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Role of dietary patterns and acculturation in cancer risk and mortality among postmenopausal Hispanic women: results from the Women’s Health Initiative (WHI)

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Abstract

Aim

To investigate the association between dietary patterns and total and obesity-related cancer risk as well as to examine if acculturation modifies this relationship.

Subjects and methods

Dietary intake of postmenopausal Hispanic women (N = 5,482) enrolled in the Women’s Health Initiative was estimated from a Food Frequency Questionnaire and used to calculate dietary pattern scores: Healthy Eating Index-2015 (HEI-2015), Mexican Diet (MexD) score, alternate Mediterranean Diet Score (aMED), and the energy adjusted Dietary Inflammatory Index (E-DII™). Associations were evaluated using Cox proportional hazard regression models.

Results

Six hundred thirty-one cancers and 396 obesity-related cancers were diagnosed over a mean follow-up of 12 years. Across dietary scores, there were no significant associations with cancer risk or mortality. Trend analysis suggested a potentially lower risk for total cancer mortality related to the highest MexD score (HR 0.68, 95% CI 0.45–1.04, P-trend = 0.03) and lower risk for obesity-related cancer mortality related to the highest score category for MexD (HR 0.65, 95% CI 0.37–1.16, P-trend = 0.02) and aMED (HR 0.87, 95% CI 0.45–1.67, P-trend = 0.04). Further analysis suggested less acculturated women with higher MexD scores had a 56% lower risk for any cancer (HR 0.44, 95% CI 0.22–0.88, P-trend = 0.03) and 83% lower risk for cancer mortality (HR 0.17, 95% CI 0.04–0.76, P-trend = 0.01) compared to more acculturated Hispanic women.

Conclusions

Dietary patterns were not associated with cancer risk and mortality in postmenopausal Hispanic women. Less acculturated, Spanish-preferred speakers who report consuming a more traditional Mexican diet may experience a lower risk of cancer and cancer mortality.

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References

  • Almiron-Roig E, Aitken A, Galloway C, Ellahi B (2017) Dietary assessment in minority ethnic groups: a systematic review of instruments for portion-size estimation in the United Kingdom. Nutr Rev 75:188–213. https://doi.org/10.1093/nutrit/nuw058

    Article  PubMed  PubMed Central  Google Scholar 

  • American Cancer Society (2018) Report: Cancer Risk Varies Widely Among Hispanic Americans

  • Arcia E, Skinner M, Bailey D, Correa V (2001) Models of acculturation and health behaviors among Latino immigrants to the US. Soc Sci Med 53:41–53

    Article  CAS  Google Scholar 

  • Arcidiacono B, Iiritano S, Nocera A, Possidente K, Nevolo MT, Ventura V, Foti D, Chiefari E, Brunetti A (2012) Insulin resistance and cancer risk: an overview of the pathogenetic mechanisms. Exp Diabetes Res 2012:789174. https://doi.org/10.1155/2012/789174

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ayala GX, Baquero B, Klinger S (2008) A systematic review of the relationship between acculturation and diet among Latinos in the United States: implications for future research. J Am Diet Assoc 108:1330–1344. https://doi.org/10.1016/j.jada.2008.05.009

    Article  PubMed  PubMed Central  Google Scholar 

  • Bamia C, Lagiou P, Buckland G, Grioni S, Agnoli C, Taylor AJ, Dahm CC, Overvad K, Olsen A, Tjønneland A, Cottet V, Boutron-Ruault MC, Morois S, Grote V, Teucher B, Boeing H, Buijsse B, Trichopoulos D, Adarakis G, Tumino R, Naccarati A, Panico S, Palli D, Bueno-de-Mesquita HB, van Duijnhoven FJ, Peeters PH, Engeset D, Skeie G, Lund E, Sánchez MJ, Barricarte A, Huerta JM, Quirós JR, Dorronsoro M, Ljuslinder I, Palmqvist R, Drake I, Key TJ, Khaw KT, Wareham N, Romieu I, Fedirko V, Jenab M, Romaguera D, Norat T, Trichopoulou A (2013) Mediterranean diet and colorectal cancer risk: results from a European cohort. Eur J Epidemiol 28:317–328. https://doi.org/10.1007/s10654-013-9795-x

