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Eur J Nutr. 2019 Apr 6. doi: 10.1007/s00394-019-01956-z. [Epub ahead of print]

Post-cancer diagnosis dietary inflammatory potential is associated with survival among women diagnosed with colorectal cancer in the Women's Health Initiative.

Author information

1
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Discovery I Building, Columbia, SC, 29208, USA.
2
Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
3
Division of Cancer Prevention and Population Sciences, Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
4
Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, 43210, USA.
5
Department of Pathology, Immunology and Microbiology, University of South Carolina School of Medicine, Columbia, SC, 29208, USA.
6
Connecting Health Innovations, LLC, Columbia, SC, 29201, USA.
7
Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, 01655, USA.
8
Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612, USA.
9
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Discovery I Building, Columbia, SC, 29208, USA. ssteck@sc.edu.
10
Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA. ssteck@sc.edu.

Abstract

PURPOSE:

Dietary factors may influence colorectal cancer (CRC) survival through effects on inflammation. We examined the association between post-CRC diagnosis inflammatory potential of diet and all-cause and cancer-specific mortality in the Women's Health Initiative.

METHODS:

The study included 463 postmenopausal women who developed CRC during follow-up and completed a food frequency questionnaire (FFQ), on average 1.7 years after diagnosis. Women were followed from CRC diagnosis until death, censoring, or the end of follow-up in October 2014. Energy-adjusted dietary inflammatory index (E-DII)® scores were calculated from the FFQ and dietary supplement inventory. Cox proportional hazards models were fitted to estimate multivariable-adjusted HRs and 95% confidence intervals (CIs) for all-cause, total cancer, and CRC-specific mortality with the most pro-inflammatory E-DII scores (tertile 3) as referent.

RESULTS:

After a median 11.6 years of follow-up, 162 deaths occurred, including 77 from CRC. Lowest tertile (i.e., most anti-inflammatory) E-DII scores from diet plus supplements were associated with significantly lower all-cause mortality (HRT1vsT3 = 0.49; 95% CI 0.31-0.79) compared to the most pro-inflammatory E-DII tertile. Modest associations with total cancer mortality or CRC-specific mortality were observed, though 95% CIs included 1.

CONCLUSIONS:

Consuming a dietary pattern and supplements with more anti-inflammatory potential after CRC diagnosis may improve overall survival among postmenopausal women.

KEYWORDS:

Cohort study; Colorectal cancer survival; Dietary pattern; Post-cancer diagnosis; Postmenopausal women

PMID:
30955051
PMCID:
PMC6778721
[Available on 2020-10-06]
DOI:
10.1007/s00394-019-01956-z

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