Dietary flavonoid, lignan and antioxidant capacity and risk of hepatocellular carcinoma in the European prospective investigation into cancer and nutrition study

Raul Zamora-Ros; Veronika Fedirko; Antonia Trichopoulou; Carlos A González; Christina Bamia; Elisabeth Trepo; Ute Nöthlings; Talita Duarte-Salles; Mauro Serafini; Lea Bredsdorff; Kim Overvad; Anne Tjønneland; Jytte Halkjaer; Guy Fagherazzi; Florence Perquier; Marie-Christine Boutron-Ruault; Verena Katzke; Annekatrin Lukanova; Anna Floegel; Heiner Boeing; Pagona Lagiou; Dimitrios Trichopoulos; Calogero Saieva; Claudia Agnoli; Amalia Mattiello; Rosario Tumino; Carlotta Sacerdote; H Bas Bueno-de-Mesquita; Petra M Peeters; Elisabete Weiderpass; Dagrun Engeset; Guri Skeie; Marcial Vicente Argüelles; Esther Molina-Montes; Miren Dorronsoro; María José Tormo; Eva Ardanaz; Ulrika Ericson; Emily Sonestedt; Malin Sund; Rikard Landberg; Kay-Tee Khaw; Nicholas J Wareham; Francesca L Crowe; Elio Riboli; Mazda Jenab

doi:10.1002/ijc.28257

Dietary flavonoid, lignan and antioxidant capacity and risk of hepatocellular carcinoma in the European prospective investigation into cancer and nutrition study

Raul Zamora-Ros
, Veronika Fedirko
, Antonia Trichopoulou
, Carlos A González
, Christina Bamia
, Elisabeth Trepo
, Ute Nöthlings
, Talita Duarte-Salles
, Mauro Serafini
, Lea Bredsdorff
, Kim Overvad
, Anne Tjønneland
, Jytte Halkjaer
, Guy Fagherazzi
, Florence Perquier
, Marie-Christine Boutron-Ruault
, Verena Katzke
, Annekatrin Lukanova
, Anna Floegel
, Heiner Boeing

Pagona Lagiou, Dimitrios Trichopoulos, Calogero Saieva, Claudia Agnoli, Amalia Mattiello, Rosario Tumino, Carlotta Sacerdote, H Bas Bueno-de-Mesquita, Petra M Peeters, Elisabete Weiderpass, Dagrun Engeset, Guri Skeie, Marcial Vicente Argüelles, Esther Molina-Montes, Miren Dorronsoro, María José Tormo, Eva Ardanaz, Ulrika Ericson, Emily Sonestedt, Malin Sund, Rikard Landberg, Kay-Tee Khaw, Nicholas J Wareham, Francesca L Crowe, Elio Riboli, Mazda Jenab

Department of Public Health - Department of Epidemiology

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

68 Citations (Scopus)

Abstract

Limited epidemiological evidence suggests a protective role for plant foods rich in flavonoids and antioxidants in hepatocellular cancer (HCC) aetiology. Our aim was to prospectively investigate the association between dietary intake of flavonoids, lignans and non enzymatic antioxidant capacity (NEAC) and HCC risk. Data analysed were from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort including 477,206 subjects (29.8% male) recruited from ten Western European countries, was analyzed. Flavonoid, lignan and NEAC intakes were calculated using a compilation of existing food composition databases linked to dietary information from validated dietary questionnaires. Dietary NEAC was based on ferric reducing antioxidant capacity (FRAP) and total radical-trapping antioxidant parameter (TRAP). Hepatitis B/C status was measured in a nested case-control subset. During a mean follow-up of 11-years, 191 incident HCC cases (66.5% men) were identified. Using Cox Regression, multivariable adjusted models showed a borderline non-significant association of HCC with total flavonoid intake (highest versus lowest tertile, HR=0.65, 95% CI: 0.40-1.04; Ptrend =0.065), but not with lignans. Among flavonoid subclasses, flavanols were inversely associated with HCC risk (HR=0.62, 95% CI: 0.39-0.99; Ptrend =0.06). Dietary NEAC was inversely associated with HCC (FRAP: HR 0.50, 95% CI: 0.31-0.81; Ptrend =0.001; TRAP: HR 0.49, 95% CI: 0.31-0.79; Ptrend =0.002), but statistical significance was lost after exclusion of the first two years of follow-up. This study suggests that higher intake of dietary flavanols and antioxidants may be associated with a reduced HCC risk. © 2013 Wiley Periodicals, Inc.

