Abstract
Objectives: To explore whether dietary factors contribute to the risk of multiple myeloma and the two-fold higher incidence among blacks compared to whites in the United States.
Methods: Data from a food-frequency questionnaire were analyzed for 346 white and 193 black subjects with multiple myeloma, and 1086 white and 903 black controls who participated in a population-based case–control study of multiple myeloma in three areas of the United States.
Results: Elevated risks were associated with obese vs. normal weight (OR = 1.9, 95% confidence interval (CI) = 1.2–3.1 for whites and OR = 1.5, 95% CI = 0.9–2.4 for blacks), while the frequency of obesity was greater for black than white controls. Reduced risks were related to frequent intake of cruciferous vegetables (OR = 0.7, 95% CI = 0.6–0.99) and fish (OR = 0.7, 95% CI = 0.5–0.9) in both races combined, and to vitamin C supplements in whites (OR = 0.6, 95% CI = 0.5–0.9) and blacks (OR = 0.8, 95% CI = 0.5–1.4), with the frequency of vitamin supplement use being greater for white than black controls. However, frequent intake of vitamin C from food and supplements combined was associated with a protective effect in whites (OR = 0.6, 95% CI = 0.4–0.9), but not blacks (OR = 1.2, 95% CI = 0.8–2.1).
Conclusions: The greater use of vitamin C supplements by whites and the higher frequency of obesity among blacks may explain part of the higher incidence of multiple myeloma among blacks compared to whites in the United States. In addition, the increasing prevalence of obesity may have contributed to the upward trend in the incidence of multiple myeloma during recent decades.
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References
American Cancer Society, Inc. (2000) 2000 Facts & Figures, Graphical Data. (www.cancer.org/statistics). Surveillance Research.
Ries L, Kosary C, Hankey B, Miller B, Clegg L, Edwards B, eds (1999) SEER Cancer Statistics Review, 19730-1996. Bethesda, MD: National Cancer Institute.
Friedman GD, Herrinton LJ (1994) Obesity and multiple myeloma. Cancer Causes Control 5: 479-483.
Chatenoud L, Tavani A, La Vecchia C, et al. (1998) Whole grain food intake and cancer risk. Int J Cancer 77: 24-28.
Fernandez E, Chatenoud L, La Vecchia C, Negri E, Franceschi S (1999) Fish consumption and cancer risk. Am J Clin Nutr 70: 85-90.
Tavani A, Pregnolato A, Negri E, et al. (1997) Diet and risk of lymphoid neoplasms and soft tissue sarcomas. Nutr Cancer 27: 256-260.
Waksberg J (1978) Sampling methods for random digit dialing. J Am Stat Assoc 73: 40-46.
Lewis DR, Pottern LM, Brown LM, et al. (1994) Multiple myeloma among blacks and whites in the United States: the role of chronic antigenic stimulation. Cancer Causes Control 5: 529-539.
Swanson CA, Gridley G, Greenberg RS, et al. (1993) A comparison of diets of blacks and whites in three areas of the United States. Nutr Cancer 20: 153-165.
Block G, Hartman AM, Dresser CM, Carroll MD, Gannon J, Gardner L (1986) A data-based approach to diet questionnaire design and testing. Am J Epidemiol 124: 453-469.
Dresser CM (1983) From nutrient data to data base for a health and nutrition examination survey. Organization, coding and values-real or imputed. Minneapolis, Minnesota: Proceedings of the 8th National Data Base Conference.
Smucker R, Block G, Coyle L, Harvin A, Kessler L (1989) A dietary and risk factor questionnaire and analysis system for personal computers. Am J Epidemiol 129: 445-449.
McCance RA, Widdowson EM (1991) McCance and Widdowson's The Composition of Foods, 5th revision edn. Cambridge, UK: Royal Society of Chemistry and Ministry of Agriculture, Fisheries and Food.
Matthews RH, Pehrsson PR, Farhat-Sabet M (1987) Sugar Content of Selected Foods: Individual and Total Sugars. United States Department of Agriculture, Human Nutrition Information Service. 48: Home Economics Research Report.
National Institutes of Health (1998) Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. NIH, National Heart, Lung, and Blood Institute.
Breslow N, Day N (1980). Statistical Methods in Cancer Research: Analysis of Case-Control Studies. Lyon, France: IARC Scientific Publication No. 32.
Engelman L (1990) Stepwise Logistic Regression. In: Dixon W, ed. BMDP Statistical Software Manual, vol. 2. Berkeley, CA: University of California Press, pp. 1013-1046.
Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL (1994) Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991. JAMA 272: 205-211.
Stallone DD (1994) The influence of obesity and its treatment on the immune system. Nutr Rev 52: 37-50.
Chandra RK (1997) Nutrition and the immune system: an introduction. Am J Clin Nutr 66: 460-463S.
Steinmetz KA, Potter JD (1991) Vegetables, fruit, and cancer. II. Mechanisms. Cancer Causes Control 2: 427-442.
Zhang Y, Kensler TW, Cho CG, Posner GH, Talalay P (1994) Anticarcinogenic activities of sulforaphane and structurally related synthetic norbornyl isothiocyanates. Proc Natl Acad Sci USA 91: 3147-3150.
Block G (1991) Epidemiologic evidence regarding vitamin C and cancer. Am J Clin Nutr 54: 1310-1314S.
Park CH, Kimler BF (1991) Growth modulation of human leukemic, preleukemic, and myeloma progenitor cells by L-ascorbic acid. Am J Clin Nutr 54: 1241-1246S.
Hughes DA (1999) Effects of dietary antioxidants on the immune function of middle-aged adults. Proc Nutr Soc 58: 79-84.
Calder PC (1998) Immunoregulatory and anti-inflammatory effects of n-3 polyunsaturated fatty acids. Braz J Med Biol Res 31: 467-490.
Harbige LS (1998) Dietary n-6 and n-3 fatty acids in immunity and autoimmune disease. Proc Nutr Soc 57: 555-562.
Cave WTJ (1991) Dietary n-3 (omega-3) polyunsaturated fatty acid effects on animal tumorigenesis. FASEB J 5: 2160-2166.
Rose DP, Connolly JM (1999) Omega-3 fatty acids as cancer chemopreventive agents. Pharmacol Ther 83: 217-244.
Girao LA, Ruck AC, Cantrill RC, Davidson BC (1986) The effect of C18 fatty acids on cancer cells in culture. Anticancer Res 6: 241-244.
Miles EA, Calder PC (1998) Modulation of immune function by dietary fatty acids. Proc Nutr Soc 57: 27-92.
Calder PC (1998) Dietary fatty acids and the immune system. Nutr Rev 56: S70-83.
Calder PC (1999) Dietary fatty acids and the immune system. Lipids 34: S137-140.
Hirano T (1991) Interleukin 6 (IL-6) and its receptor: their role in plasma cell neoplasias. Int J Cell Cloning 9: 166-184.
Herrinton LJ, Weiss NS, Olshan AF (1996) Multiple myeloma. In: Schottenfeld D, Fraumeni JF, Jr eds. Cancer Epidemiology and Prevention. 2nd edn. New York: Oxford University Press, pp. 946-970.
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Brown, L.M., Gridley, G., Pottern, L.M. et al. Diet and nutrition as risk factors for multiple myeloma among blacks and whites in the United States. Cancer Causes Control 12, 117–125 (2001). https://doi.org/10.1023/A:1008937901586
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DOI: https://doi.org/10.1023/A:1008937901586