Inflammatory potential of diet and risk of lymphoma in the European Prospective Investigation into Cancer and Nutrition

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  • Marta Solans, Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain., Spain
  • Yolanda Benavente, Unit of Molecular and Genetic Epidemiology in Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology (ICO-IDIBELL), Av. Gran Via de l'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain., Spain
  • Marc Saez, Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain., Spain
  • Antonio Agudo, Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), 08908 Barcelona, Spain., Spain
  • Paula Jakszyn, Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), 08908 Barcelona, Spain., Spain
  • Sabine Naudin, Nutritional Methodology and Biostatistics Group, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France. freislingh@iarc.fr., France
  • Fatemeh Saberi Hosnijeh, 1] Department of Pediatric Oncology/Hematology, Sophia Children's Hospital-Erasmus University Medical Center, Rotterdam, The Netherlands [2] Department of Immunology, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands., Netherlands
  • Marc Gunter, Nutritional Epidemiology Group (NEP), International Agency for Research on Cancer (IARC-WHO), Lyon, France., France
  • Inge Huybrechts, Nutritional Epidemiology Group (NEP), International Agency for Research on Cancer (IARC-WHO), Lyon, France., France
  • Pietro Ferrari, Nutritional Methodology and Biostatistics Group, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France. freislingh@iarc.fr., France
  • Caroline Besson, Institut Gustave Roussy, Villejuif, France., France
  • Yahya Mahamat-Saleh, Institut Gustave Roussy, Villejuif, France., France
  • Marie-Christine Boutron-Ruault, Institut Gustave Roussy, Villejuif, France., France
  • Tilman Kühn, Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany., Germany
  • Rudolf Kaaks, Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany., Germany
  • Heiner Boeing, Department of Epidemiology, German Institute of Human Nutrition (DIfE) Postdam-Rehbrücke, Nuthetal, Germany., Germany
  • Cristina Lasheras, Department of Functional Biology, Faculty of Medicine, University of Oviedo, CP 33006 Oviedo, Asturias, Spain., Spain
  • Maria-Jose Sánchez, Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs. GRANADA. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain., Spain
  • Pilar Amiano, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain., Spain
  • María Dolores Chirlaque, Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain., Spain
  • Eva Ardanaz, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain., Spain
  • Julie A Schmidt, Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK., United Kingdom
  • Paolo Vineis, Department of Epidemiology and Biostatistics, MRC-HPA Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom., United Kingdom
  • Elio Riboli, School of Public Health, Imperial College London, London, United Kingdom., United Kingdom
  • Antonia Trichopoulou, Hellenic Health Foundation, Athens, Greece., Greece
  • Anna Karakatsani, 2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Haidari, Greece., Greece
  • Elisavet Valanou, Hellenic Health Foundation, Athens, Greece., Greece
  • Giovanna Masala, Cancer Risk Factors and Life-Style Epidemiology Unit. Institute for Cancer Research, Prevention and Clinical Network - ISPRO, 50141, Florence, Italy., Italy
  • Claudia Agnoli, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Italy
  • Rosario Tumino, Cancer Registry and Histopathology Department, "Civic M.P. Arezzo" Hospital, ASP, Ragusa, Italy., Italy
  • Carlotta Sacerdote, Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy., Italy
  • Amalia Mattiello, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy., Italy
  • Guri Skeie, Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway., Norway
  • Elisabete Weiderpass, Genetic Epidemiology Group, Folkhälsan Research Center and Faculty of Medicine, University of Helsinki, 00014 Helsinkiv, Finland. Elisabete.Weiderpass@kreftregisteret.no., Finland
  • Mats Jerkeman, Department of Oncology, Skåne University Hospital, Lund, Sweden;, Sweden
  • Joana Alves Dias, Department of Clinical Sciences in Malmö, Research Group in Nutritional Epidemiology, Lund University, Malmö, Sweden., Sweden
  • Florentin Späth, Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden., Sweden
  • Lena Maria Nilsson, Department of Public Health and Clinical Medicine, Nutritional research and Arcum-Arctic Research Centre, Umeå University, Umeå, Sweden., Sweden
  • Christina C Dahm
  • Kim Overvad
  • Kristina Elin Nielsen Petersen, Diet, Genes and Environment Unit, Danish Cancer Society Research Center, Copenhagen, Denmark., Denmark
  • Anne Tjønneland, Department of Public Health, University of Copenhagen, Copenhagen, Denmark., Denmark
  • Silvia de Sanjose, PATH, Reproductive Health, Seattle, USA., United States
  • Roel Vermeulen, Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands., Netherlands
  • Alexandra Nieters, Center for Chronic Immunodeficiency (CCI), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany., Germany
  • Delphine Casabonne, Unit of Molecular and Genetic Epidemiology in Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology (ICO-IDIBELL), Av. Gran Via de l'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain. dcasabonne@iconcologia.net., Spain

INTRODUCTION: Chronic inflammation plays a critical role in lymphomagenesis and several dietary factors seem to be involved its regulation. The aim of the current study was to assess the association between the inflammatory potential of the diet and the risk of lymphoma and its subtypes in the European Investigation into Cancer and Nutrition (EPIC) study.

METHODS: The analysis included 476,160 subjects with an average follow-up of 13.9 years, during which 3,136 lymphomas (135 Hodgkin lymphoma (HL), 2606 non-Hodgkin lymphoma (NHL) and 395 NOS) were identified. The dietary inflammatory potential was assessed by means of an inflammatory score of the diet (ISD), calculated using 28 dietary components and their corresponding inflammatory weights. The association between the ISD and lymphoma risk was estimated by hazard ratios (HR) and 95% confidence intervals (CI) calculated by multivariable Cox regression models adjusted for potential confounders.

RESULTS: The ISD was not associated with overall lymphoma risk. Among lymphoma subtypes, a positive association between the ISD and mature B-cell NHL (HR for a 1-SD increase: 1.07 (95% CI 1.01; 1.14), p trend = 0.03) was observed. No statistically significant association was found among other subtypes. However, albeit with smaller number of cases, a suggestive association was observed for HL (HR for a 1-SD increase = 1.22 (95% CI 0.94; 1.57), p trend 0.13).

CONCLUSIONS: Our findings suggested that a high ISD score, reflecting a pro-inflammatory diet, was modestly positively associated with the risk of B-cell lymphoma subtypes. Further large prospective studies on low-grade inflammation induced by diet are warranted to confirm these findings.

Original languageEnglish
JournalEuropean Journal of Nutrition
Number of pages11
ISSN1436-6207
DOIs
Publication statusE-pub ahead of print - 22 Mar 2019

    Research areas

  • chronic inflammation, inflammatory score of the diet, lymphoma, nutrition, prospective studies

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