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Prevention of Non Communicable Diseases

Association of the Healthy Nordic Food Index with risk of bladder cancer: a case–control study

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Abstract

Background

Bladder cancer (BC) is the ninth recurrent neoplasm in the world. In Iran, incidence of BC is the third most common among men. Few dietary patterns are related to reduced carcinogenesis and consequently are amenable to modification in order to reduce the BC risk. Adherence to the traditional Nordic diet, as measured by the Healthy Nordic Food Index (HNFI), have shown a beneficial effect on chronic disease prevention, including cancer. The principal objective of this study was to investigate the association between HNFI and the odds of BC in a case-control study, in Iran.

Method

The present case-control study was performed on 100 eligible cases and 200 controls of patients ≥45 years old referred to three referral hospitals in Tehran. Dietary intakes are assessed by a valid 168-item food frequency questionnaire (FFQ). The relationship between HNFI and BC is estimated using the logistic regression tests.

Results

The average age of cases and control were 65.41 and 61.31 years, respectively. After controlling for potential confounders (age, smoke, total energy, and sex), participants in the highest tertile of HNFI (compared to the lowest tertile) have 83% lower BC risk (OR = 0.17; 95%CI = 0.07–0.42). Based on an independent assessment of HNFI component and BC risk, a significant negative association was observed for fish intake (OR = 0.30; 95%CI = 0.15– 0.60) and whole-grain bread intake (OR = 0.33; 95%CI = 0.17–0.63).

Conclusion

The findings of this study suggested that adherence to traditional Nordic diet could decrease the risk of BC. Of the elements of this diet, fish and whole-grain bread consumption seemed to decrease the odds of BC. Such findings ought to be considered in the development of evidence-base intervention for BC prevention in the country.

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Acknowledgements

We are grateful to all field investigators, staff, and participants of this study. Special thanks should be given to Marzie Pourkerman, Soheil Asadimehr, Fatemeh Samadi, Ronas Kavarizade, and Banafsheh Khalese Ranjbar for contributing in FFQ questionnaires filling.

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Authors and Affiliations

  1. Student Research Committee (National Nutrition and Food Technology Research Institute, Department of Community Nutrition, School of Nutrition Sciences and Food Technology), Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Melika Hajjar

  2. Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Behehshti University of Medical Sciences, Tehran, Iran

    Arezoo Rezazadeh & Bahram Rashidkhani

  3. Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon

    Farah Naja

  4. Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Mehdi Kardoust Parizi

  5. Department of Urology, Medical university of Vienna, Vienna, Austria

    Mehdi Kardoust Parizi

  6. Urology and Nephrology Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Saba Jalali

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  1. Melika Hajjar
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  2. Arezoo Rezazadeh
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Contributions

MH, Writing the draft, study design, analysis. AR, Nutrition consultation and analysis. FA, English editing. MKP, Urology consultation. MA, Oncology consultation. SJ, editing the draft. BR, Study design and corresponding author.

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Correspondence to Melika Hajjar, Arezoo Rezazadeh or Bahram Rashidkhani.

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Hajjar, M., Rezazadeh, A., Naja, F. et al. Association of the Healthy Nordic Food Index with risk of bladder cancer: a case–control study. Eur J Clin Nutr 76, 482–486 (2022). https://doi.org/10.1038/s41430-021-00971-w

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