Abstract

Abstract Background: There is limited-suggestive evidence for individual dietary components, and few studies have examined whether dietary patterns are associated with pancreatic cancer risk. Objective: We examined the associations between five established index-based dietary quality patterns and pancreatic ductal adenocarcinoma (PDAC) risk in middle aged and older US adults. Methods: The Healthy Eating Index (HEI)-2015, Alternative HEI-2010 (AHEI-2010), alternate Mediterranean diet (aMED), and two Dietary Approaches to Stop Hypertension (DASH) scores (Fung et al. and Mellen et al.) were calculated using responses from a food frequency questionnaire data from 535,398 (315,780 men and 224,044 women) NIH-AARP Diet and Health Study participants aged 51-70 years at baseline (1995-1996). Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for PDAC risk according to each dietary pattern quintile. Covariates included in multivariable models were age, sex, smoking, body mass index, diabetes, and energy intake. Results: During follow-up though 2011 (15.5 years median), 3,137 incident PDAC cases were identified. Participants with the highest adherence scores compared to those with the lowest adherence scores for each dietary pattern (Q5 versus Q1), had a significantly lower risk of PDAC, except for AHEI-2010: HRs (95% CIs) for HEI-2015 [0.84 (0.75, 0.94)], aMED [0.82 (0.73, 0.93)], DASH-Fung [0.86 (0.77, 0.96)], DASH-Mellen [0.86 (0.77, 0.99)] and AHEI-2010 [0.93 (0.83, 1.04)]. Sex-stratified analyses showed stronger results in men for the HEI-2015 [0.78 (0.68, 0.90)], DASH-Fung [0.78 (0.67, 0.91)], and DASH-Mellen [0.82 (0.71, 0.95)] indices. Only the aMED score remained statistically significantly associated with PDAC risk in women [0.76 (0.63, 0.92)]. Tests for interaction by sex were not significant (P-values > 0.07). Conclusions: In this analysis of dietary patterns and PDAC, we observed a 14-24% lower cancer risk with greater adherence to index-based dietary quality patterns. Our findings support the hypothesis that adherence to dietary recommendations such as the Dietary Guidelines for Americans, Harvard's Healthy Eating Plate, the Mediterranean Diet and the DASH diet may reduce the risk of developing PDAC Citation Format: Sachelly Julián-Serrano, Jill Reedy, Kim Robien, Rachael Stolzenberg-Solomon. Index-based dietary patterns and risk of pancreatic ductal adenocarcinoma: Results from the NIH-AARP Diet and Health Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 852.

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