Low-carbohydrate diets and the risk of pancreatic cancer: a large prospective cohort study

The Association of Low-Carbohydrate Diet and HECTD4 rs11066280 Polymorphism with Risk of Colorectal Cancer: A Case-Control Study in Korea

Background

Glucose is a main source of energy for tumor cells. Thus, a low-carbohydrate diet (LCD) is thought to make a significant contribution to cancer prevention. In addition, LCD and HECT domain E3 ubiquitin protein ligase 4 (HECTD4) gene may be related to insulin resistance.

Objectives

We explored whether LCD score and HECTD4 rs11066280 are etiological factors for colorectal cancer (CRC) and whether LCD score interacts with HECTD4 rs11066280 to modify CRC risk.

Methods

We included 1457 controls and 1062 cases in a case-control study. The LCD score was computed based on the proportion of energy obtained from carbohydrate, protein, and fat, as determined by a semiquantitative food frequency questionnaire. We used unconditional logistic regression models to explore the association of HECTD4 with CRC prevention and interaction of LCD score and HECTD4 polymorphism with CRC preventability.

Results

Individuals with AA/AT genotypes who carried a minor allele (A) of HECTD4 rs11066280 exhibited a decreased CRC risk [odds ratio (OR) = 0.75, 95% confidence interval (CI): 0.62, 0.91]. In addition, a protective effect of high LCD score against CRC development was identified (OR = 0.52, 95% CI: 0.40, 0.68, P for trend <0.001). However, the effect of LCD depended on individual's genetic background, which appears only in participants with TT genotype of HECTD4 rs11066280 [OR = 0.49 (0.36-0.68), P interaction = 0.044].

Conclusions

Our findings suggest a protective effect of LCD and a minor allele of HECTD4 rs11066280 against CRC development. In addition, we provide an understanding of the interaction effect of LCD and HECTD4 rs11066280 on CRC, which may be helpful for establishing diet plans regarding cancer prevention.

Nutrition and dietary restrictions in cancer prevention

The composition and pattern of dietary intake have emerged as key factors influencing aging, regeneration, and consequently, healthspan and lifespan. Cancer is one of the major diseases more tightly linked with aging, and age-related mortality. Although the role of nutrition in cancer incidence is generally well established, we are far from a consensus on how diet influences tumour development in different tissues. In this review, we will discuss how diet and dietary restrictions affect cancer risk and the molecular mechanisms potentially responsible for their effects. We will cover calorie restriction, intermittent fasting, prolonged fasting, fasting-mimicking diet, time-restricted eating, ketogenic diet, high protein diet, Mediterranean diet, and the vegan and vegetarian diets.

Ultra-processed food consumption and the risk of pancreatic cancer in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial

Whether ultra-processed food consumption is associated with the risk of pancreatic cancer has not been determined. We performed a prospective study to fill this gap. A population-based cohort of 98 265 American adults was identified from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Ultra-processed foods were defined by the NOVA classification. Cox regression was used to estimate hazard ratios (HRs) for pancreatic cancer incidence. Subgroup analysis was performed to identify the potential effect modifiers. During a mean follow-up of 8.86 years, 387 pancreatic cancer cases occurred. High consumption of ultra-processed foods was found to be associated with an increased risk of pancreatic cancer (fully adjusted HR_{quartile 4 vs 1} :1.49; 95% confidence interval [CI]: 1.07-2.07; P_trend  = .021) in a linear dose-response manner (P_nonlinearity  = .075). Subgroup analysis further found that the positive association of ultra-processed food consumption with the risk of pancreatic cancer was more pronounced in subjects aged <65 years (HR_{quartile 4 vs 1} :2.17; 95% CI: 1.14-4.15) than in those aged ≥65 years (HR_{quartile 4 vs 1} :1.32; 95% CI: 0.88-1.94), though the interaction test failed to achieve the statistical significance (P_interaction  = .061). These findings suggest that reducing ultra-processed food consumption may be beneficial in decreasing pancreatic cancer incidence.

Adherence to the Dietary Approaches to Stop Hypertension (DASH) Eating Pattern Reduces the Risk of Head and Neck Cancer in American Adults Aged 55 Years and Above: A Prospective Cohort Study

OBJECTIVES

Dietary Approaches to Stop Hypertension (DASH) pattern has been found to aid in the reduction of obesity, oxidative stress, and chronic inflammation, which are all strongly linked to the development of head and neck cancer (HNC). Nevertheless, no epidemiological studies have investigated the association between this dietary pattern and HNC risk. This study was conducted with the purpose of bridging this gap in knowledge.

DESIGN

A prospective cohort study involving 98,459 American adults aged 55 years and older.

SETTING AND PARTICIPANTS

Data were drawn from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Trial. In the present study, participants with dependable energy intake data who furnished baseline and dietary history information were identified as the study population.

METHODS

Diet was assessed by food frequency questionnaires and the DASH score was calculated to assess each participant's adherence to DASH eating pattern. Cox proportional hazards models were used to calculate multivariable adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the occurrence of HNC. To visualize the variation in cancer risk for HNC and its subtypes across the entire spectrum of DASH scores, restricted cubic spline plots were utilized. Additionally, a series of predefined subgroup analyses were performed to identify potential effect modifiers, and several sensitivity analyses were conducted to assess the stability of the findings.

