Dietary fat, fat subtypes and hepatocellular carcinoma in a large European cohort

Abstract

The role of amount and type of dietary fat consumption in the etiology of hepatocellular carcinoma (HCC) is poorly understood, despite suggestive biological plausibility. The associations of total fat, fat subtypes and fat sources with HCC incidence were investigated in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, which includes 191 incident HCC cases diagnosed between 1992 and 2010. Diet was assessed by country-specific, validated dietary questionnaires. A single 24-hr diet recall from a cohort subsample was used for measurement error calibration. Hazard ratios (HR) and 95% confidence intervals (95% CI) were estimated from Cox proportional hazard models. Hepatitis B and C viruses (HBV/HCV) status and biomarkers of liver function were assessed separately in a nested case–control subset with available blood samples (HCC = 122). In multivariable calibrated models, there was a statistically significant inverse association between total fat intake and risk of HCC (per 10 g/day, HR = 0.80, 95% CI: 0.65–0.99), which was mainly driven by monounsaturated fats (per 5 g/day, HR = 0.71, 95% CI: 0.55–0.92) rather than polyunsaturated fats (per 5 g/day, HR = 0.92, 95% CI: 0.68–1.25). There was no association between saturated fats (HR = 1.08, 95% CI: 0.88–1.34) and HCC risk. The ratio of polyunsaturated/monounsaturated fats to saturated fats was not significantly associated with HCC risk (per 0.2 point, HR = 0.86, 95% CI: 0.73–1.01). Restriction of analyses to HBV/HCV free participants or adjustment for liver function did not substantially alter the findings. In this large prospective European cohort, higher consumption of monounsaturated fats is associated with lower HCC risk

Dietary fatty acids and risk of hepatocellular carcinoma in the Singapore Chinese health study

“…By contrast, the large European Prospective Investigation into Cancer and Nutrition (EPIC) cohort did not report any association with saturated fat. Instead, they found an inverse association with monounsaturated fat intake . In this cohort of Chinese in Singapore, although we observed increased risk of HCC in the higher quartiles compared to the lowest quartile for saturated fat intake, and also decreased risk in the higher quartiles compared to the lowest quartile for monounsaturated fat intake, these associations did not reach statistical significance.…”

“…A high intake of red meat and saturated fat has been associated with increased risk of HCC in the National Institutes of Health‐AARP Diet and Health Study cohort in USA . Conversely, the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort did not find any association with saturated fat, but reported an inverse association with monounsaturated fat instead . In other studies, consumption of fish, a rich source of omega‐3 polyunsaturated fatty acids (PUFA), was associated with reduced risk of HCC .…”

Diabetes, Plasma Glucose, and Incidence of Fatty Liver, Cirrhosis, and Liver Cancer: A Prospective Study of 0.5 Million People

“…Furthermore, diabetes and NAFLD may co‐occur in the development of metabolic syndrome and share similar pathophysiological mechanisms, including hyperinsulinemia, hepatic insulin resistance, and dyslipidemia . In addition to hyperglycemia and insulin resistance, diet, microbiome, and obstructive sleep apnea may also explain the link between diabetes and liver diseases …”

“…(33) In addition to hyperglycemia and insulin resistance, diet, microbiome, and obstructive sleep apnea may also explain the link between diabetes and liver diseases. (34)(35)(36)(37) The strengths of CKB include a prospective design, a large and diverse study population, and careful adjustment for risk factors for liver diseases. In particular, we ascertained liver diseases through linkage to hospital records in addition to death and cancer registries, which allowed us to examine different types of liver diseases.…”

Nutrition and Hepatocellular Cancer

“…From these studies several important data have been collected. An inverse association between total fat intake and risk of HCC (per 10 g/day HR 0.80; 95% CI 0.65-0.99) has been observed and appears to be mainly driven by monounsaturated fats [30] . Total fish intake was also inversely associated with HCC risk (per 20 g/day HR 0.83; 95% CI 0.74-0.95) while there was no association with meat consumption [31] .…”