Poor diet quality has been associated with an increased risk of cancer. Here, we examine the association between dietary patterns derived with two methods, and combined and site-specific cancer incidence in Canada.
Dietary data were obtained from participants enrolled in Alberta’s Tomorrow Project, a prospective cohort study, between 2000 and 2008. Principle component analysis (PCA) and reduced rank regression (RRR) were used to derive dietary patterns, and data linkage with the Alberta Cancer Registry was used for incident cancer cases. Cox proportional hazard regressions were used to estimate multivariable-adjusted models for the association between each dietary pattern score with combined and site-specific cancer incidence.
PCA revealed three dietary patterns (“western”, “prudent”, and “sugar, fruits, and dairy”) and RRR resulted in four patterns (“dietary fiber“, “vitamin D”, “fructose”, and “discretionary fat”). Five cancer sites were included in our site-specific analysis: lung, colon, breast, prostate, and endometrial cancers. The most protective dietary patterns for combined cancer sites were the “Prudent” pattern (HR = 0.82, CI = 0.73–0.92) and the “Dietary fiber” pattern (HR = 0.82, CI = 0.69–0.97). The “Fructose” pattern was associated with increased risk of combined cancers (HR = 1.14, CI = 1.02–1.27). Three dietary patterns were protective against colon cancer (“Prudent”, “Dietary fiber”, and “Discretionary fats”), and other risk reductions were seen for the “sugar, fruit, and dairy” pattern (lung cancer), and the “Dietary fiber” pattern (prostate cancer).
These results support cancer prevention strategies for a diet high in vegetables, fruits, fish, and whole grains. Further studies should explore the possible association between discretionary fats and colon cancer.
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Dr. Jessica McNeil is a recipient of Postdoctoral Fellowship Awards from the Canadian Institutes of Health Research and Alberta Innovates. Dr. Christine Friedenreich was supported by a Health Senior Scholar Award from Alberta Innovates-Health Solutions and the Alberta Cancer Foundation Weekend to End Women’s Cancers Breast Cancer Chair. Dr. Darren Brenner was supported by a Capacity Development Award in Cancer Prevention from the Canadian Cancer Society (#703917). Alberta’s Tomorrow Project is only possible due to the commitment of its research participants, its staff, and its funders: Alberta Health and the Alberta Cancer Prevention Legacy Fund, Alberta Cancer Foundation, Canadian Partnership Against Cancer and substantial in kind funding from Alberta Health Services. The views expressed herein represent the views of the authors and not of Alberta’s Tomorrow Project or any of its funders.
Alberta’s Tomorrow Project received funding from Alberta Health and the Alberta Cancer Prevention Legacy Fund, the Alberta Cancer Foundation, the Canadian Partnership Against Cancer and substantial in kind funding from Alberta Health Services. Funding was not received for the analysis and writing of this manuscript.
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Willemsen, R.F., McNeil, J., Heer, E. et al. Dietary patterns with combined and site-specific cancer incidence in Alberta’s Tomorrow Project cohort. Eur J Clin Nutr (2021). https://doi.org/10.1038/s41430-021-00958-7