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JNCI Cancer Spectr. 2019 Jun;3(2):pkz025. doi: 10.1093/jncics/pkz025. Epub 2019 Apr 27.

Dietary Pattern and Risk of Multiple Myeloma in Two Large Prospective US Cohort Studies.

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Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
Department of Nutrition, Simmons University, Boston, MA.
Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH.
Department of Public Health Sciences, Washington University School of Medicine, St. Louis, MO.
Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.



The limited data on specific dietary components and risk of multiple myeloma (MM) show no consistent association. Studies have not examined the association of dietary pattern with MM risk.


In prospective cohorts of 69 751 women (Nurses' Health Study, 1984-2014) and 47 232 men (Health Professionals Follow-up Study, 1986-2014), we examined the association between dietary pattern and risk of MM using Cox proportional hazard models. Diet was assessed repeatedly every 4 years with food frequency questionnaires and was used to calculate dietary patterns including the Alternate Healthy Eating Index-2010, Alternate Mediterranean Diet, Dietary Approaches to Stop Hypertension, Prudent and Western patterns, the empirical dietary inflammatory pattern (EDIP), and empirical dietary indices for insulin resistance (EDIR) and hyperinsulinemia (EDIH).


During 2 792 257 person-years of follow-up, we identified 478 incident MM cases (215 women, 263 men). In men, high EDIP was statistically significantly associated with a 16% increase in MM risk (hazard ratio [HR] = 1.16, 95% confidence interval [CI] = 1.02 to 1.32 per 1-SD increase). Moreover, EDIR and EDIH had a suggestive positive association (EDIR: HR = 1.09, 95% CI = 0.96 to 1.24; and EDIH: HR = 1.11, 95% CI = 0.97 to 1.28 per 1-SD increase). We observed no other associations with MM risk in men and no associations for any dietary pattern with MM risk in women.


We present the first evidence for a role of diets with higher inflammatory or insulinemic potential in MM development. Further studies are warranted to explore these associations in other populations, including the apparent restriction to men.

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