    Article  CAS  PubMed  Google Scholar 

  • Bethel JW, Schenker MB (2005) Acculturation and smoking patterns among Hispanics: a review. Am J Prev Med 29:143–148. https://doi.org/10.1016/j.amepre.2005.04.014

    Article  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention (2017) Cancers Associated with Overweight and Obesity Make up 40 percent of Cancers Diagnosed in the United States

  • Chang ET, Yang J, Alfaro-Velcamp T, So SK, Glaser SL, Gomez SL (2010) Disparities in liver cancer incidence by nativity, acculturation, and socioeconomic status in California Hispanics and Asians Cancer. Epidemiol Biomarkers Prev 19:3106–3118. https://doi.org/10.1158/1055-9965.EPI-10-0863

    Article  Google Scholar 

  • Couto E, Boffetta P, Lagiou P, Ferrari P, Buckland G, Overvad K, Dahm CC, Tjønneland A, Olsen A, Clavel-Chapelon F, Boutron-Ruault MC, Cottet V, Trichopoulos D, Naska A, Benetou V, Kaaks R, Rohrmann S, Boeing H, von Ruesten A, Panico S, Pala V, Vineis P, Palli D, Tumino R, May A, Peeters PH, Bueno-de-Mesquita HB, Büchner FL, Lund E, Skeie G, Engeset D, Gonzalez CA, Navarro C, Rodríguez L, Sánchez MJ, Amiano P, Barricarte A, Hallmans G, Johansson I, Manjer J, Wirfärt E, Allen NE, Crowe F, Khaw KT, Wareham N, Moskal A, Slimani N, Jenab M, Romaguera D, Mouw T, Norat T, Riboli E, Trichopoulou A (2011) Mediterranean dietary pattern and cancer risk in the EPIC cohort. Br J Cancer 104:1493–1499. https://doi.org/10.1038/bjc.2011.106

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Doll R, Peto R (1981) The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. J Natl Cancer Inst 66:1191–1308

    Article  CAS  Google Scholar 

  • Fowler ME, Akinyemiju TF (2017) Meta-analysis of the association between dietary inflammatory index (DII) and cancer outcomes. Int J Cancer 141:2215–2227. https://doi.org/10.1002/ijc.30922

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Fung TT, Hu FB, McCullough ML, Newby PK, Willett WC, Holmes MD (2006) Diet quality is associated with the risk of estrogen receptor-negative breast cancer in postmenopausal women J Nutr 136:466–472

  • George SM, Ballard-Barbash R, Manson JE, Reedy J, Shikany JM, Subar AF, Tinker LF, Vitolins M, Neuhouser ML (2014) Comparing indices of diet quality with chronic disease mortality risk in postmenopausal women in the Women's Health Initiative observational study: evidence to inform national dietary guidance. Am J Epidemiol 180:616–625. https://doi.org/10.1093/aje/kwu173

    Article  PubMed  PubMed Central  Google Scholar 

  • Harmon BE, Boushey CJ, Shvetsov YB, Ettienne R, Reedy J, Wilkens LR, Le Marchand L, Henderson BE, Kolonel LN (2015) Associations of key diet-quality indexes with mortality in the multiethnic cohort: the dietary patterns methods project. Am J Clin Nutr 101:587–597. https://doi.org/10.3945/ajcn.114.090688

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Harmon BE, Wirth MD, Boushey CJ, Wilkens LR, Draluck E, Shivappa N, Steck SE, Hofseth L, Haiman CA, Le Marchand L, Hébert JR (2017) The dietary inflammatory index is associated with colorectal Cancer risk in the multiethnic cohort. J Nutr 147:430–438. https://doi.org/10.3945/jn.116.242529

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hays J, Hunt JR, Hubbell FA, Anderson GL, Limacher M, Allen C, Rossouw JE (2003) The Women's Health Initiative recruitment methods and results. Ann Epidemiol 13:S18–S77

