TY - JOUR
T1 - Mediterranean diet adherence and risk of esophageal and gastric cancer subtypes in the Netherlands Cohort Study
AU - Schulpen, Maya
AU - Peeters, Petra H.
AU - van den Brandt, Piet A.
N1 - Funding Information:
We are indebted to the participants of the Netherlands Cohort Study (NLCS) and further wish to thank the Netherlands Cancer Registry and the Dutch Pathology Registry. In addition, NLCS staff members are acknowledged for their valuable assistance and advice.
Funding Information:
Funding This study and the NLCS were supported by the Wereld Kanker Onderzoek Fonds Nederland (WCRF-NL), as part of the World Cancer Research Fund International grant program (Grant number 2015/1390). The WCRF-NL had no role in the design, analysis, or writing of this article.
Publisher Copyright:
© 2019, The Author(s).
PY - 2019/7
Y1 - 2019/7
N2 - BackgroundMediterranean diet (MD) adherence has been associated with reduced risks of esophageal and gastric cancer (subtypes) in a limited number of studies. We prospectively investigated associations between MD adherence and risks of esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EAC), gastric cardia adenocarcinoma (GCA), and gastric non-cardia adenocarcinoma (GNCA) in a Dutch cohort.MethodsAnalyses were conducted using data from the 120852 participants of the Netherlands Cohort Study (NLCS), who were aged between 55 and 69years at enrollment. Various MD scores, with and without alcohol, were calculated to estimate MD adherence. Using 20.3years of follow-up, 133 ESCC, 200 EAC, 191 GCA, and 586 GNCA cases could be included in multivariable Cox regression analyses.ResultsOf the investigated scores, the alternate Mediterranean diet score without alcohol (aMEDr) performed best. aMEDr was inversely associated with risks of GCA and GNCA in men and women. However, statistical significance was only reached in men [p(trend): 0.019 (GCA), 0.016 (GNCA)]. Furthermore, higher aMEDr values were significantly associated with a reduced ESCC risk in men [HRper two-point increment (95% CI)=0.57 (0.41-0.80), p(trend)=0.013], but not in women (p(heterogeneity)=0.008). There was no evidence of an association between aMEDr and EAC risk. Educational level was a significant effect modifier for the association between aMEDr and GNCA risk (p(heterogeneity)=0.0073).ConclusionsHigher MD adherence was associated with reduced risks of ESCC, GCA, and GNCA in the NLCS. However, the decreased ESCC risk might be limited to men.
AB - BackgroundMediterranean diet (MD) adherence has been associated with reduced risks of esophageal and gastric cancer (subtypes) in a limited number of studies. We prospectively investigated associations between MD adherence and risks of esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EAC), gastric cardia adenocarcinoma (GCA), and gastric non-cardia adenocarcinoma (GNCA) in a Dutch cohort.MethodsAnalyses were conducted using data from the 120852 participants of the Netherlands Cohort Study (NLCS), who were aged between 55 and 69years at enrollment. Various MD scores, with and without alcohol, were calculated to estimate MD adherence. Using 20.3years of follow-up, 133 ESCC, 200 EAC, 191 GCA, and 586 GNCA cases could be included in multivariable Cox regression analyses.ResultsOf the investigated scores, the alternate Mediterranean diet score without alcohol (aMEDr) performed best. aMEDr was inversely associated with risks of GCA and GNCA in men and women. However, statistical significance was only reached in men [p(trend): 0.019 (GCA), 0.016 (GNCA)]. Furthermore, higher aMEDr values were significantly associated with a reduced ESCC risk in men [HRper two-point increment (95% CI)=0.57 (0.41-0.80), p(trend)=0.013], but not in women (p(heterogeneity)=0.008). There was no evidence of an association between aMEDr and EAC risk. Educational level was a significant effect modifier for the association between aMEDr and GNCA risk (p(heterogeneity)=0.0073).ConclusionsHigher MD adherence was associated with reduced risks of ESCC, GCA, and GNCA in the NLCS. However, the decreased ESCC risk might be limited to men.
KW - Mediterranean diet
KW - Esophageal neoplasms
KW - Stomach neoplasms
KW - Cohort studies
KW - Epidemiology
KW - SCALE PROSPECTIVE COHORT
KW - CORONARY-HEART-DISEASE
KW - QUALITY SCORES
KW - BREAST-CANCER
KW - PATTERNS
KW - MORTALITY
KW - SURVIVAL
KW - ADENOCARCINOMA
KW - QUESTIONNAIRE
KW - INFLAMMATION
U2 - 10.1007/s10120-019-00927-x
DO - 10.1007/s10120-019-00927-x
M3 - Article
C2 - 30771119
SN - 1436-3291
VL - 22
SP - 663
EP - 674
JO - Gastric Cancer
JF - Gastric Cancer
IS - 4
ER -