Nutrition/Obesity
Diabetes risk reduction diet and risk of liver cancer and chronic liver disease mortality: a prospective cohort study Yun Chen* Yun Chen Longgang Zhao Su Yon Jung Margaret S. Pichardo Melissa Lopez-Pentecost Thomas E. Rohan Nazmus Saquib Yangbo Sun Fred K. Tabung Tongzhang Zheng Jean Wactawski-Wende JoAnn E. Manson Marian L Neuhouser Xuehong Zhang
Background: Global incidence of type 2 diabetes mellitus (T2DM) continues to increase rapidly and is an important risk factor for end-stage liver diseases. Better understanding of the role of lifestyle factors for T2DM could help prevent the development of liver diseases. We evaluated the association between adherence to a diabetes risk reduction diet (DRRD) and the risk of liver cancer development and chronic liver disease mortality in postmenopausal women.
Methods: We included 98,786 postmenopausal women from the Women’s Health Initiative Observational Study and the usual diet arm of the Diet Modification trial. The DRRD score was estimated based on responses to a food-frequency questionnaire administered at baseline (1993-1998). Adherence to the DRRD is characterized by high intakes of dietary fiber, coffee, nuts, and polyunsaturated fatty acids, and low intakes of red and processed meat, foods with high glycemic index, sugar-sweetened beverages (SSBs), and trans fat. Multivariable HRs and 95% CIs for liver cancer incidence and chronic liver disease mortality were estimated using Cox proportional hazards regressions adjusted for liver disease risk factors.
Results: After a median follow-up of 22.0 years, 216 incident liver cancer cases and 153 chronic liver disease deaths were identified. A higher DRRD score was significantly associated with a reduced risk of developing liver cancer (HRTertile 3 vs. Tertile 1 = 0.69; 95% CI: 0.49-0.97; Ptrend = 0.03) and chronic liver disease mortality (HRT3 vs. T1 = 0.54; 95% CI: 0.35-0.82; Ptrend = 0.003). We further found that high dietary fiber and coffee intake showed inverse associations, while dietary glycemic index, SSBs, and trans fat showed positive associations.
Conclusions: Adherence to a DRRD was associated with reduced risk of developing liver cancer and chronic liver disease mortality among postmenopausal women. Further studies are needed to validate our findings and elucidate the underlying biological mechanisms.