    Article  Google Scholar 

  • Hu FB (2002) Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13:3–9

    Article  CAS  Google Scholar 

  • Jackson RD, LaCroix AZ, Cauley JA, McGowan J (2003) The Women's Health Initiative calcium-vitamin D trial: overview and baseline characteristics of participants. Ann Epidemiol 13:S98–S106

    Article  Google Scholar 

  • John EM, Phipps AI, Davis A, Koo J (2005) Migration history, acculturation, and breast cancer risk in Hispanic women. Cancer Epidemiol Biomarkers Prev 14:2905–2913. https://doi.org/10.1158/1055-9965.EPI-05-0483

    Article  PubMed  Google Scholar 

  • Kennedy ET, Ohls J, Carlson S, Fleming K (1995) The healthy eating index: design and applications. J Am Diet Assoc 95:1103–1108. https://doi.org/10.1016/S0002-8223(95)00300-2

    Article  CAS  PubMed  Google Scholar 

  • Krebs-Smith SM, Pannucci TE, Subar AF, Kirkpatrick SI, Lerman JL, Tooze JA, Wilson MM, Reedy J (2018) Update of the healthy eating index: HEI-2015. J Acad Nutr Diet, 118:1591–1602. https://doi.org/10.1016/j.jand.2018.05.021

  • Langer RD, White E, Lewis CE, Kotchen JM, Hendrix SL, Trevisan M (2003) The Women's Health Initiative observational study: baseline characteristics of participants and reliability of baseline measures. Ann Epidemiol 13:S107–S121

    Article  Google Scholar 

  • Murtaugh MA, Sweeney C, Giuliano AR, Herrick JS, Hines L, Byers T, Baumgartner KB, Slattery ML (2008) Diet patterns and breast cancer risk in Hispanic and non-Hispanic white women: the Four-Corners Breast Cancer Study. Am J Clin Nutr 87:978–984. https://doi.org/10.1093/ajcn/87.4.978

    Article  CAS  PubMed  Google Scholar 

  • Natarajan L, Pu M, Fan J, Levine RA, Patterson RE, Thomson CA, Rock CL, Pierce JP (2010) Measurement error of dietary self-report in intervention trials. Am J Epidemiol 172:819–827. https://doi.org/10.1093/aje/kwq216

    Article  PubMed  PubMed Central  Google Scholar 

  • Nodora JN, Gallo L, Cooper R, Wertheim BC, Natarajan L, Thompson PA, Komenaka IK, Brewster A, Bondy M, Daneri-Navarro A, Meza-Montenegro MM, Gutierrez-Millan LE, Martinez ME (2014) Reproductive and hormonal risk profile according to language acculturation and country of residence in the Ella Binational breast Cancer study. J Women's Health (Larchmt) 23:532–540. https://doi.org/10.1089/jwh.2013.4498

    Article  Google Scholar 

  • Panizza CE, Shvetsov YB, Harmon BE, Wilkens LR, Le Marchand L, Haiman C, Reedy J, Boushey CJ (2018) Testing the Predictive Validity of the Healthy Eating Index-2015 in the Multiethnic Cohort: Is the Score Associated with a Reduced Risk of All-Cause and Cause-Specific Mortality? Nutrients 10. https://doi.org/10.3390/nu10040452

  • Park SY, Boushey CJ, Wilkens LR, Haiman CA, Le Marchand L (2017) High-quality diets associate with reduced risk of colorectal cancer: analyses of diet quality indexes in the multiethnic cohort. Gastroenterology 153:386–394.e382. https://doi.org/10.1053/j.gastro.2017.04.004

    Article  PubMed  Google Scholar 

  • Patterson RE, Kristal AR, Tinker LF, Carter RA, Bolton MP, Agurs-Collins T (1999) Measurement characteristics of the Women's Health Initiative food frequency questionnaire. Ann Epidemiol 9:178–187

    Article  CAS  Google Scholar 

  • Perez-Escamilla R, Putnik P (2007) The role of acculturation in nutrition, lifestyle, and incidence of type 2 diabetes among Latinos. J Nutr 137:860–870. https://doi.org/10.1093/jn/137.4.860

