BACKGROUND
Pancreatic cancer is relatively rare but remains one of the most lethal tumors. Identifying modifiable risk factors is a crucial step to reduce disease burden. Evidence suggests a potential role of type 2 diabetes mellitus in its pathogenesis.
OBJECTIVE
To examine the association between dietary patterns related to diabetes and pancreatic cancer risk in a European population.
METHODS
A total of 367,395 participants from the European Prospective Investigation into Cancer and Nutrition study were included. After a median follow-up of 14.9 years, 926 incident cases were identified. The Diabetes Risk Reduction Diet (DRRD), the Empirical Dietary Index for Hyperinsulinemia (EDIH) and the Empirical Dietary Index for Insulin Resistance (EDIR) were estimated from food frequency questionnaires at recruitment. Hazard ratios (HRs) and 95% confidence intervals (CI) for the association between dietary patterns and pancreatic cancer were calculated using multivariable Cox proportional hazards regression models, adjusted for relevant confounders.
RESULTS
Adherence to DRRD showed no association with risk of pancreatic cancer (HRT3vsT1 = 0.94, 95% CI 0.79-1.12). Higher adherence to EDIH was associated with a borderline 19% increased pancreatic cancer risk (HRT3vsT1 = 1.19, 95% CI 0.99-1.44). No significant associations were observed in relation to EDIR. No heterogeneity was observed among the subgroups.
CONCLUSIONS
Higher adherence to a hyperinsulinemic dietary pattern may contribute to the risk of developing pancreatic cancer in our population. Further research is warranted to elucidate the potential role of dietary factors in cancer risk prevention.
L.F. Torres-Laiton, W. Balcerzak, R. Zamora et al.· Journal of NutriLife· 0 citations
Benefits of healthy diets for type 2 diabetes (T2D) prevention are established. It remains unclear whether such recommendations should be tailored to specific subgroups according to their susceptibility to the disease. This study aimed to assess whether the association of diet quality with T2D risk differs across subgroups with different genetic or epigenetic susceptibility. We used data from a case-cohort within the European Prospective Investigation into Cancer and Nutrition (EPIC)–Potsdam cohort (random subsample with genetic data of 2204 participants, 750 verified incident T2D cases; random subsample with epigenetic data of 1065 participants, 676 verified incident T2D cases). The Alternative Healthy Eating Index (AHEI-2010), Dietary Approaches to Stop Hypertension (DASH), Dietary Inflammatory Index (DII) and the Mediterranean Diet Pyramid score (MedPyr) were used to assess diet quality. A blood DNA methylation risk score (MRS) was used to reflect epigenetic risk. Genetic risk was characterized using global polygenic risk scores (PRS) and pathway-specific polygenic risk scores (pPRS). Cox proportional hazards models were used to assess the modification of the diet quality-diabetes risk association by the risk scores. Higher adherence to the AHEI-2010 was associated with a lower risk of T2D, while higher MRS, PRS and pPRS predictably indicated higher risk in this population. We detected significant modification of the diet quality-T2D association by the MRS for AHEI-2010 (p = 0.008) and MedPyr (p < 0.0001) and DII (p = 0.010) but only the AHEI-2010 × MRS interaction was robust across all sensitivity analyses. However, we did not find evidence of interaction between diet quality and genetic risk. The associations of healthy diets with T2D could depend on the diabetes risk captured by blood DNA methylation profiles, but they do not seem to depend on the genetic predisposition for T2D. Confirmation of the effect modification by the MRS in independent populations is further required before considering clinical application.
Christine El-Khoury, F. Eichelmann, F. Jannasch et al.· Cardiovascular Diabetology· 0 citations
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