Dietary Patterns, Diet Quality + Cancer Risk

Summary

Principal Investigator: Frank Hu
Affiliation: Harvard University
Country: USA
Abstract: DESCRIPTION: We propose to expand our current project by prospectively examining the associations between new dietary indexes and dietary patterns and risk of breast, colon, and prostate cancer in cohort studies of 121,700 women aged 30-55 years at baseline (1976, the Nurses'Health Study), 11,686 women aged 24-44 years at baseline (1989, Nurses'Healthy Study II), and 51,529 men aged 40-75 years at baseline (1986, Health Professionals Follow-up Study). Detailed dietary data have been collected through validated semi-quantitative food frequency questionnaires every 2-4 years in each cohort. This competing renewal has four specific aims: 1). We will construct overall, animal, and vegetable low-carbohydrate scores based on intakes of macronutrients and assess their associations with risk of breast cancer (NHS I, II only), colorectal cancer, and prostate cancer (HPFS only). We will consider tumor subtypes/locations as endpoints. 2). We will examine whether adherence to the 2005 Dietary Guidelines for Americans is associated with lower risk of breast, colorectal, and prostate cancers. In addition, we will evaluate the relationship between changes in dietary indices over time and subsequent risk of cancers. The temporal relationship between diet and cancer will be analyzed by using different lag-periods (e.g., 4-12 years). 3). Using a novel statistical approach, Reduced Rank Regression (RRR), we will develop diet patterns that represent the effect of diet on increased insulin resistance (as reflected by increased plasma levels of fasting insulin and C-peptide and decreased adiponectin concentrations), IGF-1 and IGFBP-3, and endogenous sex steroid hormones and examine the relationships between the identified patterns and risk of major cancers. 4). We will examine both pre- and post-diagnostic dietary patterns (including low-carbohydrate scores and the Healthy Eating Index) in relation to survival rates of patients with breast, colon, or prostate cancer. Specifically, we will examine death from any cause, death from the specific cancer, and cancer recurrence, taking into account different tumor stages and treatment. The large size of these cohorts, the prospective design, the repeated and detailed measurements of diet and covariates, the high follow-up rates, and the availability of biochemical measurements provide a unique opportunity to study the relationship between overall diet patterns and risk of the three major cancers and their survivals in an extremely cost-efficient manner. This competing renewal builds on exciting results from the current cycle of our grant and will extend to new cancer sites with tumor subtypes and also address dietary predictors of survival of three major cancers. PUBLIC HEALTH RELEVANCE: The traditional paradigm in epidemiology focuses on cancer risk in relation to a single or a few nutrients or foods. Our currently funded grant has addressed the limitations of traditional nutritional epidemiologic analyses by examining dietary patterns by considering how foods and nutrients are consumed in combinations. In the competing renewal, we propose to examine low carbohydrate diets and adherence to the 2005 Dietary Guidelines for Americans and risk of breast, colorectal, and prostate cancers in three large cohort studies. We will also examine the impact of these dietary patterns on cancer survival. In addition, we will use a novel statistical approach, Reduced Rank Regression (RRR), to develop diet patterns that represent the effect of diet on cancer biomarkers.
Funding Period: 2002-04-01 - 2013-02-28
more information: NIH RePORT