Original language	English
Journal	International Journal of Cancer
Volume	133
Issue	10
Pages (from-to)	2429-43
ISSN	0020-7136
DOIs	https://doi.org/10.1002/ijc.28257
Publication status	Published - 15 Nov 2013

Access to Document

10.1002/ijc.28257

Library access?

Check availability with the Royal Danish Library

Cite this

Zamora-Ros, R., Fedirko, V., Trichopoulou, A., González, C. A., Bamia, C., Trepo, E., Nöthlings, U., Duarte-Salles, T., Serafini, M., Bredsdorff, L., Overvad, K., Tjønneland, A., Halkjaer, J., Fagherazzi, G., Perquier, F., Boutron-Ruault, M.-C., Katzke, V., Lukanova, A., Floegel, A., ... Jenab, M. (2013). Dietary flavonoid, lignan and antioxidant capacity and risk of hepatocellular carcinoma in the European prospective investigation into cancer and nutrition study. International Journal of Cancer, 133(10), 2429-43. https://doi.org/10.1002/ijc.28257

@article{2c24ff18556a4a0d8ca119c9d2268f55,

title = "Dietary flavonoid, lignan and antioxidant capacity and risk of hepatocellular carcinoma in the European prospective investigation into cancer and nutrition study",

abstract = "Limited epidemiological evidence suggests a protective role for plant foods rich in flavonoids and antioxidants in hepatocellular cancer (HCC) aetiology. Our aim was to prospectively investigate the association between dietary intake of flavonoids, lignans and non enzymatic antioxidant capacity (NEAC) and HCC risk. Data analysed were from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort including 477,206 subjects (29.8\% male) recruited from ten Western European countries, was analyzed. Flavonoid, lignan and NEAC intakes were calculated using a compilation of existing food composition databases linked to dietary information from validated dietary questionnaires. Dietary NEAC was based on ferric reducing antioxidant capacity (FRAP) and total radical-trapping antioxidant parameter (TRAP). Hepatitis B/C status was measured in a nested case-control subset. During a mean follow-up of 11-years, 191 incident HCC cases (66.5\% men) were identified. Using Cox Regression, multivariable adjusted models showed a borderline non-significant association of HCC with total flavonoid intake (highest versus lowest tertile, HR=0.65, 95\% CI: 0.40-1.04; Ptrend =0.065), but not with lignans. Among flavonoid subclasses, flavanols were inversely associated with HCC risk (HR=0.62, 95\% CI: 0.39-0.99; Ptrend =0.06). Dietary NEAC was inversely associated with HCC (FRAP: HR 0.50, 95\% CI: 0.31-0.81; Ptrend =0.001; TRAP: HR 0.49, 95\% CI: 0.31-0.79; Ptrend =0.002), but statistical significance was lost after exclusion of the first two years of follow-up. This study suggests that higher intake of dietary flavanols and antioxidants may be associated with a reduced HCC risk. {\textcopyright} 2013 Wiley Periodicals, Inc.",

author = "Raul Zamora-Ros and Veronika Fedirko and Antonia Trichopoulou and Gonz{\'a}lez, \{Carlos A\} and Christina Bamia and Elisabeth Trepo and Ute N{\"o}thlings and Talita Duarte-Salles and Mauro Serafini and Lea Bredsdorff and Kim Overvad and Anne Tj{\o}nneland and Jytte Halkjaer and Guy Fagherazzi and Florence Perquier and Marie-Christine Boutron-Ruault and Verena Katzke and Annekatrin Lukanova and Anna Floegel and Heiner Boeing and Pagona Lagiou and Dimitrios Trichopoulos and Calogero Saieva and Claudia Agnoli and Amalia Mattiello and Rosario Tumino and Carlotta Sacerdote and Bueno-de-Mesquita, \{H Bas\} and Peeters, \{Petra M\} and Elisabete Weiderpass and Dagrun Engeset and Guri Skeie and Arg{\"u}elles, \{Marcial Vicente\} and Esther Molina-Montes and Miren Dorronsoro and Tormo, \{Mar{\'i}a Jos{\'e}\} and Eva Ardanaz and Ulrika Ericson and Emily Sonestedt and Malin Sund and Rikard Landberg and Kay-Tee Khaw and Wareham, \{Nicholas J\} and Crowe, \{Francesca L\} and Elio Riboli and Mazda Jenab",

