Poor Diet Linked to Preventable Cancer Burden in the US

Preventable cancer burden in the US is linked to poor diet, reports a new study from Tufts University, USA. The study indicates that both under and over consumption of foods and sugar-rich beverages could impact various types of preventable cancers. This is a rare study that highlights the effect of diet, a modifiable risk factor, on the incidence of cancer in the US. The new research, published in JNCI Cancer Spectrum, has estimated that dietary factors could have been responsible for 80,110 new metastatic cancer cases in 2015, which accounted for 5.2 percent of total cancer cases for that year in the US. Besides dietary factors, other factors responsible for the increased incidence of cancer include excessive body weight (7-8%), alcohol (4-6%), and physical inactivity (2-3%).

This study is a part of the NIH-funded Food Policy Review and Intervention Cost-Effectiveness (Food-PRICE) Research Initiative, which is spearheaded by scientists at the Tufts Friedman School of Nutrition Science and Policy, who are developing cost-effective nutrition strategies for improving population health in the USA.

The study was led by Professor Dariush Mozaffarian, MD, MPH, DrPH, who is a cardiologist, Dean and Jean Mayer Professor at the Tufts Friedman School of Nutrition Science and Policy, and Professor of Medicine at Tufts University School of Medicine, Boston, Massachusetts, USA.

The lead and corresponding author of the paper was Dr. Fang Fang Zhang, MD, PhD, who is an Associate Professor and Miriam E. Nelson Tisch Faculty Fellow at the Tufts Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA.

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Salient Features of the Study

• Seven dietary factors were analyzed based on data from the National Health and Nutrition Examination Surveys (NHANES) for 2013-2014 and 2015-2016, conducted by the Centers for Disease Control and Prevention (CDC)
• Dietary data were linked to cancer incidence data for 2015 from CDC’s National Program of Cancer Registries (NPCR), as well as the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program
• Optimal dietary intake, which has the lowest disease risk, was based on WHO’s Global Burden of Disease (GBD) Study
• All cancer cases arising from the suboptimal diet, stratified according to age, gender, and race/ethnicity, were estimated by modifying GBD’s equation for Population Attributable Fraction (PAF)
• Cancer burden due to suboptimal diet was estimated based on meta-analysis data from the Third Expert Report on “Diet, Nutrition, Physical Activity and Cancer: A Global Perspective” published by the World Cancer Research Fund (WCRF), UK and the American Institute for Cancer Research (AICR), USA

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Findings of the Study

• Colorectal cancer constituted the highest proportion (38.3%) and number (52,225) of cancer cases due to poor diet
• Cancers of the mouth, pharynx, and larynx constituted the second-highest proportion (25.9%) of cancer cases due to poor diet
• The number of cancer cases, in decreasing order, due to poor diet, include the following:
• Cancers of the mouth, pharynx, and larynx: 14,421 cases
• Uterine cancer: 3,165 cases
• Breast cancer (post-menopausal): 3,059 cases
• Kidney cancer: 2,017 cases
• Stomach cancer: 1,564 cases
• Liver cancer: 1,000 cases
• Suboptimal whole grain consumption was linked to the highest proportion and number of cancer cases
• Consumption of other foodstuffs, in decreasing order, that led to cancer include the following:
• Low intake of dairy products
• High intake of processed meat
• Low intake of fruits and vegetables
• High intake of red meat
• High intake of sugary beverages
• 16 percent of diet-related cancers were due to obesity
• Middle-aged (45-64 years) American men and those of other racial/ethnic groups had the highest burden of diet-related cancers, compared to other age, gender, or racial/ethnic groups

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Limitations of the Study

The researchers caution on the following aspects:

• Measurement errors may be present in self-reported dietary intake
• Risk estimates of diet-related cancers are likely to differ by age, gender, and race/ethnicity, among other factors
• It was not possible to establish how interactions between different dietary factors when consumed together, would influence the outcome

Summary & Conclusion

To summarize, the study presents the following convincing evidence on diet-related cancers:

• Risk of colorectal cancer increases due to the consumption of high red meat, high processed meat, low whole grain and low dairy products
• Risk of cancers of the mouth, pharynx, and larynx increases due to low consumption of fruits and vegetables
• Risk of stomach cancer increases due to high consumption of processed meat
• Sugary beverages were included in the study since it is a known fact that they are linked to obesity and 13 types of cancer

Zhang concludes: “Our findings underscore the opportunity to reduce cancer burden and disparities in the United States by improving food intake.”

Funding Source

The study was funded by the National Institutes of Health’s National Institute on Minority Health and Health Disparities and the National Heart, Lung, and Blood Institute, USA. Other funders included the United Kingdom Medical Research Council Epidemiology Unit Core Support and the American Heart Association.

Reference:

1. New Study Estimates Preventable Cancer Burden Linked to Poor Diet in the U.S.  - (https://now.tufts.edu/news-releases/new-study-estimates-preventable-cancer-burden-linked-poor-diet-us)

Source-Medindia