    Article  CAS  PubMed  Google Scholar 

  • Prentice RL, Thomson CA, Caan B, Hubbell FA, Anderson GL, Beresford SA, Pettinger M, Lane DS, Lessin L, Yasmeen S, Singh B, Khandekar J, Shikany JM, Satterfield S, Chlebowski RT (2007) Low-fat dietary pattern and cancer incidence in the Women's Health Initiative dietary modification randomized controlled. Trial J Natl Cancer Inst 99:1534–1543. https://doi.org/10.1093/jnci/djm159

    Article  PubMed  Google Scholar 

  • Ramos BM, Jurkowski J, Gonzalez BA, Lawrence C (2010) Latina women: health and healthcare disparities. Soc Work Public Health 25:258–271. https://doi.org/10.1080/19371910903240605

    Article  PubMed  Google Scholar 

  • Ritenbaugh C, Patterson RE, Chlebowski RT, Caan B, Fels-Tinker L, Howard B, Ockene J (2003) The Women's Health Initiative dietary modification trial: overview and baseline characteristics of participants. Ann Epidemiol 13:S87–S97

    Article  Google Scholar 

  • Santiago-Torres M, Tinker LF, Allison MA, Breymeyer KL, Garcia L, Kroenke CH, Lampe JW, Shikany JM, Van Horn L, Neuhouser ML (2015) Development and use of a traditional Mexican diet score in relation to systemic inflammation and insulin resistance among women of Mexican descent. J Nutr 145:2732–2740. https://doi.org/10.3945/jn.115.213538

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Schwingshackl L, Hoffmann G (2015) Adherence to Mediterranean diet and risk of cancer: an updated systematic review and meta-analysis of observational studies. Cancer Med 4:1933–1947. https://doi.org/10.1002/cam4.539

    Article  PubMed  PubMed Central  Google Scholar 

  • Shivappa N, Blair CK, Prizment AE, Jacobs DR, Hébert JR (2017a) Prospective study of the dietary inflammatory index and risk of breast cancer in postmenopausal women. Mol Nutr Food Res:61. https://doi.org/10.1002/mnfr.201600592

  • Shivappa N, Blair CK, Prizment AE, Jacobs DR, Hébert JR (2018) Dietary inflammatory index and risk of renal cancer in the Iowa Women's health study. Eur J Nutr 57:1207–1213. https://doi.org/10.1007/s00394-017-1403-5

    Article  PubMed  Google Scholar 

  • Shivappa N, Bosetti C, Zucchetto A, Serraino D, La Vecchia C, Hébert JR (2015a) Dietary inflammatory index and risk of pancreatic cancer in an Italian case-control study. Br J Nutr 113:292–298. https://doi.org/10.1017/S0007114514003626

    Article  CAS  PubMed  Google Scholar 

  • Shivappa N, Hébert JR, Ferraroni M, La Vecchia C, Rossi M (2016a) Association between dietary inflammatory index and gastric Cancer risk in an Italian case-control study. Nutr Cancer 68:1262–1268. https://doi.org/10.1080/01635581.2016.1224367

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Shivappa N, Hébert JR, Rosato V, Rossi M, Montella M, Serraino D, La Vecchia C (2016b) Dietary inflammatory index and ovarian cancer risk in a large Italian case-control study. Cancer Causes Control 27:897–906. https://doi.org/10.1007/s10552-016-0767-9

    Article  PubMed  PubMed Central  Google Scholar 

  • Shivappa N, Hébert JR, Rosato V, Rossi M, Montella M, Serraino D, La Vecchia C (2017b) Dietary inflammatory index and renal cell carcinoma risk in an Italian case-control study. Nutr Cancer 69:833–839. https://doi.org/10.1080/01635581.2017.1339815

    Article  PubMed  PubMed Central  Google Scholar 

  • Shivappa N, Sandin S, Löf M, Hébert JR, Adami HO, Weiderpass E (2015b) Prospective study of dietary inflammatory index and risk of breast cancer in Swedish women. Br J Cancer 113:1099–1103. https://doi.org/10.1038/bjc.2015.304

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Shivappa N, Steck SE, Hurley TG, Hussey JR, Hébert JR (2014) Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr 17:1689–1696. https://doi.org/10.1017/S1368980013002115

