Dietary Patterns and Risk of Hepatocellular Carcinoma Among U.S. Men and Women

Abstract

Although adherence to healthy dietary guidelines has been associated with a reduced risk of several health outcomes, including cardiovascular diseases, type 2 diabetes, and some cancers, little is known about the role of dietary patterns in the development of hepatocellular carcinoma (HCC). We prospectively assessed the associations of three key commonly used a priori dietary patterns—the Alternative Healthy Eating Index‐2010 (AHEI‐2010), Alternate Mediterranean Diet (AMED), and Dietary Approaches to Stop Hypertension (DASH)—with risk of incident HCC in the Health Professionals Follow‐Up Study (HPFS) and the Nurses’ Health Study (NHS), two large prospective cohort studies. Diet was assessed almost every 4 years using validated food frequency questionnaires (FFQs). Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression. During up to 32 years of follow‐up, 160 incident HCC cases were identified. After adjustment for most HCC risk factors, participants in the highest tertile of Alternative Healthy Eating Index‐2010 (AHEI‐2010) had a multivariable HR of 0.61 (95% CI, 0.39‐0.95; Ptrend = 0.03), compared with those in the lowest tertile. There was a suggestive, but nonsignificant, inverse association for Alternate Mediterranean Diet (AMED; HR = 0.75; 95% CI, 0.49‐1.15; Ptrend = 0.18) and a null association for Dietary Approaches to Stop Hypertension (DASH; HR = 0.90; 95% CI, 0.59‐1.36; Ptrend = 0.61) in relation to the risk of HCC development. Conclusion: Our findings suggest that better adherence to the AHEI‐2010 may decrease the risk of developing HCC among U.S. adults. Future studies are needed to replicate our results, examine these associations in other populations, and elucidate the underlying mechanisms.

Diet and liver cancer risk: a narrative review of epidemiological evidence

“…Also, findings from such research might provide important data to the development of dietary guidelines. There are four studies (102,(160)(161)(162) , two in China (102,160) and two in the USA (161,162) , investigating the associations between certain dietary patterns and the risk of incident liver cancer to date (online Supplementary Table S4). Our study in the Shanghai Men's Health Study and Shanghai Women's Health Study (102) showed that a vegetable-based dietary pattern was associated with a lower risk of liver cancer.…”

“…Our study in the Shanghai Men's Health Study and Shanghai Women's Health Study (102) showed that a vegetable-based dietary pattern was associated with a lower risk of liver cancer. Two cohort studies in the USA (161,162) suggested that participants with higher 2010 Alternative Healthy Eating Index (2010) and Alternate Mediterranean Diet scores had a lower risk of incident HCC (161) . Consistently, one case-control study showed an association of higher adherence to Healthy Eating Index-2015 with lower HCC risk among Chinese adults (160) .…”

“…Consistently, one case-control study showed an association of higher adherence to Healthy Eating Index-2015 with lower HCC risk among Chinese adults (160) . These healthy dietary patterns share several common dietary components (such as high intake of fruits and vegetables, nuts and legumes, and whole grains and low intake of red and processed meats) and showed moderate correlation between one another (161,162) , although they were not developed specifically for cancer prevention.…”

Demystifying the manipulation of host immunity, metabolism, and extraintestinal tumors by the gut microbiome

“…Considering these results, dietary modulation represents an additional avenue through which cancer treatment can be improved. 181,535 However, owing to the deficiency of convincing clinicians and patients of normalized dietary guidelines, patients can be nonadherent to prespecified dietary recommendations. 394 Additionally, short and intense modulation of dietary patterns can elicit rapid and reproducible alterations in the gut microbiome, but it is relatively difficult to modulate the gut microbiome community structure and function through long-term dietary intervention.…”

Association between dietary patterns and prognosis of hepatocellular carcinoma in the Guangdong liver cancer cohort study

“…The studies observed that adhering to healthy dietary patterns reduced the risk of developing HCC in diverse populations. [9][10][11][12][13][14][15] However, to date, few studies have investigated whether adherence to a healthy diet could improve the prognosis of HCC. Nevertheless, adherence to dietary recommendations has been reported to be associated with a lower risk of dying from chronic liver disease (CLD).…”