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Eur J Nutr. 2019 Mar 22. doi: 10.1007/s00394-019-01947-0. [Epub ahead of print]

Inflammatory potential of diet and risk of lymphoma in the European Prospective Investigation into Cancer and Nutrition.

Author information

1
Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
2
Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain.
3
Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain.
4
Unit of Molecular and Genetic Epidemiology in Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology (ICO-IDIBELL), Av. Gran Via de l'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain.
5
Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain.
6
Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France.
7
Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
8
Immunology Department, Erasmus University Medical Center, Rotterdam, The Netherlands.
9
Nutritional Epidemiology Group (NEP), International Agency for Research on Cancer (IARC-WHO), Lyon, France.
10
Department of Hematology and Oncology, Hospital of Versailles, Le Chesnay, France.
11
CESP, Fac. de médecine-Univ. Paris-Sud, Fac. de médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.
12
Gustave Roussy, Villejuif, France.
13
Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
14
Department of Epidemiology, German Institute of Human Nutrition (DIfE) Postdam-Rehbrücke, Nuthetal, Germany.
15
Department of Functional Biology, Oviedo University, Oviedo, Spain.
16
Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain.
17
Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain.
18
Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.
19
Navarra Public Health Institute, Pamplona, Spain.
20
IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
21
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
22
Department of Epidemiology and Biostatistics, MRC-HPA Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.
23
School of Public Health, Imperial College London, London, UK.
24
Hellenic Health Foundation, Athens, Greece.
25
Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Haidari, Greece.
26
Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network-ISPRO, 50141, Florence, Italy.
27
Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
28
Cancer Registry and Histopathology Department, "Civic-M. P. Arezzo" Hospital, ASP, Ragusa, Ragusa, Italy.
29
Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy.
30
Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy.
31
Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.
32
Department of Research, Cancer Registry of Norway-Institute of Population-Based Cancer Research, Oslo, Norway.
33
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
34
Genetic Epidemiology Group, Folkhälsan Research Center, Faculty of Medicine, Helsinki University, Helsinki, Finland.
35
Department of Oncology, Skåne University Hospital, Lund, Sweden.
36
Department of Clinical Sciences, Research Group in Nutritional Epidemiology, Lund University, Malmö, Sweden.
37
Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden.
38
Public Health and Clinical Medicine, Nutritional Research and Arctic Research Centre, Umeå University, Umeå, Sweden.
39
Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.
40
Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark.
41
Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
42
PATH, Reproductive Health, Seattle, USA.
43
Center for Chronic Immunodeficiency (CCI), Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany.
44
Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. dcasabonne@iconcologia.net.
45
Unit of Molecular and Genetic Epidemiology in Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology (ICO-IDIBELL), Av. Gran Via de l'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain. dcasabonne@iconcologia.net.

Abstract

INTRODUCTION:

Chronic inflammation plays a critical role in lymphomagenesis and several dietary factors seem to be involved its regulation. The aim of the current study was to assess the association between the inflammatory potential of the diet and the risk of lymphoma and its subtypes in the European Investigation into Cancer and Nutrition (EPIC) study.

METHODS:

The analysis included 476,160 subjects with an average follow-up of 13.9 years, during which 3,136 lymphomas (135 Hodgkin lymphoma (HL), 2606 non-Hodgkin lymphoma (NHL) and 395 NOS) were identified. The dietary inflammatory potential was assessed by means of an inflammatory score of the diet (ISD), calculated using 28 dietary components and their corresponding inflammatory weights. The association between the ISD and lymphoma risk was estimated by hazard ratios (HR) and 95% confidence intervals (CI) calculated by multivariable Cox regression models adjusted for potential confounders.

RESULTS:

The ISD was not associated with overall lymphoma risk. Among lymphoma subtypes, a positive association between the ISD and mature B-cell NHL (HR for a 1-SD increase: 1.07 (95% CI 1.01; 1.14), p trend = 0.03) was observed. No statistically significant association was found among other subtypes. However, albeit with smaller number of cases, a suggestive association was observed for HL (HR for a 1-SD increase = 1.22 (95% CI 0.94; 1.57), p trend 0.13).

CONCLUSIONS:

Our findings suggested that a high ISD score, reflecting a pro-inflammatory diet, was modestly positively associated with the risk of B-cell lymphoma subtypes. Further large prospective studies on low-grade inflammation induced by diet are warranted to confirm these findings.

KEYWORDS:

Chronic inflammation; Inflammatory score of the diet; Lymphoma; Nutrition; Prospective studies

PMID:
30903361
DOI:
10.1007/s00394-019-01947-0

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