    Article  PubMed  Google Scholar 

  • Shivappa N, Zucchetto A, Serraino D, Rossi M, La Vecchia C, Hébert JR (2015c) Dietary inflammatory index and risk of esophageal squamous cell cancer in a case-control study from Italy. Cancer Causes Control 26:1439–1447. https://doi.org/10.1007/s10552-015-0636-y

    Article  PubMed  Google Scholar 

  • Siegel RL, Fedewa SA, Miller KD, Goding-Sauer A, Pinheiro PS, Martinez-Tyson D, Jemal A (2015) Cancer statistics for Hispanics/Latinos, 2015. CA Cancer J Clin 65:457–480. https://doi.org/10.3322/caac.21314

    Article  PubMed  Google Scholar 

  • Stefanick ML, Cochrane BB, Hsia J, Barad DH, Liu JH, Johnson SR (2003) The Women's Health Initiative postmenopausal hormone trials: overview and baseline characteristics of participants. Ann Epidemiol 13:S78–S86

    Article  Google Scholar 

  • Tabung FK, Steck SE, Ma Y, Liese AD, Zhang J, Caan B, Hou L, Johnson KC, Mossavar-Rahmani Y, Shivappa N, Wactawski-Wende J, Ockene JK, Hebert JR (2015) The association between dietary inflammatory index and risk of colorectal cancer among postmenopausal women: results from the Women's Health Initiative. Cancer Causes Control 26:399–408. https://doi.org/10.1007/s10552-014-0515-y

    Article  PubMed  Google Scholar 

  • The Women's Health Initiative Study Group (1998) Design of the Women's health initiative clinical trial and observational study. Control Clin Trials 19:61–109

    Article  Google Scholar 

  • Thomson CA, McCullough ML, Wertheim BC, Chlebowski RT, Martinez ME, Stefanick ML, Rohan TE, Manson JE, Tindle HA, Ockene J, Vitolins MZ, Wactawski-Wende J, Sarto GE, Lane DS, Neuhouser ML (2014) Nutrition and physical activity cancer prevention guidelines, cancer risk, and mortality in the women's health initiative. Cancer Prev Res (Phila) 7:42–53. https://doi.org/10.1158/1940-6207.CAPR-13-0258

    Article  Google Scholar 

  • Trichopoulou A, Bamia C, Lagiou P, Trichopoulos D (2010) Conformity to traditional Mediterranean diet and breast cancer risk in the Greek EPIC (European prospective investigation into Cancer and nutrition) cohort. Am J Clin Nutr 92:620–625. https://doi.org/10.3945/ajcn.2010.29619

    Article  CAS  PubMed  Google Scholar 

  • Turati F, Carioli G, Bravi F, Ferraroni M, Serraino D, Montella M, Giacosa A, Toffolutti F, Negri E, Levi F, La Vecchia C (2018) Mediterranean Diet and Breast Cancer Risk. Nutrients 10. https://doi.org/10.3390/nu10030326

  • Vargas AJ, Neuhouser ML, George SM, Thomson CA, Ho GY, Rohan TE, Kato I, Nassir R, Hou L, Manson JE (2016) Diet quality and colorectal cancer risk in the Women's Health Initiative observational study. Am J Epidemiol 184:23–32. https://doi.org/10.1093/aje/kwv304

    Article  PubMed  PubMed Central  Google Scholar 

  • Yang YC, Johnson MP, Schorpp KM, Boen CE, Harris KM (2017) Young adult risk factors for cancer: obesity, inflammation, and sociobehavioral mechanisms. Am J Prev Med 53:S21–S29. https://doi.org/10.1016/j.amepre.2017.04.025

