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.
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.
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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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.
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.
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.
Authors declare no potential conflicts of interest.
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