Dietary quality using four dietary indices and lung cancer risk: the Golestan Cohort Study (GCS)

Purpose The lung cancer incidence in Iran has increased almost ten times over the past three decades. In addition to the known causes such as smoking and certain occupational exposure, dietary quality has been suggested to play a role in lung cancer. We aim to explore the association between dietary...

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Published in:	Cancer causes & control Vol. 32; no. 5; pp. 493 - 503
Main Authors:	Wang, Qian, Hashemian, Maryam, Sepanlou, Sadaf G., Sharafkhah, Maryam, Poustchi, Hossein, Khoshnia, Masoud, Gharavi, Abdolsamad, Pourshams, Akram, Malekshah, Akbar Fazeltabar, Kamangar, Farin, Etemadi, Arash, Abnet, Christian C., Dawsey, Sanford M., Malekzadeh, Reza, Boffetta, Paolo
Format:	Journal Article
Language:	English
Published:	Cham Springer International Publishing 01-05-2021 Springer Nature B.V
Subjects:	Biomedical and Life Sciences Biomedicine Cancer Research Cohort analysis Diet Eating Epidemiology Health risks Hematology Hypertension Lung cancer Occupational exposure Occupational health Oncology Original Paper Public Health Regression analysis Risk management Smoking Middle East Golestan cohort study Opium consumption Dietary quality index Cigarette smoking Lung cancer Cohort study
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Summary:	Purpose The lung cancer incidence in Iran has increased almost ten times over the past three decades. In addition to the known causes such as smoking and certain occupational exposure, dietary quality has been suggested to play a role in lung cancer. We aim to explore the association between dietary pattern and lung cancer risk among a Middle East population. Methods Data came from Golestan Cohort Study which included 48,421 participants with 136 lung cancer cases diagnosed during a median follow-up of 12 years. Multivariable Cox proportional hazards regression models were used to calculate the HRs and 95% CI of lung cancer risk by tertile of the four dietary index scores—the Health Eating Index (HEI)-2015, the Alternative Health Eating Index (AHEI)-2010, the Alternative Mediterranean Diet (AMED), and the Dietary Approach to Stop Hypertension (DASH)-Fung. Results A higher DASH-Fung score was inversely associated with risk of lung cancer after adjusting for potential confounders (tertile three vs. tertile one: HR = 0.59 (0.38–0.93); p for trend = 0.07), and p interaction with smoking was 0.46. Similar findings were observed among current smokers with the HEI-2015 score (tertile three vs. tertile one: HR = 0.22 (0.08–0.60): p for trend < 0.01), and p interaction between smoking and the HEI-2015 score was 0.03. Conclusion In the GCS, consuming a diet more closely aligned with the DASH diet was associated with a reduced risk of lung cancer, which appeared to be independent of smoking status. There was also an inverse link between the HEI-2015 score and lung cancer risk among current smokers. Our finding is particularly important for the Middle East population, as diet may play an important role in cancer prevention and overall health.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Authors’ contributions Dr. Sadaf Sepanlou: Contributed to the intellectual input for design of GCS follow up, data cleaning and follow up data acquisition, provided review and confirmation of the final version of the manuscript. Dr. Akram Pourshams: Contributed to the intellectual input for design of GCS, field officer of GCS for data acquisition, provided review and confirmation of the final version of the manuscript. Dr. Reza Malekzadeh: Contributed to the intellectual input for the design of the experiments as well as accomplishment of Golestan cohort study. He supervised all data and biospecimen collection, and provided review and confirmation of the final version of the manuscript. Dr. Qian Wang: Contributed to the data analysis and interpretation, and wrote the initial draft of the manuscript. Dr. Farin Kamangar: Contributed to the intellectual input into the design and follow up of GCS, and provided review and confirmation of the final version of the manuscript. Dr. Maryam Sharafkhah: Contributed to the data analysis, dietary score calculation, and reviewed provided feedback to the manuscript. Dr. Paolo Boffetta: Contributed to the intellectual input for the design of the experiments as well as accomplishment of Golestan cohort study, and provided review and confirmation of the final version of the manuscript. Dr. Masoud Khoshnia: Contributed to outcome assessment by collecting and reviewing file to make the final diagnosis during GCS follow up, provided review and confirmation of the final version of the manuscript. Dr. Hossein Poustchi: Contributed to the intellectual input for design of GCS, field officer of GCS for data acquisition, provided review and confirmation of the final version of the manuscript Dr. Abdolamad Gharavi: Contributed to outcome assessment by collecting and reviewing file to make the final diagnosis during GCS follow up, provided review and confirmation of the final version of the manuscript. Dr. Arash Etemadi: Contributed to the intellectual input into the design and follow up of GCS, and provided review and confirmation of the final version of the manuscript. Dr. Akbar Fazeltabar Malekshah: Contributed by design and validation of food frequency questioner for GCS, provided review and confirmation of the final version of the manuscript. Dr. Maryam Hashemian: Contributed to the data analysis, dietary score calculation, and reviewed provided feedback to the manuscript.
ISSN:	0957-5243 1573-7225
DOI:	10.1007/s10552-021-01400-w