Diets, Dietary Patterns, Single Foods and Pancreatic Cancer Risk: An Umbrella Review of Meta-Analyses

Abstract

Pancreatic cancer (PC) represents the third leading cause of cancer death in 2020. Despite the fact that, in 2018, the World Cancer Research Fund report concluded that there is still a lack of evidence on the role of foods or diets and risk for PC, a flourishing body of evidence has been published and needs to be analyzed. For this reason, we conducted an umbrella review on the association between different dietary patterns/food components and PC. Data sources PubMed/MEDLINE, Scopus, Web of Science, EMBASE, and the Cochrane Collaboration were searched. The Joanna Briggs Institute Umbrella Review Methodology was used. The protocol was registered in PROSPERO. A total of 23 articles were included, covering a wide range of dietary patterns/food components: healthy/prudent dietary patterns (n = 4), Mediterranean diets (MedDiet) (n = 1), plant-based diets (n = 2), the Dietary Inflammatory Index (DII) (n = 2), western diets (n = 2), and, lastly, unhealthy diets (n = 2). Regarding dietary components, the following were assessed: total fruit (n = 2), citrus fruit (n = 1), total vegetables (n = 2), cruciferous vegetables (n = 1), red meat (n = 6), processed meat (n = 4), poultry (n = 2), eggs (n = 1), fish (n = 5), whole grain (n = 2), potato (n = 1), and nuts (n = 2). The methodological quality of the included meta-analyses was generally low or critically low. Although the strength of evidence was generally weak, convincing or suggestive evidence was found for a healthy/prudent, plant-based diet, fruit and vegetables, and lower risk of PC, whereas a high intake of red meat was associated with a higher risk of PC at a convincing level of evidence. Further studies are needed to confirm the role of the other dietary patterns/food components and the risk of PC.

A Cross-Sectional Study Based on Forty Systematic Reviews of Foods with Function Claims (FFC) in Japan: Quality Assessment Using AMSTAR 2

“…Our findings of the poor methodological quality of SRs in the food field are in line with those from assessments of the methodological quality of SRs that used the AMSTAR 2 tool in other fields, including acupuncture [16,17], dentistry [18], Tai Chi [19,20], surgery [21,22], major depression in adults [23], chronic obstructive pulmonary disease [24], cardiovascular risk [25], physical activity [26], pancreatic cancer [27], chronic heart failure [28], cancerrelated fatigue [29], Alzheimer's disease [30], chronic spinal pain [31], neonatal pain [32], hip fractures [33], and atopic eczema [34]. Although the target patients or participants and interventions in those studies differed between each study, all demonstrated that the majority of SRs included had low methodological quality ("low" or "critically low").…”

“…However, there may be considerable correlations between the certainty of the results of the evidence and the results of quality assessments based on AMSTAR 2. Recently, many umbrella reviews have been performed that used both AMSTAR 2 and GRADE in healthcare settings [22,25,27,[32][33][34]. These studies were consistently determined to be "low" and "very low" according to the GRADE evaluation when the ratings were also "low" or "critically low" in AMSTAR 2.…”

Dietary patterns in relation to incidence rate of pancreatic cancer – the Norwegian women and cancer cohort study

“…Conversely, high intake of red meat was associated with increased risk of pancreatic cancer. However, the general quality of evidence was low to critically low (26). Similar results were obtained in a multi case-control study published shortly after the umbrella review.…”

Cardiovascular health and cancer risk associated with plant based diets: An umbrella review

“…The umbrella review by Gianfredi et al [ 59 ], did describe a lower risk of pancreatic cancer associated with vegetarian diets.…”