Top Publications

  1. pmc Dietary patterns and risk of mortality from cardiovascular disease, cancer, and all causes in a prospective cohort of women
    Christin Heidemann
    Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave, Boston, MA 02215, USA
    Circulation 118:230-7. 2008
  2. pmc The Gene, Environment Association Studies consortium (GENEVA): maximizing the knowledge obtained from GWAS by collaboration across studies of multiple conditions
    Marilyn C Cornelis
    Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115
    Genet Epidemiol 34:364-72. 2010
  3. pmc A dietary pattern that is associated with C-peptide and risk of colorectal cancer in women
    Teresa T Fung
    Department of Nutrition, Simmons College, 300 The Fenway, Boston, MA 02115, USA
    Cancer Causes Control 23:959-65. 2012
  4. pmc Intake of specific fruits and vegetables in relation to risk of estrogen receptor-negative breast cancer among postmenopausal women
    Teresa T Fung
    Department of Nutrition, Simmons College, 300 The Fenway, Boston, MA 02115, USA
    Breast Cancer Res Treat 138:925-30. 2013
  5. pmc Eating patterns and type 2 diabetes risk in older women: breakfast consumption and eating frequency
    Rania A Mekary
    Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA
    Am J Clin Nutr 98:436-43. 2013
  6. pmc Isotemporal substitution analysis for physical activity, television watching, and risk of depression
    Rania A Mekary
    Harvard School of Public Health, Building 2, 665 Huntington Avenue, Boston, MA 02115, USA
    Am J Epidemiol 178:474-83. 2013
  7. pmc The association of serum lipids and inflammatory biomarkers with renal function in men with type II diabetes mellitus
    J Lin
    Channing Laboratory, Department of Medicine, Brigham and Women s Hospital, Harvard Medical School, Boston, Massachusetts, USA
    Kidney Int 69:336-42. 2006
  8. pmc Are diet quality scores after breast cancer diagnosis associated with improved breast cancer survival?
    Monika A Izano
    the Channing Division of Network Medicine, Department of Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA
    Nutr Cancer 65:820-6. 2013
  9. pmc Dietary patterns during high school and risk of colorectal adenoma in a cohort of middle-aged women
    Katharina Nimptsch
    Department of Nutrition, Harvard School of Public Health, Boston, MA Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine MDC, Berlin, Germany
    Int J Cancer 134:2458-67. 2014
  10. pmc The association between a nutritional quality index and risk of chronic disease
    Stephanie E Chiuve
    Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA
    Am J Prev Med 40:505-13. 2011

Scientific Experts

  • T T Fung
  • Kana Wu
  • B M Wolpin
  • D Mozaffarian
  • Stephanie E Chiuve
  • Christos Mantzoros
  • Candyce Kroenke
  • D S Michaud
  • Frank B Hu
  • Rania A Mekary
  • Walter C Willett
  • Edward Giovannucci
  • Rob M van Dam
  • Katharina Nimptsch
  • Monika A Izano
  • Marie France Hivert
  • Jane C Figueiredo
  • Marilyn C Cornelis
  • Christin Heidemann
  • J Lin
  • Shuji Ogino
  • Tobias Pischon
  • Andrew T Chan
  • Vasanti S Malik
  • Charles S Fuchs
  • Eric L Ding
  • An Pan
  • Michel Lucas
  • Olivia I Okereke
  • Michelle D Holmes
  • Leah Cahill
  • Charles Fuchs
  • Bernard Cole
  • Matthew J Grainge
  • James B Meigs
  • Leila A Mott
  • Qi Sun
  • Richard F Logan
  • John A Baron
  • Peter Shrader
  • Myriam Fornage
  • Kathleen C Barnes
  • Kayleen Williams
  • Terri H Beaty
  • Jenna Udren
  • Kimberly F Doheny
  • Mary L Marazita
  • Jae H Kang
  • John A Heit
  • Siiri N Bennett
  • Eleanor Feingold
  • Eric Boerwinkle
  • Bjarke Feenstra
  • Hua Ling
  • Christopher A Haiman
  • Nadia N Hansel
  • Rasika A Mathias
  • John W Cole
  • Cathy C Laurie
  • Daniel B Mirel
  • Teri A Manolio
  • Louis R Pasquale
  • Arpana Agrawal
  • M Geoffrey Hayes
  • John P Rice
  • Emily L Harris
  • Elizabeth W Pugh
  • Kai Yu
  • Janey L Wiggs
  • Laura J Bierut
  • Xiaojing Wang
  • Justin Paschall
  • Matthias B Schulze
  • Oscar H Franco
  • E B Rimm
  • F B Hu
  • N Rifai
  • G C Curhan

