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Dietary flavonoid, lignan and antioxidant capacity and risk of hepatocellular carcinoma in the European prospective investigation into cancer and nutrition study
Author(s) -
ZamoraRos Raul,
Fedirko Veronika,
Trichopoulou Antonia,
González Carlos A.,
Bamia Christina,
Trepo Elisabeth,
Nöthlings Ute,
DuarteSalles Talita,
Serafini Mauro,
Bredsdorff Lea,
Overvad Kim,
Tjønneland Anne,
Halkjær Jytte,
Fagherazzi Guy,
Perquier Florence,
BoutronRuault MarieChristine,
Katzke Verena,
Lukanova Annekatrin,
Floegel Anna,
Boeing Heiner,
Lagiou Pagona,
Trichopoulos Dimitrios,
Saieva Calogero,
Agnoli Claudia,
Mattiello Amalia,
Tumino Rosario,
Sacerdote Carlotta,
BuenodeMesquita H. Bas,
Peeters Petra H.M.,
Weiderpass Elisabete,
Engeset Dagrun,
Skeie Guri,
Argüelles Marcial Vicente,
MolinaMontes Esther,
Dorronsoro Miren,
Tormo María José,
Ardanaz Eva,
Ericson Ulrika,
Sonestedt Emily,
Sund Malin,
Landberg Rikard,
Khaw KayTee,
Wareham Nicholas J.,
Crowe Francesca L.,
Riboli Elio,
Jenab Mazda
Publication year - 2013
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.28257
Subject(s) - european prospective investigation into cancer and nutrition , medicine , hepatocellular carcinoma , flavonoid , prospective cohort study , cancer , epidemiology , antioxidant , gastroenterology , biology , biochemistry
Limited epidemiological evidence suggests a protective role for plant foods rich in flavonoids and antioxidants in hepatocellular cancer (HCC) etiology. Our aim was to prospectively investigate the association between dietary intake of flavonoids, lignans and nonenzymatic antioxidant capacity (NEAC) and HCC risk. Data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort including 477,206 subjects (29.8% male) recruited from ten Western European countries, was analyzed. Flavonoid, lignan and NEAC intakes were calculated using a compilation of existing food composition databases linked to dietary information from validated dietary questionnaires. Dietary NEAC was based on ferric reducing antioxidant capacity (FRAP) and total radical‐trapping antioxidant parameter (TRAP). Hepatitis B/C status was measured in a nested case–control subset. During a mean follow‐up of 11‐years, 191 incident HCC cases (66.5% men) were identified. Using Cox regression, multivariable adjusted models showed a borderline nonsignificant association of HCC with total flavonoid intake (highest versus lowest tertile, HR = 0.65, 95% CI: 0.40–1.04; p trend = 0.065), but not with lignans. Among flavonoid subclasses, flavanols were inversely associated with HCC risk (HR = 0.62, 95% CI: 0.39–0.99; p trend = 0.06). Dietary NEAC was inversely associated with HCC (FRAP: HR 0.50, 95% CI: 0.31–0.81; p trend = 0.001; TRAP: HR 0.49, 95% CI: 0.31–0.79; p trend = 0.002), but statistical significance was lost after exclusion of the first 2 years of follow‐up. This study suggests that higher intake of dietary flavanols and antioxidants may be associated with a reduced HCC risk.