RESULTS

During a follow-up period of 871,879.6 person-years, 268 cases of HNC were identified, comprising 161 cases pertaining to oral cavity and pharynx cancers, as well as 96 cases of larynx cancer. In the fully adjusted model, adherence to the DASH diet was associated with a remarkable 57% reduction in the risk of HNC when comparing extreme quartiles (HR quartile 4 vs 1: 0.43; 95% CI: 0.28, 0.66; P for trend < 0.001). The restricted cubic spline plots demonstrated a linear dose-response relationship between the DASH score and the risk of HNC as well as its subtypes. Subgroup analysis revealed that the protective effect of the DASH diet against HNC was particularly pronounced in individuals with lower daily energy intake. The primary association remained robust in the sensitivity analysis.

CONCLUSIONS

In American middle-aged and older population, adherence to the DASH diet may help prevent HNC, particularly for individuals with lower daily energy intake.

Obesity, diabetes mellitus, and pancreatic carcinogenesis: Correlations, prevention, and diagnostic implications

The prevalence of obesity, diabetes mellitus (DM), and pancreatic cancer (PC) has been consistently increasing in the last two decades worldwide. Sharing various influential risk factors in genetics and environmental inducers in pathogenesis, the close correlations of these three diseases have been demonstrated in plenty of clinical studies using multiple parameters among different populations. On the contrary, most measures aimed to manage and treat obesity and DM effectively reduce the risk and prevent PC occurrence, yet certain drugs can inversely promote pancreatic carcinogenesis instead. Most importantly, an elevation of blood glucose with or without a reduction in body weight, along with other potential tools, may provide valuable clues for detecting PC at an early stage in patients with obesity and DM, favoring a timely intervention and prolonging survival. Herein, the epidemiological and etiological correlations among these three diseases and the supporting clinical evidence of their connections are first summarized to favor a better and more thorough understanding of obesity- and DM-related pancreatic carcinogenesis. After comparing the distinct impacts of different weight-lowering and anti-diabetic treatments on the risk of PC, the possible diagnostic implications of hyperglycemia and weight loss in PC screening are also addressed in detail.

Fried food consumption and the risk of pancreatic cancer: A large prospective multicenter study

Background and aims

Whether fried food consumption is associated with the risk of pancreatic cancer remains elusive. We aimed to examine this association in a US population.

Methods

A population-based cohort of 101,729 US adults was identified. Fried food consumption was assessed with a validated food frequency questionnaire. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated. Explanatory analyses were conducted to identify main contributor(s) to the observed association.

Results

During an average follow-up of 8.86 years (900871.2 person-years), 402 pancreatic cancer cases occurred. High consumption of total fried foods (deep-fried plus pan-fried foods; HRquartile4 vs. 1 0.71, 95% CI 0.51-0.99, P trend = 0.047) and deep-fried foods (HRquartile 4 vs. 1 0.64, 95% CI 0.47-0.88, P trend = 0.011), but not pan-fried foods (HRquartile 4 vs. 1 0.98, 95% CI 0.73-1.32; P trend = 0.815), was found to be associated with a reduced risk of pancreatic cancer in a non-linear dose-response manner, which was not modified by predefined stratification factors and persisted in sensitivity analyses. In explanatory analyses, only chip consumption was found to be inversely associated with the risk of pancreatic cancer; consistently, the initial significant associations between total fried food and deep-fried food consumption and the risk of pancreatic cancer changed to be non-significant after omitting or further adjusting for chip consumption.

Conclusion

Consumption of deep-fried foods, but not pan-fried foods, is inversely associated with the risk of pancreatic cancer in this US population. The role of deep-fried foods in reducing the risk of pancreatic cancer appears to be mainly attributable to chips. More studies are needed to confirm our findings in other populations and settings.

Type 2 diabetes prevention diet and the risk of pancreatic cancer: A large prospective multicenter study

BACKGROUND & AIMS

Type 2 diabetes prevention diet confers a lower risk of type 2 diabetes, which exhibits overlapping mechanisms with pancreatic cancer. We performed a prospective study to examine whether adherence to this dietary pattern is associated with a reduced risk of pancreatic cancer.

METHODS

A population-based cohort of 101,729 American adults was identified. A dietary diabetes risk reduction score was computed to reflect adherence to this dietary pattern, with higher scores representing greater adherence. Cox regression was used to compute hazard ratios (HRs) for pancreatic cancer incidence. Prespecified subgroup analyses were used to identify the potential effect modifiers.

RESULTS

After an average follow-up of 8.86 years (900,871.67 person-years), a total of 402 pancreatic cancer cases were observed. In the fully adjusted model, participants in the highest quartile of dietary diabetes risk reduction score were found to have a reduced risk of pancreatic cancer compared with those in the lowest quartile [HR_{quartiles 4versus1}: 0.62; 95% confidence interval (CI): 0.44, 0.86; P_trend = 0.004], which remained in a series of sensitivity analyses. Subgroup analyses further found that this favorable association was more pronounced in current or former smokers (HR_{quartiles 4versus1}: 0.48; 95% CI: 0.30, 0.77) than in never smokers (HR_{quartiles 4versus1}: 0.71; 95% CI: 0.44, 1.15), although the interaction test did not reach statistical significance (P_interaction = 0.095).

CONCLUSIONS

Greater adherence to type 2 diabetes prevention diet is associated with a lower risk of pancreatic cancer in this US population. More studies are needed to confirm our findings.