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Quality diet indexes and risk of hepatocellular carcinoma: Findings from the Singapore Chinese Health Study
Author(s) -
Luu Hung N.,
Neelakantan Nithya,
Geng Tingting,
Wang Renwei,
Goh George BoonBee,
Clemente Jose C.,
Jin Aizhen,
Dam Rob M,
Jia Wei,
Behari Jaideep,
Koh WoonPuay,
Yuan JianMin
Publication year - 2020
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.33367
Subject(s) - medicine , dash , hazard ratio , quartile , hepatocellular carcinoma , confidence interval , lower risk , logistic regression , cohort , prospective cohort study , mediterranean diet , hbsag , cohort study , proportional hazards model , demography , environmental health , hepatitis b virus , immunology , virus , sociology , computer science , operating system
There is limited research on the effect of dietary quality on hepatocellular carcinoma (HCC) risk in populations with relatively high risk of HCC. Using data from Singapore Chinese Health Study, a prospective cohort study, of 63 257 Chinese aged 45 to 74, we assessed four diet‐quality index (DQI) scores: the Alternative Health Eating Index‐2010 (AHEI‐2010), Alternate Mediterranean Diet (aMED), Dietary Approaches to Stop Hypertension (DASH) and Heathy Diet Indicator (HDI). We identified 561 incident HCC cases among the cohort participants after a mean of 17.6 years of follow‐up. Cox proportional hazard regression model was used to estimate hazard ratio (HR) and 95% confidence interval (CI) for HCC in relation to these DQI scores. Unconditional logistic regression method was used to evaluate the associations between DQIs and HCC risk among a subset of individuals who tested negative for hepatitis B surface antigen (HBsAg). High scores of AHEI‐2010, aMED and DASH, representing higher dietary quality, were associated with lower risk of HCC (all P trend < .05). Compared with the lowest quartile, HRs (95% CIs) of HCC for the highest quartile of AHEI‐2010, aMED and DASH were 0.69 (0.53‐0.89), 0.70 (0.52‐0.95) and 0.67 (0.51‐0.87), respectively. No significant association between HDI and HCC risk was observed. Among HBsAg‐negative individuals, similar inverse associations were observed, and the strongest inverse association was for aMED (HR Q4vsQ1 = 0.46, 95% CI: 0.23‐0.94, P trend = .10). These findings support the notion that adherence to a healthier diet may lower the risk of HCC, suggesting that dietary modification may be an effective approach for primary prevention of HCC.