Diet diversity and the risk of oral and pharyngeal cancer
ABSTRACT Diet diversity has been recommended to achieve a healthy diet and prevent cancer.
The relation between diet diversity (i.e., variety in food intake computed as the total number of foods consumed at least once per week) and the risk of oral and pharyngeal cancer was investigated using data from a multicentric case-control study carried out between 1991 and 2005 in Italy.
Cases were 805 patients with histologically confirmed incident cancers of the oral cavity and pharynx, and controls were 2,081 patients admitted for acute, non-neoplastic diseases, unrelated to tobacco or alcohol consumption.
A significant inverse association was observed with total diet diversity. The multivariate odds ratio (OR), adjusted for education, tobacco and alcohol, was 0.78 (95% confidence interval, CI 0.61-0.98) for subjects in the highest tertile of diversity. Inverse relations were found also for diversity within vegetables (OR = 0.62; 95% CI 0.49-0.78) and fruits (OR = 0.67; 95% CI 0.53-0.86).
This study suggests that a more diversified, and particularly a diet varied in vegetables and fruit, is a favourable indicator of oral and pharyngeal cancer risk, independently from the major recognised risk factors, i.e. alcohol and tobacco consumption.
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ABSTRACT: A population-based case-control study of oral and pharyngeal cancer conducted in four areas of the United States provided information on a number of risk factors, including diet. Interviews were obtained from 871 oral cancer patients and 979 controls among whites, frequency matched for age and sex. Consumption frequency of 61 food items was assessed in the questionnaire; attention was given to foods that are sources of vitamins A and C and carotene. The major finding was an inverse relationship between fruit intake and risk of oral and pharyngeal cancer; individuals in the highest quartile of intake had about half the risk of those in the lowest quartile. Vitamin C, carotene, or fiber in fruit did not appear to account completely for this relationship, since these nutrients in vegetables did not provide similar protection. This finding suggests the influence of other constituents in fruits, although it is possible that cooking vegetables may have a nutrient-diminishing effect. Dietary intake of other nutrients, such as the B vitamins, vitamin E, folate, and iron, showed no consistent relationship to risk of oral and pharyngeal cancer. Coffee or other hot beverage consumption did not increase risk; intake of nitrite-containing meats or cooking practices, such as smoking, pickling, or charcoal grilling, also did not increase risk. All analyses were adjusted for the effects of tobacco and alcohol, strong risk factors for oral and pharyngeal cancer. Dietary findings among the few subjects who did not use tobacco or alcohol were similar to those for all subjects.JNCI Journal of the National Cancer Institute 11/1988; 80(15):1237-43. DOI:10.1093/jnci/80.15.1237 · 12.58 Impact Factor
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ABSTRACT: A varied diet may have a favorable role against digestive tract cancers. We analyzed the relationship between diet diversity (i.e. measured by the number of different foods consumed at least once per week) and the risk of esophageal cancer. We considered data from a case-control study conducted between 1992 and 1997 in northern Italy on 304 squamous cell esophageal cancer cases below age 78 years and 743 controls admitted to hospital for acute, nonneoplastic conditions, unrelated to tobacco or alcohol consumption. There was a significant inverse association for total diet diversity: the multivariate odds ratio (OR), adjusted for age, sex, area of residence, education, tobacco smoking, alcohol drinking and non-alcohol energy intake was 0.42 (95% confidence interval, CI: 0.25-0.71) for subjects in the highest versus those in the lowest quartile of diversity. Inverse relations were also found for diversity within vegetables (OR = 0.34, 95% CI: 0.21-0.55) and fruits (OR = 0.51, 95% CI: 0.33-0.80). No significant association was found for meat and cereal diversity. These results add epidemiological support to the dietary guidelines recommending a more varied diet, particularly in fruit and vegetables, for esophageal cancer prevention.International Journal of Cancer 11/2008; 123(10):2397-400. DOI:10.1002/ijc.23761 · 5.09 Impact Factor
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ABSTRACT: We reviewed data from six cohort studies and approximately 40 case-control studies on the relation between selected aspects of diet and the risk of oral and pharyngeal cancer. Fruit and vegetables were inversely related to the risk: the pooled relative risk (RR) for high vegetable consumption was 0.65 from three cohort studies on upper aerodigestive tract cancers and 0.52 from 18 case-control studies of oral and pharyngeal cancer; corresponding RRs for high fruit consumption were 0.78 and 0.55. beta-carotene, vitamin C and selected flavonoids have been inversely related to the risk, but it is difficult to disentangle their potential effect from that of fruit and vegetables. Whole grain, but not refined grain, intake was also favorably related to oral cancer risk. The results were not consistent with reference to other foods beverages, and nutrients, but it is now possible to exclude a strong relation between these foods and oral and pharyngeal cancer risk. In western countries, selected aspects of diet may account for 20-25% of oral and pharyngeal cancer, and the population attributable risk increases to 85-95% when tobacco and alcohol consumption are also considered.Oral Oncology 12/2008; 45(6):461-7. DOI:10.1016/j.oraloncology.2008.09.002 · 3.61 Impact Factor