A prospective study of dietary patterns and cancer mortality among Blacks and Whites in the REGARDS cohort

• Type of Material: Article
• Authors: Tomi Akinyemiju, University of Alabama; Justin Xavier Moore, University of Alabama; Maria Pisu, University of Alabama; Susan G. Lakoski, University of Texas; James Shikany, University of Alabama; Michael Goodman, Emory University; Suzanne E. Judd, University of Alabama
• Language: English
• Date: 2016-11-15
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 UICC
• Final Published Version (URL): http://dx.doi.org/10.1002/ijc.30287
• Title of Journal or Parent Work: International Journal of Cancer
• ISSN: 0020-7136
• Volume: 139
• Issue: 10
• Start Page: 2221
• End Page: 2231
• Grant/Funding Information: Dr Akinyemiju was supported by grant U54 CA118948 from the NIH.; Grant sponsor: National Heart, Lung and Blood Institute; Grant number: K08HL096841; Grant sponsor: National Institute for Nursing Research; Grant number: R01-NR012726; Grant sponsor: National Center for Research Resources; Grant number: UL1-RR025777; Grant sponsor: National Institute of Neurological Disorders and Stroke; Grant number: U01-NS041588; Grant sponsor: NIH (Mr. Moore); Grant number: R25 CA47888; Grant sponsor: NIH (Dr Akinyemiju); Grant number: U54 CA118948; Mr Moore received grant support from grant R25 CA47888 from the NIH.
• Keywords: prospective cohort; racial disparities; FAT; RACIAL-DIFFERENCES; diet; BREAST-CANCER; COLORECTAL-CANCER; EPIDEMIOLOGIC EVIDENCE; CARDIOVASCULAR-DISEASE; PHYSICAL-ACTIVITY; mortality; RISK-FACTORS; Oncology; cancer; POSTMENOPAUSAL WOMEN; Life Sciences & Biomedicine; CORONARY-HEART-DISEASE; Science & Technology
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Oncology

Abstract

Marked racial differences exist in dietary patterns and obesity, as well as cancer mortality. This study aims to assess whether dietary patterns are associated with cancer mortality overall and by race. We identified 22,041 participants from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. Dietary patterns were categorized into: Convenience (Chinese and Mexican foods, pasta, pizza), Plant-based (fruits, vegetables), Southern (added fats, fried foods, sugar-sweetened beverages), Sweets/Fats (sugary foods) and Alcohol/Salads (alcohol, green-leafy vegetables, salad dressing). Using Cox regression, we examined the association between quartiles of dietary patterns and cancer mortality, adjusted for potential confounders, overall among all participants and stratified by race. A total of 873 cancer deaths were observed over the 10-year observation period: 582 (66.7%) in Whites and 291 (33.3%) in Blacks. Greater adherence to the Southern dietary pattern was associated with an increased risk of cancer mortality (4th vs. 1st quartile HR: 1.67; 95% CI: 1.32–2.10) overall, especially among Whites (4th vs. 1st quartile HR: 1.59; 95% CI: 1.22–2.08). The convenience (HR: 0.73; 95% CI: 0.56–0.94) and Plant-based (HR: 0.72; 95% CI: 0.55–0.93) dietary patterns were associated with up to a 28% reduced risk of cancer mortality, but only among Whites. Greater adherence to the Southern dietary pattern increased the risk of cancer mortality, while greater adherence to the convenience and Plant-based diets reduced the risk of cancer mortality among Whites. Racial differences were observed in the association between dietary patterns and cancer mortality, but warrant further study.