year = "2013",

month = nov,

day = "15",

doi = "10.1002/ijc.28257",

language = "English",

volume = "133",

pages = "2429--43",

journal = "International Journal of Cancer",

issn = "0020-7136",

publisher = "John Wiley \& Sons Inc.",

number = "10",

}

Zamora-Ros, R, Fedirko, V, Trichopoulou, A, González, CA, Bamia, C, Trepo, E, Nöthlings, U, Duarte-Salles, T, Serafini, M, Bredsdorff, L, Overvad, K, Tjønneland, A, Halkjaer, J, Fagherazzi, G, Perquier, F, Boutron-Ruault, M-C, Katzke, V, Lukanova, A, Floegel, A, Boeing, H, Lagiou, P, Trichopoulos, D, Saieva, C, Agnoli, C, Mattiello, A, Tumino, R, Sacerdote, C, Bueno-de-Mesquita, HB, Peeters, PM, Weiderpass, E, Engeset, D, Skeie, G, Argüelles, MV, Molina-Montes, E, Dorronsoro, M, Tormo, MJ, Ardanaz, E, Ericson, U, Sonestedt, E, Sund, M, Landberg, R, Khaw, K-T, Wareham, NJ, Crowe, FL, Riboli, E & Jenab, M 2013, 'Dietary flavonoid, lignan and antioxidant capacity and risk of hepatocellular carcinoma in the European prospective investigation into cancer and nutrition study', International Journal of Cancer, vol. 133, no. 10, pp. 2429-43. https://doi.org/10.1002/ijc.28257

Dietary flavonoid, lignan and antioxidant capacity and risk of hepatocellular carcinoma in the European prospective investigation into cancer and nutrition study. / Zamora-Ros, Raul; Fedirko, Veronika; Trichopoulou, Antonia et al.
In: International Journal of Cancer, Vol. 133, No. 10, 15.11.2013, p. 2429-43.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Dietary flavonoid, lignan and antioxidant capacity and risk of hepatocellular carcinoma in the European prospective investigation into cancer and nutrition study

