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Associations of dietary patterns with kidney cancer risk, kidney cancer-specific mortality and all-cause mortality among postmenopausal women



The empirical dietary index for hyperinsulinemia (EDIH) and empirical dietary inflammatory pattern (EDIP) are novel measures of dietary quality associated with insulin hypersecretion or chronic inflammation, respectively, whereas the Healthy Eating Index (HEI-2015) measures adherence to the Dietary Guidelines for Americans (DGA). We evaluated associations of EDIH, EDIP and HEI-2015 on the risk of both kidney cancer development and mortality.


We calculated the dietary scores from baseline food frequency questionnaires among 115,830 participants aged 50–79 years in the Women’s Health Initiative. Multivariable-adjusted Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (95%CI) for kidney cancer risk, kidney cancer-specific mortality and all-cause mortality, per 1-standard deviation increment in dietary pattern scores.


Higher EDIH was associated with greater risk of kidney cancer development [HR, 1.12; 95%CI, (1.01,1.23)], kidney cancer-specific death [1.22(0.99,1.48)], and all-cause mortality, [1.05(1.02,1.08)]. Higher HEI-2015 was associated with lower risk of kidney cancer development, [0.85(0.77, 0.94)], kidney cancer-specific death, [0.84(0.69,1.03)] and all-cause mortality, [0.97(0.95,1.00)]. However, EDIP was not significantly associated with outcomes. Associations did not differ by BMI categories.


Low-insulinemic dietary patterns and higher quality diets, are worthy of testing in dietary pattern intervention trials for kidney cancer prevention and improved survivorship.

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Fig. 1: Relative risk estimates for the associations of dietary patterns (per 1 standard deviation increment) and future development of kidney cancer.
Fig. 2: Kaplan–Meier curves of kidney cancer death and all-cause death by binary median cutoffs of baseline multivariable adjusted EDIH, EDIP, and HEI2015 scores.

Data availability

The data used in this project were provided by the Women’s Health Initiative. Data will be made available on request via the Women’s Health Initiative manuscript proposal process available at:


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The WHI program is funded by the National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, U.S. Department of Health and Human Services through contracts 75N92021D00001, 75N92021D00002, 75N92021D00003, 75N92021D00004, 75N92021D00005.

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Authors and Affiliations



QJ and FKT designed research. QJ conducted research, performed statistical analysis; NS analyzed, and interpreted the data and provided critical output. QJ, JG, and SN wrote initial drafts of the manuscript. SN conducted data reviews for accuracy. FKT provided study oversight. All other authors revised the manuscript and agreed to be accountable for all aspects of the work.

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Correspondence to Fred K. Tabung.

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The authors declare no competing interests.

Ethics approval and consent to participate

The WHI protocol was approved by the institutional review boards at the Clinical Coordinating Center at the Fred Hutchinson Cancer Research Center (Seattle, WA) and at each Clinical Center and all women signed written informed consent. WHI is registered at as NCT00000611.

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Jin, Q., Gheeya, J., Nepal, S. et al. Associations of dietary patterns with kidney cancer risk, kidney cancer-specific mortality and all-cause mortality among postmenopausal women. Br J Cancer 129, 1978–1987 (2023).

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