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Sex-specific impact of dietary patterns on liver cancer incidence: updated results from two population-based cohort studies in China

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Abstract

Purpose

The associations between dietary patterns and liver cancer risk have received much attention, but evidence among the Chinese population is scarce. This study aims to update the results of two cohort studies and provide the sex-specific associations in the Chinese population.

Methods

This study was based on two cohorts from the Shanghai Men’s Health Study (SMHS) and the Shanghai Women’s Health Study (SWHS). Diet information was collected by validated food frequency questionnaires. Dietary patterns were derived by factor analysis. Cox regression model was utilized to estimate the hazard ratio (HR) and 95% confidence interval (CI) for associations between dietary patterns and liver cancer risk.

Results

During median follow-up years of 11.2 (male) and 17.1 (female) years, 427 males and 252 females were identified as incident primary liver cancer cases. In males, vegetable-based dietary pattern was inversely associated with liver cancer (HRQ4-Q1: 0.67, 95%CI 0.51–0.88, Ptrend < 0.001). Interaction analysis indicated that in males lower vegetable-based dietary pattern score and older age/medical history of chronic hepatitis combined increase the hazard of liver cancer more than the sum of them, with a 114% and 1061% higher risk, respectively. In females, the fruit-based dietary pattern was associated with a reduced risk of liver cancer (HRQ4-Q1: 0.63, 95%CI 0.42–0.95, Ptrend = 0.03). In both males and females, null associations were observed between the meat-based dietary pattern and the risk of liver cancer.

Conclusion

A vegetable-based dietary pattern in males and a fruit-based dietary pattern in females tended to have a protective role on liver cancer risk. This study provided updated information that might be applied to guide public health action for the primary prevention of liver cancer.

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Availability of data and materials

Data will be available upon request pending application and approval by the scientific committee of the relevant institutes.

Abbreviations

AP:

Attributable proportion due to interaction

BMI:

Body mass index

CI:

Confidence interval

EPIC:

European Prospective Investigation into Cancer and Nutrition

FFQ:

Food frequency questionnaires

HBV:

Hepatitis B virus

HCV:

Hepatitis C virus

HR:

Hazard ratio

PAQ:

Physical activity questionnaires

RERI:

Relative excess risk due to interaction

SI:

Synergy index

SMHS:

Shanghai Men’s Health Study

SWHS:

Shanghai Women’s Health Study

WCRF/AICR:

World Cancer Research Fund/ American Institute for Cancer Research

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Acknowledgements

We thank all participants for their contribution to this research.

Funding

This work was supported by the National Key Project of the Research and Development Program of China [2021YFC2500404, 2021YFC2500405]. and the parent cohort was supported by subcontracts from the grants of the US National Institutes of Health [UM1 CA173640, UM1 CA182910]. All funders had no role in the design, analysis, and writing of this article.

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Authors and Affiliations

  1. State Key Laboratory of Systems Medicine for Cancer & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 25, Lane 2200, Xie Tu Road, Shanghai, 200032, People’s Republic of China

    Qiu-Ming Shen, Jia-Yi Tuo, Zhuo-Ying Li, Jie Fang, Yu-Ting Tan, Wei Zhang, Hong-Lan Li & Yong-Bing Xiang

  2. School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, People’s Republic of China

    Jia-Yi Tuo & Yong-Bing Xiang

  3. School of Public Health, Fudan University, Shanghai, 200032, People’s Republic of China

    Zhuo-Ying Li & Yong-Bing Xiang

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Contributions

Y-BX designed research and obtained funding; Q-MS, J-YT, Z-YL, J-F, Y-TT, W-Z, H-LL, and Y-BX conducted the study; Q-MS, Y-BX analyzed the data and interpreted the results; J-YT and Y-BX prepared and wrote the first draft; All authors reviewed and approved the final version of the paper; and Y-BX has primary responsibility for final content.

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Correspondence to Yong-Bing Xiang.

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Shen, QM., Tuo, JY., Li, ZY. et al. Sex-specific impact of dietary patterns on liver cancer incidence: updated results from two population-based cohort studies in China. Eur J Nutr (2024). https://doi.org/10.1007/s00394-024-03347-5

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