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

Program Office: (National Heart, Lung, and Blood Institute, Bethesda, Maryland) Jacques Rossouw, Shari Ludlam, Joan McGowan, Leslie Ford, and Nancy Geller. Clinical Coordinating Center: (Fred Hutchinson Cancer Research Center, Seattle, WA) Garnet Anderson, Ross Prentice, Andrea LaCroix, and Charles Kooperberg. Investigators and Academic Centers: (Brigham and Women’s Hospital, Harvard Medical School, Boston, MA) JoAnn E. Manson; (MedStar Health Research Institute/Howard University, Washington, DC) Barbara V. Howard; (Stanford Prevention Research Center, Stanford, CA) Marcia L. Stefanick; (The Ohio State University, Columbus, OH) Rebecca Jackson; (University of Arizona, Tucson/Phoenix, AZ) Cynthia A. Thomson; (University at Buffalo, Buffalo, NY) Jean Wactawski-Wende; (University of Florida, Gainesville/Jacksonville, FL) Marian Limacher; (University of Iowa, Iowa City/Davenport, IA) Jennifer Robinson; (University of Pittsburgh, Pittsburgh, PA) Lewis Kuller; (Wake Forest University School of Medicine, Winston-Salem, NC) Sally Shumaker; (University of Nevada, Reno, NV) Robert Brunner. Women’s Health Initiative Memory Study: (Wake Forest University School of Medicine, Winston-Salem, NC) Mark Espeland.

Funding

Initiative for Maximizing Student Development (IMSD) NIH GM-62584. This project was funded by PA-16-288 Research Supplement to Promote Diversity in Health-Related Research, Parent Grant 3RO1CA186700-03 W1, NIH-NCI.

The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, and US Department of Health and Human Services through contracts HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C.

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Authors and Affiliations

  1. Clinical Translational Sciences, College of Medicine, University of Arizona, 3950 S. Country Club Rd #300, Tucson, AZ, 85714, USA

    Melissa Lopez-Pentecost

  2. University of Arizona Cancer Center, Tucson, AZ, USA

    Tracy E. Crane, Betsy C. Wertheim & Cynthia A. Thomson

  3. Biobehavioral Health Sciences Division, College of Nursing, University of Arizona, Tucson, AZ, USA

    Tracy E. Crane

  4. Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA

    David O. Garcia, Lindsay N. Kohler & Cynthia A. Thomson

  5. Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

    James R. Hebert, Susan E. Steck & Nitin Shivappa

  6. Connecting Health Innovations LLC, Columbia, SC, USA

    James R. Hebert & Nitin Shivappa

  7. Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchison Cancer Research Center, Seattle, WA, USA

    Margarita Santiago-Torres & Marian L. Neuhouser

  8. Department of Human Sciences, College of Education and Human Ecology, Ohio State University, Columbus, OH, USA

    Irene E. Hatsu

  9. Department of Epidemiology, University of Iowa, Iowa City, IA, USA

    Linda Snetselaar

  10. Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA

    Mridul Datta

  11. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA

    Candyce H. Kroenke

  12. Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin- Madison, Madison, WI, USA

    Gloria E. Sarto

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  1. Melissa Lopez-Pentecost
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Contributions

The authors’ responsibilities were as follows: Designed research; MLP and CAT; analyzed data or performed statistical analysis; MLP, LNK, BCW; manuscript written by: MLP, TEC, DOG, LNK, BCW, JRH, SES, NS, MST, MLN, IEH, LS, MD, CHK, GES, CAT; had primary responsibility for final content; MLP and CAT.

Corresponding author

Correspondence to Melissa Lopez-Pentecost.

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Ethical approval

The Institutional Review Board (IRB) approved study protocols at every Women’s Health Initiative site. All participants provided written informed consent prior to enrolling in the study.

Competing interests

Authors declare no potential conflicts of interest.

Disclaimer

Dr. James R. Hébert owns controlling interest in Connecting Health Innovations LLC (CHI), a company that has licensed the right to his invention of the Dietary Inflammatory Index (E-DII™) from the University of South Carolina in order to develop computer and smart phone applications for patient counselling and dietary intervention in clinical settings. Dr. Nitin Shivappa is an employee of CHI. The subject matter of this paper will not have any direct bearing on that work, nor has that activity exerted any influence on this project.

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Lopez-Pentecost, M., Crane, T.E., Garcia, D.O. et al. Role of dietary patterns and acculturation in cancer risk and mortality among postmenopausal Hispanic women: results from the Women’s Health Initiative (WHI). J Public Health (Berl.) 30, 811–822 (2022). https://doi.org/10.1007/s10389-020-01342-8

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