Detail Information

Publications31

  1. pmc Dietary patterns and risk of mortality from cardiovascular disease, cancer, and all causes in a prospective cohort of women
    Christin Heidemann
    Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave, Boston, MA 02215, USA
    Circulation 118:230-7. 2008
    ..The impact of overall dietary patterns that reflect actual eating behaviors on mortality caused by cardiovascular or other chronic diseases is largely unknown...
  2. pmc The Gene, Environment Association Studies consortium (GENEVA): maximizing the knowledge obtained from GWAS by collaboration across studies of multiple conditions
    Marilyn C Cornelis
    Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115
    Genet Epidemiol 34:364-72. 2010
    ..By maximizing knowledge obtained through collaborative GWAS incorporating environmental exposure information, GENEVA aims to enhance our understanding of disease etiology, potentially identifying opportunities for intervention...
  3. pmc A dietary pattern that is associated with C-peptide and risk of colorectal cancer in women
    Teresa T Fung
    Department of Nutrition, Simmons College, 300 The Fenway, Boston, MA 02115, USA
    Cancer Causes Control 23:959-65. 2012
    ..Therefore, we used diet information to identify food groups that correlated with fasting serum concentrations of C-peptide and assess the association of this dietary pattern and CRC risk...
  4. pmc Intake of specific fruits and vegetables in relation to risk of estrogen receptor-negative breast cancer among postmenopausal women
    Teresa T Fung
    Department of Nutrition, Simmons College, 300 The Fenway, Boston, MA 02115, USA
    Breast Cancer Res Treat 138:925-30. 2013
    ..In conclusion, higher intake of berries and peaches was associated with lower risk of ER- breast cancer among postmenopausal women. These results are considered exploratory and need to be confirmed in further studies...
  5. pmc Eating patterns and type 2 diabetes risk in older women: breakfast consumption and eating frequency
    Rania A Mekary
    Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA
    Am J Clin Nutr 98:436-43. 2013
    ..Little is known about the association between eating patterns and type 2 diabetes (T2D) risk in women...
  6. pmc Isotemporal substitution analysis for physical activity, television watching, and risk of depression
    Rania A Mekary
    Harvard School of Public Health, Building 2, 665 Huntington Avenue, Boston, MA 02115, USA
    Am J Epidemiol 178:474-83. 2013
    ..95) was found when 60 minutes/day of brisk walking replaced 60 minutes/day of television watching. Thus, the ISM could offer a more meaningful alternative to the standard nonsubstitution models to support public health recommendations. ..
  7. pmc The association of serum lipids and inflammatory biomarkers with renal function in men with type II diabetes mellitus
    J Lin
    Channing Laboratory, Department of Medicine, Brigham and Women s Hospital, Harvard Medical School, Boston, Massachusetts, USA
    Kidney Int 69:336-42. 2006
    ....
  8. pmc Are diet quality scores after breast cancer diagnosis associated with improved breast cancer survival?
    Monika A Izano
    the Channing Division of Network Medicine, Department of Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA
    Nutr Cancer 65:820-6. 2013
    ..However, healthy dietary choices after breast cancer were associated with reduced risk of nonbreast cancer mortality in women with breast cancer. ..
  9. pmc Dietary patterns during high school and risk of colorectal adenoma in a cohort of middle-aged women
    Katharina Nimptsch
    Department of Nutrition, Harvard School of Public Health, Boston, MA Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine MDC, Berlin, Germany
    Int J Cancer 134:2458-67. 2014
    ..Our results support the hypothesis that diet during early life may influence colorectal carcinogenesis. ..
  10. pmc The association between a nutritional quality index and risk of chronic disease
    Stephanie E Chiuve
    Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA
    Am J Prev Med 40:505-13. 2011
