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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

Jankovic N 1 , Geelen A 2 , Winkels RM 2 , Mwungura B 2 , Fedirko V 3 , Jenab M 4 Show all authors , Illner AK 5 , Brenner H 6 , Ordóñez-Mena JM 6 , Kiefte de Jong JC 7 , Franco OH 7 , Orfanos P 8 , Trichopoulou A 8 , Boffetta P 9 , Agudo A 10 , Peeters PH 11 , Tjønneland A 12 , Hallmans G 13 , Bueno-de-Mesquita HB 14 , Park Y 15 , Feskens EJ 2 , de Groot LC 2 , Kampman E 2 , Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES)

Affiliations 

  • 1 Department Agrotechnology and Food Sciences, Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands. Nicole.Jankovic@uk-essen.de
  • 2 Department Agrotechnology and Food Sciences, Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
  • 3 Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, Georgia
  • 4 Department Nutritional Epidemiology, International Agency for Research on Cancer, Lyon, France
  • 5 Department of Nutrition & Health Sciences, Institut Polytechnique LaSalle Beauvais, Beauvais, France
  • 6 Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
  • 7 Department of Epidemiology, Erasmus Medical Centre Rotterdam, University Medical Centre Rotterdam, Rotterdam, The Netherlands
  • 8 Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece
  • 9 Hellenic Health Foundation, Athens, Greece
  • 10 Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
  • 11 Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
  • 12 Danish Cancer Society Research Centre, Copenhagen, Denmark
  • 13 Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
  • 14 Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
  • 15 Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
Cancer Epidemiol Biomarkers Prev, 2017 Jan;26(1):136-144.
PMID: 27793797 DOI: 10.1158/1055-9965.EPI-16-0428

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 meta-analysis. 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. Cancer Epidemiol Biomarkers Prev; 26(1); 136-44. ©2016 AACR.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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