Adherence to diabetes risk reduction diet and the risk of head and neck cancer: a prospective study of 101,755 American adults

Xia Wu; Linglong Peng; Haoyun Luo; Zhiquan Xu; Jijian Wang; Haitao Gu; Yaxu Wang; Yi Xiao; Chaohua Zhang; Ling Xiang

doi:10.3389/fnut.2023.1218632

Adherence to diabetes risk reduction diet and the risk of head and neck cancer: a prospective study of 101,755 American adults

Front Nutr. 2023 Sep 22:10:1218632. doi: 10.3389/fnut.2023.1218632. eCollection 2023.

Authors

Xia Wu¹, Linglong Peng², Haoyun Luo², Zhiquan Xu², Jijian Wang², Haitao Gu², Yaxu Wang², Yi Xiao², Chaohua Zhang², Ling Xiang³

Affiliations

¹ Department of Health Management Centre, Chongqing General Hospital, Chongqing, China.
² Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
³ Department of Clinical Nutrition, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Abstract

Background: Adherence to the diabetes risk reduction diet (DRRD) may potentially reduce the risk of developing head and neck cancer (HNC) as the diet includes fruits and limits red and processed meats, known risk factors for HNC. However, there is currently no epidemiological research to investigate this potential association.

Methods: The present study utilized data on demographics, lifestyles, medications, and diets of participants from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial to explore the potential association between adherence to DRRD and the risk of HNC. We used a DRRD score to evaluate adherence to the dietary pattern and employed Cox regression analysis to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for HNC risk. Several subgroup analyses were carried out to identify potential effect modifiers, and multiple sensitivity analyses were performed to evaluate the stability of the correlation. The nine components of the DRRD was assessed separately for its association with the risk of HNC.

Results: During a mean follow up of 8.84 years, 279 cases of HNC were observed. DDRD score was found to be inversely associated with the risk of HNC (HR _{Q4 vs. Q1}: 0.582; 95% CI: 0.396, 0.856; p = 0.005 for trend) in a linear dose-response manner (p = 0.211 for non-linearity). Subgroup analysis indicated this inverse correlation was more pronounced among participants who had never smoked (HR_{Q4 vs. Q1}: 0.193; 95% CI: 0.073, 0.511; p < 0.001 for trend) compared to current or former smokers (p = 0.044 for interaction). The primary association of DDRD and HNC risk remained robust after several sensitivity analyses. Regarding the individual components of DRRD, an inverse association was also observed between the risk of HNC and increased intake of cereal fiber and whole fruit (all p < 0.05 for trend).

Conclusion: Our findings provide evidence that following the DRRD pattern may reduce the risk of NHC, especially for non-smokers.

Keywords: cohort study; diabetes risk reduction diet; diet; epidemiology; head and neck cancer.