    ..The Overall Nutritional Quality Index (ONQI) algorithm is a nutrient profiling scheme that incorporates more than 30 dietary components, and it aims to rank foods by relative healthfulness...
  11. pmc Changes in diet and lifestyle and long-term weight gain in women and men
    Dariush Mozaffarian
    Division of Cardiovascular Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, MA, USA
    N Engl J Med 364:2392-404. 2011
    ..Specific dietary and other lifestyle behaviors may affect the success of the straightforward-sounding strategy "eat less and exercise more" for preventing long-term weight gain...
  12. pmc Low-carbohydrate diets, dietary approaches to stop hypertension-style diets, and the risk of postmenopausal breast cancer
    Teresa T Fung
    Department of Nutrition, Simmons College, 300 The Fenway, Boston, MA 02115, USA
    Am J Epidemiol 174:652-60. 2011
    ..In addition, a diet high in plant protein and fat and moderate in carbohydrate content was associated with a lower risk of ER- cancer...
  13. pmc A dietary pattern derived to correlate with estrogens and risk of postmenopausal breast cancer
    Teresa T Fung
    Department of Nutrition, Simmons College, 300 The Fenway, Boston, MA 02115, USA
    Breast Cancer Res Treat 132:1157-62. 2012
    ..Although these results were null, it should be repeated in other populations as differences in food intake may yield a dietary pattern with stronger association with estrogens...
  14. pmc The joint association of eating frequency and diet quality with colorectal cancer risk in the Health Professionals Follow-up Study
    Rania A Mekary
    Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA
    Am J Epidemiol 175:664-72. 2012
    ..01, P for trend = 0.01). There was an implied protective association between increased eating frequency of healthy meals and colorectal cancer risk and in men with factors associated with higher insulin sensitivity...
  15. pmc Eating patterns and type 2 diabetes risk in men: breakfast omission, eating frequency, and snacking
    Rania A Mekary
    Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA
    Am J Clin Nutr 95:1182-9. 2012
    ..Little is known about the association between eating patterns and type 2 diabetes (T2D) risk...
  16. pmc Folic acid and prevention of colorectal adenomas: a combined analysis of randomized clinical trials
    Jane C Figueiredo
    Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
    Int J Cancer 129:192-203. 2011
    ..7% vs. 0.5%, p = 0.002). In conclusion, after up to 3.5 years of folic acid use, there is no clear decrease or increase in the occurrence of new adenomas in patients with a history of adenoma...
  17. pmc Low-carbohydrate diets and all-cause and cause-specific mortality: two cohort studies
    Teresa T Fung
    Harvard School of Public Health, Boston, Massachusetts 02115, USA
    Ann Intern Med 153:289-98. 2010
    ..Data on the long-term association between low-carbohydrate diets and mortality are sparse...
  18. pmc Higher adiponectin levels predict greater weight gain in healthy women in the Nurses' Health Study
    Marie France Hivert
    General Medicine Division, Massachusetts General Hospital, Boston, Massachusetts, USA
    Obesity (Silver Spring) 19:409-15. 2011
    ..High adiponectin production by adipocytes might be a sign of "healthy" adipose tissue with further capacity to store fat...
  19. pmc Maternal diet and cord blood leptin and adiponectin concentrations at birth
    Christos S Mantzoros
    Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, ST816, Boston, MA 02215, USA
    Clin Nutr 29:622-6. 2010
    ....
  20. ncbi Dietary patterns and pancreatic cancer risk in men and women
    Dominique S Michaud
    Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
    J Natl Cancer Inst 97:518-24. 2005
    ..Dietary patterns have been associated with fasting insulin levels and risk of diabetes. To determine whether dietary patterns are associated with pancreatic cancer risk, we analyzed data from two large prospective cohort studies...
  21. ncbi Dietary patterns and survival after breast cancer diagnosis
