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cohort·epidemiology, nutrition, oncology, obstetrics and gynecology, public health·PMC10046106

Hyperinsulinemic and Pro-Inflammatory Dietary Patterns and Metabolomic Profiles Are Associated with Increased Risk of Total and Site-Specific Cancers among Postmenopausal Women

Cancers · 18 authors, 15 centres

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This prospective cohort study analyzed associations between three dietary pattern indices and metabolomic profiles with cancer risk in 112,468 postmenopausal women from the Women’s Health Initiative. Over a median of 17.8 years of follow-up, 18,768 incident invasive cancers were documented. Conversely, a higher score for overall dietary quality (HEI-2015) was associated with lower risk of total and colorectal cancer. The metabolomic profile score for higher dietary quality was associated with lower lung cancer risk. Limitations include reliance on self-reported dietary intake at baseline and the potential for residual confounding.

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cohort

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epidemiology

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ORIGINAL PAPER

PMC10046106

Hyperinsulinemic and Pro-Inflammatory Dietary Patterns and Metabolomic Profiles Are Associated with Increased Risk of Total and Site-Specific Cancers among Postmenopausal Women

Cancers

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ABSTRACT

Simple Summary We investigated whether dietary patterns of insulinemia, inflammation and overall dietary quality are associated with the risk of total cancer, site-specific cancers, and pathological subtypes among postmenopausal women. We followed 112,468 women, 50–79 years of age, in the Women’s Health Initiative for a median of 17.8 years, documenting 18,768 incident invasive cancers. A higher overall dietary quality was associated with lower risk of total cancer and colorectal cancer. The potential of the dietary pattern to contribute to higher insulinemia and inflammation was associated with greater risk of total cancer, colorectal cancer and more strongly associated with risk of endometrial cancer and breast cancer (including triple negative breast cancer) than overall dietary quality. Additionally, a higher score of metabolites reflecting higher dietary quality was associated with lower lung cancer risk. Dietary patterns associated with cancer risk, therefore, warrant testing in clinical trials for cancer prevention among postmenopausal women. Abstract We evaluated associations of the Empirical Dietary Index for Hyperinsulinemia (EDIH), Empirical Dietary Inflammatory Pattern (EDIP) and Healthy Eating Index (HEI2015) and their metabolomics profiles with the risk of total and site-specific cancers. We used baseline food frequency questionnaires to calculate dietary scores among 112,468 postmenopausal women in the Women’s Health Initiative. We used multivariable-adjusted Cox regression to estimate hazard ratios (HR) and 95% confidence intervals for cancer risk estimation. Metabolomic profile scores were derived using elastic-net regression with leave-one-out cross validation. In over 17.8 years, 18,768 incident invasive cancers were adjudicated. Higher EDIH and EDIP scores were associated with greater total cancer risk, and higher HEI-2015 with lower risk: HR Q5vsQ1 (95% CI): EDIH, 1.10 (1.04–1.15); EDIP, 1.08 (1.02–1.15); HEI-2015, 0.93 (0.89–0.98). The multivariable-adjusted incidence rate difference(Q5 vs Q1) for total cancer was: +52 (EDIH), +41 (EDIP) and −49 (HEI-2015) per 100,000 person years. All three indices were associated with colorectal cancer, and EDIH and EDIP with endometrial and breast cancer risk. EDIH was further associated with luminal-B, ER-negative and triple negative breast cancer subtypes. Dietary patterns contributing to hyperinsulinemia and inflammation were associated with greater cancer risk, and higher overall dietary quality, with lower risk. The findings warrant the testing of these dietary patterns in clinical trials for cancer prevention among postmenopausal women.

CITATION EXPORT

Qi Jin, Ni Shi, Dong Hoon Lee et al.. Hyperinsulinemic and Pro-Inflammatory Dietary Patterns and Metabolomic Profiles Are Associated with Increased Risk of Total and Site-Specific Cancers among Postmenopausal Women. Cancers. (2023). https://doi.org/10.3390/cancers15061756

AUTHORS

18 · 15 CENTRES

Qi Jin, Ni Shi, Dong Hoon Lee, Kathryn M. Rexrode, JoAnn E. Manson, Raji Balasubramanian, Xuehong Zhang, Marian L. Neuhouser, Melissa Lopez-Pentecost, Cynthia A. Thomson, Suzanna M. Zick, Ashley S. Felix, Daniel G. Stover, Sagar D. Sardesai, Ashwini Esnakula, Xiaokui Mo, Steven K. Clinton, Fred K. Tabung

1Interdisciplinary Ph.D. Program in Nutrition, The Ohio State University, Columbus, OH 43210, USA
2Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
3Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
4Department of Sport Industry Studies, Yonsei University, Seoul 03722, Republic of Korea
5Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
6Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
7Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at Amherst, Amherst, MA 01003, USA
8Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
9Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
10Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85721, USA
11Department of Family Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
12Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
13Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
14Department of Pathology, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
15Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA

EDITOR / REVIEWER

Alina Vrieling