Abstract:Context
Diet is emerging as a modifiable component of lifestyle for influencing the incidence of liver cancer.
Objective
To investigate and quantify the potential relationship between food groups and liver cancer.
Data sources
PubMed and Web of Science were searched for eligible observational studies until 31st March, 2023.
Data extraction
The meta-analysi… Show more
Background and aims:
The association between fiber or whole grain intakes and risk of liver cancer remains unclear. We assessed the associations between fiber or whole grain intakes and liver cancer risk among two prospective studies, and systematically reviewed and meta-analyzed these results with published prospective studies.
Approach and results:
A total of 111,396 participants from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) and 26,085 men from the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (ATBC) were included. Intakes of total fiber and whole grains were estimated from validated food frequency questionnaires. Study-specific hazard ratios (HRs) and 95% confidence intervals (CI) with liver cancer risk were estimated using multivariable-adjusted Cox regression. We systematically reviewed existing literature and studies were combined in a dose-response meta-analysis. A total of 277 (median follow-up=15.6 y) and 165 (median follow-up=16.0 y) cases of liver cancer were observed in PLCO and ATBC, respectively. Dietary fiber was inversely associated with liver cancer risk in PLCO (HR10g/day:0.69; 95%CI:0.55-0.86). No significant associations were observed between whole grain intakes and liver cancer risk in either study. Our meta-analysis included 2,383 incident liver cancer cases (seven prospective cohorts) for fiber intake and 1,523 cases (five prospective cohorts) for whole grain intake; combined HRs for liver cancer risk were 0.83 (0.76-0.91) per 10 g/day of fiber and 0.92 (0.85-0.99) per 16 g/day (1 serving) of whole grains.
Conclusions:
Dietary fiber and whole grains were inversely associated with liver cancer risk. Further research exploring potential mechanisms and different fiber types is needed.
Primary liver cancer is globally on the rise, partially due to poor diets and sedentary lifestyles. Shifting to more plant-based diets may lower the risk. We aimed to estimate the effect of replacing total red meat, unprocessed red meat and processed red meat with legumes on primary liver cancer in a free-living population. We analyzed data from 126,744 UK Biobank participants who completed ≥ two 24 h diet recalls. Baseline characteristics were collected from the initial assessment visit. Information on liver cancer diagnoses was collected via external linkage to inpatient hospital episodes or central cancer registries. Cox proportional hazards regression models were used to estimate the substitution of 15 g/day of legumes with 15 g/day of total red meat, unprocessed red meat or processed red meat on liver cancer risk, using the leave-one-out food substitution model. During a median follow-up time of 11.1 years, 173 participants developed liver cancer. In the fully adjusted models, no association was observed when substituting 15 g/day of legumes with total red meat (HR: 1.02 (95% CI 0.96–1.08)), unprocessed red meat (HR: 1.00 (95% CI 0.94–1.06)) or processed red meat (HR: 1.09 (95% CI 0.99–1.21)). Overall, little evidence of an association between replacing red meat with legumes and liver cancer was observed. Further research in other study populations with longer follow-up time is warranted.
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