Abstract
Lung cancer is the most commonly diagnosed cancer in men worldwide. Studies regarding dietary patterns (DPs) and lung cancer are limited, with results remaining inconclusive, and the association of DPs with lung cancer in smokers is unclear. This study analyzed the associations between DPs, including the Polish-adapted Mediterranean diet (Polish-aMED) score, and lung cancer risk in Polish adult male smokers. This case-control study involved 439 men aged 45–80 years from northeastern Poland, including 187 newly diagnosed lung cancer cases. Dietary data was collected with a 62-item food frequency questionnaire (FFQ-6). Two approaches were applied to identify dietary patterns. The Polish-aMED score was calculated (hypothesis-driven approach) and a principal component analysis (PCA) was used to identify PCA-driven DPs (data-driven approach). A logistic regression analysis was performed to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of the lung cancer risk associated with the adherence to DPs overall as well as for moderate (2.5–11 pack-years) and heavy (>11 pack-years) smokers. Among moderate smokers, the risk of lung cancer was lower by 41% (OR: 0.59; 95% CI: 0.39–0.90; p < 0.05; adjusted model) in the higher adherence to the prudent DP when compared to the lower adherence, and by 66% (OR: 0.34; 95% CI: 0.15–0.76; p < 0.05; adjusted model) in the high adherence (7–9 points) to the Polish-aMED score when compared to the low adherence (0–3 points). No significant association between the westernized traditional DP or the sweet dairy DP and lung cancer was revealed. In conclusion, the current study suggests that pro-healthy dietary patterns, including the Mediterranean pattern, may favour lower risk of lung cancer in moderate smokers, although it was not confirmed in heavy smokers.
Highlights
There were an estimated 18 million cancer cases around the world in 2018; of these, 9.5 million cases were in men and 8.5 million in women [1]
For the Polish a-Mediterranean diet (MED) dietary patterns (DPs), the risk of lung cancer was lower by 49% (OR: 0.51; 95% confidence interval (95% CI): 0.31–0.81; p < 0.05, adjusted model and odds ratio (OR): 0.51; 95% CI: 0.32–0.81; p < 0.05; adjusted model) in subjects with moderate adherence (4–6 points) and high adherence (7–9 points) to the Polish-aMED score when compared to the low adherence (0–3 points)
The risk of lung cancer was lower by 65% (OR: 0.35; 95% CI: 0.18–0.65; p < 0.05; adjusted model) and 66% (OR: 0.34; 95% CI: 0.15–0.76; p < 0.05; adjusted model) in the moderate adherence (4–6 points) and the high adherence (7–9 points) to the Polish-aMED score when compared to the low adherence (0–3 points)
Summary
There were an estimated 18 million cancer cases around the world in 2018; of these, 9.5 million cases were in men and 8.5 million in women [1]. Lung cancer is the most commonly diagnosed cancer and the most common cancer cause of death in men in Poland and across the world. In Poland, longevity for men over the past few decades has been lower than in more developed European countries. This is partly due to the higher likelihood of unhealthy lifestyle behaviours of Polish men, e.g., tobacco use, alcohol abuse, and an unhealthy diet, resulting in more deaths from heart disease, cancer, and other diseases [5]
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