutet and Stockholm University, Stockholm, Sweden 

Corresponding author at: Dept. of Epidemiology & Biostatistics, School of Public Health, Tianjin Medical University, Qixiangtai Road 22, Heping District, 300070, Tianjin, China.Dept. of Epidemiology & Biostatistics, School of Public Health, Tianjin Medical UniversityQixiangtai Road 22, Heping DistrictTianjin300070China⁎⁎Corresponding author at: Department of Neurobiology, Health Care Sciences and Society, Karolinska Institutet, Tomtebodavägen 18A Floor 10, SE-171 65 Solna, Stockholm, Sweden.Department of NeurobiologyHealth Care Sciences and SocietyKarolinska InstitutetTomtebodavägen 18A Floor 10SolnaStockholmSE-171 65Sweden

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Abstract

Objectives

The association of the dietary inflammatory potential with cancer risk remains uncertain. We examined the relationship of the dietary inflammatory potential with risk of overall and site-specific cancers and explored its sex and age differences.

Design

A community-based longitudinal study.

Setting

Participants from the UK Biobank completed baseline surveys during 2006–2010 and were followed for up to 15 years to detect incident cancer.

Participants

170,899 cancer-free participants with dietary data available (mean age: 55.73 ± 7.95, 54.10% female).

Measurements

At baseline, dietary intake was assessed with a 24-h dietary record for up to 5 times. The inflammatory diet index (IDI) was calculated to assess the dietary inflammatory potential as a weighted sum of 31 food groups (including 14 anti-inflammatory and 17 pro-inflammatory) based on plasma high-sensitivity C-reactive protein (hsCRP) levels, and tertiled as low (indicating low-inflammatory diet), moderate, and high IDI (as reference). Overall and site-specific cancers were ascertained via linkage to routine hospital admission, cancer registry, and death certificate data. Data were analyzed using Cox regression and Laplace regression.

Results

During the follow-up (median 10.32 years, interquartile range: 9.95 to 11.14 years), 18,884 (11.05 %) participants developed cancer. In multi-adjusted Cox regression, low IDI scores were associated with decreased risk of rectal cancer (hazard ratio [95% confidence interval, CI] 0.76 [0.61, 0.94]), thyroid cancer [0.45 (0.27, 0.74)], lung cancer [0.73 (0.61, 0.88)]. However, the association between IDI score and the risk of overall cancer was not significant. Laplace regression analysis showed that 10th percentile differences (95% CIs) of cancer onset time for participants with low IDI scores was prolonged by 1.29 (0.32, 2.27), 1.44 (0.58, 2.30), and 2.62 (0.98, 4.27) years for rectal cancer, thyroid cancer, and lung cancer, respectively, compared to those with high IDI scores. Stratified analysis revealed that low IDI scores were associated with a lower risk of rectal cancer (p interaction between IDI score and sex = 0.035) and lung cancer in males, but not in females, and with a reduced risk of thyroid cancer in females, but not in males. Moreover, low IDI scores were associated with a reduced risk of rectal cancer and lung cancer in the participants aged ≥60 years, but not in those <60 years, and with a reduced risk of thyroid cancer in those aged ≥60 years and <60 years.

Conclusions

A low-inflammatory diet is associated with decreased risk and prolonged onset time of rectal cancer and lung cancer, especially among males and individuals aged ≥60 years, and thyroid cancer among females.

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Keywords : the dietary inflammatory potential, cancer risk, overall cancer, site-specific cancer, UK Biobank

Abbreviations : ANOVA, BMI, CI, DII, EDIP, hsCRP, HR, ICD, IDI, PD, RRR



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