Abstract
Many studies show that dietary factors may affect the risk of nasopharyngeal carcinoma (NPC). We examined the association between overall diet quality and NPC risk in a Chinese population. This case-control study included 600 NPC patients and 600 matched controls between 2009 and 2011 in Guangzhou, China. Habitual dietary intake and various covariates were assessed via face-to-face interviews. Diet quality scores were calculated according to the Healthy Eating Index-2005 (HEI-2005), the alternate Healthy Eating Index (aHEI), the Diet Quality Index-International (DQI-I), and the alternate Mediterranean Diet Score (aMed). After adjustment for various lifestyle and dietary factors, greater diet quality scores on the HEI-2005, aHEI, and DQI-I—but not on the aMed—showed a significant association with a lower risk of NPC (p-trends, <0.001–0.001). The odds ratios (95% confidence interval) comparing the extreme quartiles of the three significant scores were 0.47 (0.32–0.68) (HEI-2005), 0.48 (0.33–0.70) (aHEI), and 0.43 (0.30–0.62) (DQI-I). In gender-stratified analyses, the favorable association remained significant in men but not in women. We found that adherence to the predefined dietary patterns represented by the HEI-2005, aHEI, and DQI-I scales predicted a lower risk of NPC in adults from south China, especially in men.
Highlights
Nasopharyngeal carcinoma (NPC), which originates in the epithelial cells lining the nasopharynx, is a rare type of neoplasm worldwide
Studies have consistently reported a positive association between the risk of nasopharyngeal carcinoma (NPC) and the consumption of salt-preserved fish [7,8], salted vegetables, and preserved meat [9,10], and favorable associations have been observed between the intake of fresh fruit and vegetables and the risk of NPC in Chinese adults [4,11]
0.199 a Abbreviations: see Table 2; n: men 448 pairs, women 152 pairs; *, **: Compared with Quartile 1, p < 0.05, p < 0.01; #,## : Compared with Quartile 2, p < 0.05, p < 0.01; &,&& : Compared with Quartile 3, p < 0.05, p < 0.01; b Odds ratios: from multivariate conditional logistic regression models after adjustments for the covariates as indicated in Table 2. α for interactions = 0.05/4 tests = 0.0125. This case-control study with 600 patients and 600 control subjects showed that three diet quality scores (HEI-2005, alternate Healthy Eating Index (aHEI), and Diet Quality Index-International (DQI-I)) had approximate favorable associations with the risk of NPC, but the alternate Mediterranean Diet Score (aMed) score had no such association
Summary
Nasopharyngeal carcinoma (NPC), which originates in the epithelial cells lining the nasopharynx, is a rare type of neoplasm worldwide. Much higher incidences have been observed in southern China, especially in the province of Guangdong (incidence, 10.5 ˆ 10 ́5 ; mortality rate, 5.3 ˆ 10 ́5 ) in 2011 [2]. More efforts are needed to explore the risk factors of NPC to allow more effective prevention in the Guangdong population. NPC is believed to result from a combination of genetic susceptibility, Epstein–Barr virus infection, and a variety of environmental factors (e.g., carcinogens and dietary factors) [3,4]. An increasing body of evidence has shown that dietary factors may have an enigmatic effect on the initiation and promotion of NPC [4,5,6]. Data on the role of overall dietary quality in the risk of NPC are scarce
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