Adherence to the WCRF/AICR Dietary Recommendations for Cancer Prevention and Risk of Cancer in Elderly from Europe and the United States: A Meta-Analysis within the CHANCES Project

• Type of Material: Article
• Authors: Nicole Jankovic, Wageningen University; Anouk Geelen, Wageningen University; Renate M. Winkels, Wageningen University; Blaise Mwungura, Wageningen University; Veronika Fedirko, Emory University; Mazda Jenab, International Agency for Research on Cancer; Anne K. Illner, Institut Polytechnique LaSalle Beauvais; Hermann Brenner, German Cancer Research Center; José M. Ordonez-Mena, German Cancer Research Center; Jessica C. Kiefte de Jong, University Medical Centre Rotterdam; Oscar H. Franco, University Medical Centre Rotterdam; Philippos Orfanos, University of Athens; Antonia Trichopoulou, University of Athens; Paolo Boffetta, Hellenic Health Foundation; Antonio Agudo, Catalan Institute of Oncology; Petra H. Peeters, University Medical Center Utrecht; Anne Tjonneland, Danish Cancer Society Research Centre; Göran Hallmans, Umea University; H. Bas Bueno-de-Mesquita, National Institute for Public Health and the Environment (RIVM); Yikyung Park, National Cancer institute; Edith J. Feskens, Wageningen University; Lisette C. de Groot, Wageningen University; Ellen Kampman, Wageningen University
• Language: English
• Date: 2017-01-01
• Publisher: American Association for Cancer Research
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 American Association for Cancer Research.
• Final Published Version (URL): http://dx.doi.org/10.1158/1055-9965.EPI-16-0428
• Title of Journal or Parent Work: Cancer Epidemiology, Biomarkers and Prevention
• ISSN: 1055-9965
• Volume: 26
• Issue: 1
• Start Page: 136
• End Page: 144
• Grant/Funding Information: The included cohorts were financially supported by the Regional Governments of Andalucia, Asturias, Basque Country, Murcia, and Navarra, Spain; the Regional Government of Västerbotten, Sweden; the Dutch Ministry of Public Health, Welfare, and Sports; the Netherlands Cancer Registry; LK Research Funds; Dutch Prevention Funds; Dutch Zorg Onderzoek Nederland; the World Cancer Research Fund; Statistics Netherlands; the Danish Cancer Society; the Hellenic Health Foundation; the Stavros Niarchos Foundation; the Intramural Research Program of the National Institutes of Health; the National Cancer Institute; The Rotterdam Elderly Study is supported by the Erasmus Medical Center and Erasmus University Rotterdam; the Netherlands Organization for Scientific Research; the Netherlands Organization for Health Research and Development; the Research Institute for Diseases in the Elderly; the Netherlands Genomics Initiative; the Ministry of Education, Culture, and Science; the Ministry of Health, Welfare, and Sports; the European Commission; and the Municipality of Rotterdam.; This work was part of the Consortium on Health and Ageing (CHANCES) project supported by the FP7 framework programme of the Directorate-General for Research & Innovation in the European Commission (grant 242244).
• Keywords: Science & Technology; COHORT; CONCORDANCE; HEALTH; Public, Environmental & Occupational Health; DESIGN; MORTALITY; Life Sciences & Biomedicine; BREAST-CANCER; Oncology; RESEARCH GUIDELINES; RESEARCH FUND/AMERICAN INSTITUTE; NUTRITION; PATTERNS
• Research Categories: Health Sciences, Nutrition; Health Sciences, Epidemiology

Abstract

Background: It is unknown whether dietary recommendations for cancer prevention are applicable to the elderly. We analyzed WCRF/AICR recommendations in cohorts of European and U.S. adults ages 60 years and above. Methods: Individual participant data meta-Analysis included 362,114 participants (43% women), from seven prospective cohort studies, free from cancer at enrollment. The WCRF/AICR diet score was based on: (i) energy-dense foods and sugary drinks, (ii) plant foods, (iii) red and processed meat, and (iv) alcoholic drinks. Cox proportional hazards regression was used to examine the association between the diet score and cancer risks. Adjusted, cohort-specific HRs were pooled using random-effects metaanalysis. Risk advancement periods (RAP) were calculated to quantify the time period by which the risk of cancer was postponed among those adhering to the recommendations. Results: After a median follow-up of 11 to 15 years across cohorts, 70,877 cancer cases were identified. Each one-point increase in the WCRF/AICR diet score [range, 0 (no) to 4 (complete adherence)] was significantly associated with a lower risk of total cancer [HR, 0.94; 95% confidence interval (CI), 0.92-0.97], cancers of the colorectum (HR, 0.84; 95% CI, 0.80-0.89) and prostate (HR, 0.94; 95% CI, 0.92-0.97), but not breast or lung. Adherence to an additional component of the WCRF/AICR diet score significantly postponed the incidence of cancer at any site by 1.6 years (RAP, 1.6; 95% CI, 4.09 to 2.16). Conclusions: Adherence to WCRF/AICR dietary recommendations is associated with lower risk of cancer among older adults. Impact: Dietary recommendations for cancer prevention are applicable to the elderly.