Dietary patterns and risk of hepatocellular carcinoma among US men and women

Abstract

Although adherence to healthy dietary guidelines has been associated with a reduced risk of several health outcomes including cardiovascular diseases, type 2 diabetes, and some cancers, little is known about the role of dietary patterns in the development of hepatocellular carcinoma. We prospectively assessed the associations of 3 key commonly used a priori dietary patterns, the Alternative Healthy Eating Index‐2010 (AHEI‐2010), Alternate Mediterranean Diet (AMED), and Dietary Approaches to Stop Hypertension (DASH) with risk of incident hepatocellular carcinoma in the Health Professionals Follow‐up Study and the Nurses' Health Study, two large prospective cohort studies. Diet was assessed almost every 4 years using validated food frequency questionnaires. Multivariable hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated using Cox proportional hazards regression. During up to 32 years of follow‐up, 160 incident hepatocellular carcinoma cases were identified. After adjustment for most hepatocellular carcinoma risk factors, participants in the highest tertile of AHEI‐2010 had a multivariable HR of 0.61 (95% CI: 0.39‐0.95, P _trend = 0.03), compared with those in the lowest tertile. There was a suggestive but non‐significant inverse association for AMED (HR = 0.75, 95% CI: 0.49‐1.15, P _trend = 0.18), and a null association for DASH (HR = 0.90, 95% CI: 0.59‐1.36, P _trend = 0.61) in relation to the risk of hepatocellular carcinoma development. Our findings suggest that better adherence to the Alternative Healthy Eating Index‐2010 may decrease the risk of developing hepatocellular carcinoma among US adults. Future studies are needed to replicate our results, to examine these associations in other populations, and to elucidate the underlying mechanisms.

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