AU - Zamora-Ros, Raul

AU - Fedirko, Veronika

AU - Trichopoulou, Antonia

AU - González, Carlos A

AU - Bamia, Christina

AU - Trepo, Elisabeth

AU - Nöthlings, Ute

AU - Duarte-Salles, Talita

AU - Serafini, Mauro

AU - Bredsdorff, Lea

AU - Overvad, Kim

AU - Tjønneland, Anne

AU - Halkjaer, Jytte

AU - Fagherazzi, Guy

AU - Perquier, Florence

AU - Boutron-Ruault, Marie-Christine

AU - Katzke, Verena

AU - Lukanova, Annekatrin

AU - Floegel, Anna

AU - Boeing, Heiner

AU - Lagiou, Pagona

AU - Trichopoulos, Dimitrios

AU - Saieva, Calogero

AU - Agnoli, Claudia

AU - Mattiello, Amalia

AU - Tumino, Rosario

AU - Sacerdote, Carlotta

AU - Bueno-de-Mesquita, H Bas

AU - Peeters, Petra M

AU - Weiderpass, Elisabete

AU - Engeset, Dagrun

AU - Skeie, Guri

AU - Argüelles, Marcial Vicente

AU - Molina-Montes, Esther

AU - Dorronsoro, Miren

AU - Tormo, María José

AU - Ardanaz, Eva

AU - Ericson, Ulrika

AU - Sonestedt, Emily

AU - Sund, Malin

AU - Landberg, Rikard

AU - Khaw, Kay-Tee

AU - Wareham, Nicholas J

AU - Crowe, Francesca L

AU - Riboli, Elio

AU - Jenab, Mazda

PY - 2013/11/15

Y1 - 2013/11/15

N2 - Limited epidemiological evidence suggests a protective role for plant foods rich in flavonoids and antioxidants in hepatocellular cancer (HCC) aetiology. Our aim was to prospectively investigate the association between dietary intake of flavonoids, lignans and non enzymatic antioxidant capacity (NEAC) and HCC risk. Data analysed were from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort including 477,206 subjects (29.8% male) recruited from ten Western European countries, was analyzed. Flavonoid, lignan and NEAC intakes were calculated using a compilation of existing food composition databases linked to dietary information from validated dietary questionnaires. Dietary NEAC was based on ferric reducing antioxidant capacity (FRAP) and total radical-trapping antioxidant parameter (TRAP). Hepatitis B/C status was measured in a nested case-control subset. During a mean follow-up of 11-years, 191 incident HCC cases (66.5% men) were identified. Using Cox Regression, multivariable adjusted models showed a borderline non-significant association of HCC with total flavonoid intake (highest versus lowest tertile, HR=0.65, 95% CI: 0.40-1.04; Ptrend =0.065), but not with lignans. Among flavonoid subclasses, flavanols were inversely associated with HCC risk (HR=0.62, 95% CI: 0.39-0.99; Ptrend =0.06). Dietary NEAC was inversely associated with HCC (FRAP: HR 0.50, 95% CI: 0.31-0.81; Ptrend =0.001; TRAP: HR 0.49, 95% CI: 0.31-0.79; Ptrend =0.002), but statistical significance was lost after exclusion of the first two years of follow-up. This study suggests that higher intake of dietary flavanols and antioxidants may be associated with a reduced HCC risk. © 2013 Wiley Periodicals, Inc.

AB - Limited epidemiological evidence suggests a protective role for plant foods rich in flavonoids and antioxidants in hepatocellular cancer (HCC) aetiology. Our aim was to prospectively investigate the association between dietary intake of flavonoids, lignans and non enzymatic antioxidant capacity (NEAC) and HCC risk. Data analysed were from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort including 477,206 subjects (29.8% male) recruited from ten Western European countries, was analyzed. Flavonoid, lignan and NEAC intakes were calculated using a compilation of existing food composition databases linked to dietary information from validated dietary questionnaires. Dietary NEAC was based on ferric reducing antioxidant capacity (FRAP) and total radical-trapping antioxidant parameter (TRAP). Hepatitis B/C status was measured in a nested case-control subset. During a mean follow-up of 11-years, 191 incident HCC cases (66.5% men) were identified. Using Cox Regression, multivariable adjusted models showed a borderline non-significant association of HCC with total flavonoid intake (highest versus lowest tertile, HR=0.65, 95% CI: 0.40-1.04; Ptrend =0.065), but not with lignans. Among flavonoid subclasses, flavanols were inversely associated with HCC risk (HR=0.62, 95% CI: 0.39-0.99; Ptrend =0.06). Dietary NEAC was inversely associated with HCC (FRAP: HR 0.50, 95% CI: 0.31-0.81; Ptrend =0.001; TRAP: HR 0.49, 95% CI: 0.31-0.79; Ptrend =0.002), but statistical significance was lost after exclusion of the first two years of follow-up. This study suggests that higher intake of dietary flavanols and antioxidants may be associated with a reduced HCC risk. © 2013 Wiley Periodicals, Inc.

U2 - 10.1002/ijc.28257

DO - 10.1002/ijc.28257

M3 - Journal article

C2 - 23649669

SN - 0020-7136

VL - 133

SP - 2429

EP - 2443

JO - International Journal of Cancer

JF - International Journal of Cancer

IS - 10

ER -

Dietary flavonoid, lignan and antioxidant capacity and risk of hepatocellular carcinoma in the European prospective investigation into cancer and nutrition study

Abstract

Access to Document

Library access?

Fingerprint

Cite this