    Candyce H Kroenke
    University of California, Robert Wood Johnson Health and Society Scholars Program, San Francisco, CA 94118, USA
    J Clin Oncol 23:9295-303. 2005
    ..There is little prior study of major dietary patterns and breast cancer survival...
  22. ncbi Diet quality is associated with the risk of estrogen receptor-negative breast cancer in postmenopausal women
    Teresa T Fung
    Department of Nutrition, Simmons College, Boston, MA, USA
    J Nutr 136:466-72. 2006
    ..01) with the vegetable component of the scores. We conclude that women who scored high in AHEI, RFS, and aMed had a lower risk of ER- breast cancer. The HEI and DQI-R appeared to be of limited value in predicting breast cancer risk...
  23. ncbi Meat mutagens and risk of distal colon adenoma in a cohort of U.S. men
    Kana Wu
    Department of Nutrition, Harvard School of Public Health, Building 2, 665 Huntington Avenue, Boston, MA 02115, USA
    Cancer Epidemiol Biomarkers Prev 15:1120-5. 2006
    ..Because mutagens other than heterocyclic amines also contribute to MDM, our results suggest that mutagens other than heterocyclic amines in cooked meats may also play a role in increasing the risk of distal adenoma...
  24. ncbi A prospective study of periodontal disease and pancreatic cancer in US male health professionals
    Dominique S Michaud
    Department of Epidemiology, Harvard School of Public Health, Kresge 920, 677 Huntington Ave, Boston, MA 02115, USA
    J Natl Cancer Inst 99:171-5. 2007
    ..The association between periodontal disease and increased risk of pancreatic cancer may occur through plausible biologic mechanisms, but confirmation of this association is necessary...
  25. ncbi Dietary patterns, the Alternate Healthy Eating Index and plasma sex hormone concentrations in postmenopausal women
    Teresa T Fung
    Department of Nutrition, Simmons College, Boston, MA 02115, USA
    Int J Cancer 121:803-9. 2007
    ..In contrast, the Western pattern was positively associated with estrogen levels and inversely with SHBG. However, these associations appeared to be largely accounted for by BMI...
  26. pmc Circulating insulin-like growth factor axis and the risk of pancreatic cancer in four prospective cohorts
    B M Wolpin
    Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02115, USA
    Br J Cancer 97:98-104. 2007
    ..In four prospective cohorts, we found no association between the risk of pancreatic cancer and prediagnostic plasma levels of IGF-I, IGF-II, or IGFBP-3...
  27. ncbi Circulating insulin-like growth factor binding protein-1 and the risk of pancreatic cancer
    Brian M Wolpin
    Department of Medical Oncology, Dana Farber Cancer Institute, MA 02115, USA
    Cancer Res 67:7923-8. 2007
    ..30; 95% CI, 1.48-7.35). Among participants in four U.S. prospective cohort studies, low plasma IGFBP-1 levels significantly predicted an increased risk of pancreatic cancer...
  28. ncbi Prediagnostic plasma C-peptide and pancreatic cancer risk in men and women
    Dominique S Michaud
    Channing Laboratory, Department of Medicine, Brigham and Women s Hospital, Boston, MA 02115, USA
    Cancer Epidemiol Biomarkers Prev 16:2101-9. 2007
    ..An association between serum insulin levels and pancreatic cancer risk was reported in a recent study, but the population was composed of heavy smokers and their findings may not be generalizable to nonsmokers...
  29. pmc A randomized trial on folic acid supplementation and risk of recurrent colorectal adenoma
    Kana Wu
    Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA
    Am J Clin Nutr 90:1623-31. 2009
    ..Evidence from observational studies suggests that inadequate folate status enhances colorectal carcinogenesis, but results from some randomized trials do not support this hypothesis...
  30. ncbi Dietary patterns and the risk of postmenopausal breast cancer
    Teresa T Fung
    Department of Nutrition, Simmons College, Boston, MA 02115, USA
    Int J Cancer 116:116-21. 2005
    ..However, a Western-type diet may elevate risk of breast cancer among smokers, and a prudent diet may protect against estrogen receptive-negative tumors...