Abstract
To analyze the association between dietary patterns and oral cancer. The study, part of a Latin American multicenter hospital-based case-control study, was conducted in São Paulo, Southeastern Brazil, between November 1998 and March 2002 and included 366 incident cases of oral cancer and 469 controls, frequency-matched with cases by sex and age. Dietary data were collected using a food frequency questionnaire. The risk associated with the intake of food groups defined a posteriori, through factor analysis (called factors), was assessed. The first factor, labeled "prudent," was characterized by the intake of vegetables, fruit, cheese, and poultry. The second factor, "traditional," consisted of the intake of rice, pasta, pulses, and meat. The third factor, "snacks," was characterized as the intake of bread, butter, salami, cheese, cakes, and desserts. The fourth, "monotonous," was inversely associated with the intake of fruit, vegetables and most other food items. Factor scores for each component retained were calculated for cases and controls. After categorization of factor scores into tertiles according to the distribution of controls, odds ratios and 95% confidence intervals were calculated using unconditional multiple logistic regression. "Traditional" factor showed an inverse association with cancer (OR=0.51; 95% CI: 0.32; 0.81, p-value for trend 0.14), whereas "monotonous" was positively associated with the outcome (OR=1.78; 95% CI: 1.78; 2.85, p-value for trend <0.001). The study data suggest that the traditional Brazilian diet, consisting of rice and beans plus moderate amounts of meat, may confer protection against oral cancer, independently of any other risk factors such as alcohol intake and smoking.
Highlights
The role of diet in the etiology of oral and pharyngeal cancer remains unresolved
The most consistent results show decreased risk associated with the consumption of fruit and vegetables, but available evidence is still inconsistent for other diet components.[20,25]
Diet has traditionally been studied in terms of the effects of certain nutrients or foods on disease
Summary
The role of diet in the etiology of oral and pharyngeal cancer remains unresolved. The most consistent results show decreased risk associated with the consumption of fruit and vegetables, but available evidence is still inconsistent for other diet components.[20,25] Further studies on the relationship between food and food groups and the risk of oral cancer are of great interest. Diet has traditionally been studied in terms of the effects of certain nutrients or foods on disease. In addition to the complex composition of food, the diversity of combinations between foods in the diet may lead to competition, antagonism, or alteration in the bioavailability of certain nutrients. Diet represents a complex set of exposures that are highly correlated. The true relationship between the range of compounds present in a food item and disease may be erroneously attributed to a single compound, given of the multicollinearity that exists between nutrients and foods.[24]
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