Adherence to the Chinese or American Dietary Guidelines is Associated with a Lower Risk of Primary Liver Cancer in China: A Case-Control Study.

Pei-Yan Chen,Zhao-Yan Liu,Qiu-Ye Lan,Dao-Ming Zhang,Yu-Ming Chen,Ai-Ping Fang,Xiao-Yan Wang,Yao-Yun Zhang,Hui-Lian Zhu,Gong-Cheng Liao

doi:10.3390/nu10081113

Abstract

Adherence to healthy dietary guidelines has been related to a lower risk of several cancers, but its role in primary liver cancer (PLC) has not been fully investigated, especially among Eastern populations. This study enrolled 720 PLC patients and 720 healthy controls who were frequency-matched by age and sex between September 2013 and October 2017 in South China. Dietary quality was assessed by the Chinese Healthy Eating Index (CHEI) and the Healthy Eating Index 2015 (HEI-2015), which manifests as scores of adhering to the 2016 Dietary Guidelines for Chinese and adhering to the 2015–2020 Dietary Guidelines for Americans, respectively. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression models, adjusting for potential confounders. Higher scores in both the CHEI and HEI-2015 were associated with a lower risk of PLC (per 5-points increment of the total scores: OR: 0.43, 95% CI: 0.38–0.50 for CHEI; OR: 0.47, 95% CI: 0.40–0.55 for HEI-2015). The protective associations persisted significantly in the stratified analyses by sex, smoker status, alcohol consumption, HBV infection, and histological types of PLC, without statistical evidence for heterogeneity (p-interaction > 0.05). Closer adherence to the most recent dietary guidelines for Chinese or Americans may protect against PLC.

Highlights

Primary liver cancer (PLC), one of the most malignant cancers with a poor prognosis, was the sixth most common cancer, and the second leading cause of cancer-related death worldwide in 2012
Ascertainment of the primary liver cancer (PLC) diagnosis was based on biopsy, computed tomography (CT), magnetic resonance imaging (MRI), or elevated a-fetoprotein (AFP) levels, according to the National Comprehensive Cancer Network (NCCN)
3 A ratio of total unsaturated fatty acids to saturated fatty acids (SFAs). In this large case-control study, with 720 patients and 720 control subjects conducted in China, we found that a higher score in the Chinese Healthy Eating Index (CHEI) or HEI-2015, reflecting better adherence to the most recent and authoritative dietary guidelines for the Chinese or Americans, was independently associated with a decreased risk of PLC

Summary

Introduction

Primary liver cancer (PLC), one of the most malignant cancers with a poor prognosis, was the sixth most common cancer, and the second leading cause of cancer-related death worldwide in 2012. Most PLC cases are attributable to chronic infection with viral hepatitis (Hepatitis B virus (HBV) or Hepatitis C virus (HCV)), other risk factors have been identified, including heavy alcohol consumption, tobacco smoking, exposure to aflatoxins, obesity and diabetes [2]. Nutrients 2018, 10, 1113 dietary factors may be relevant to the development of PLC. Epidemiological studies have shown that a higher intake of vegetables [3], white meat [4], dairy [5], and soy foods [6] as well as a lower intake of red meat and saturated fat [7] were associated with the reduced risk of PLC. Dietary pattern analysis, considering overall diet rather than a single food or nutrient, can overcome this challenge.

Methods

Results

Conclusion