Food groups and risk of non‐Hodgkin lymphoma: A multicenter, case‐control study in Italy

Abstract

Incidence of non-Hodgkin lymphoma (NHL) has been rising worldwide, but the reasons are undefined. Dietary habits may play a role in the etiology of NHL by influencing the metabolic pathways of several cells of the immune system. This case-control study investigated the relation between food consumption and NHL risk. Between 1999 and 2002, we conducted a hospital-based case-control study on NHL in 2 areas of Italy. Cases were 190 patients (median age 58 years) with incident NHL admitted to specialized and general hospitals. Controls were 484 patients (median age 63 years) with acute non-neoplastic conditions admitted to the same hospitals network of cases. A validated food-frequency questionnaire was used to assess habitual diet 2 years before interview. Unconditional multiple logistic regression was used to estimate the odds ratios (OR) and the corresponding 95% confidence intervals (CI), with allowance for energy intake, according to the residual model. Consumption of highest versus lowest quartile of pasta/rice (OR 5 1.87, 95% CI: 1.04-3.36) and cheese (OR 5 1.66, 95% CI: 0.98-2.83) were associated with a significantly increased NHL risk. Inverse association was found for vegetables (OR 5 0.49, 95% CI: 0.28-0.87), fruits (OR 5 0.51, 95% CI: 0.30-0.85), and egg consumption (OR 5 0.59, 95% CI: 0.36-0.97). The association of pasta/rice was also supported by an increased risk of high glycemic load levels (OR 5 1.86, 95% CI: 1.04-3.32). In conclusion, our results suggested that diet could affect NHL risk. ' 2005 Wiley-Liss, Inc.Key words: case-control study; risk factors; non-Hodgkin lymphoma; diet; glycemic load Unlike most cancers whose mortality rates have been decreasing over the last 2 decades, non-Hodgkin lymphoma (NHL) incidence and mortality rates have been steadily increasing. Since the 1970s and the 1980s, an increasing NHL incidence rate of 3-4% per year has been observed worldwide, and these rises are greater in developed than in developing countries. 1,2 The reasons of such an increase are largely unknown, and include diagnostic improvements, changes in NHL classification, HIV/AIDS and other immunosuppressive conditions, 3 and other infectious agents. [4][5][6][7] Various occupational, environmental and chemical agents have also been analyzed as risk factors for NHL, 8,9 but none of these factors explain the recent rise in NHL rates.Functions and metabolic pathways of several cells of the immune system are known to depend on certain nutrients, 10 pointing to a possible role of diet in the etiology of NHL. 11 Since the late 1980s, at least 15 epidemiological studies have examined the role of diet and NHL. Five were hospital-based case-control studies [12][13][14][15][16] ; 6 were population-based case-control studies [17][18][19][20][21][22] ; 4 were cohort studies. [23][24][25][26] Among these, 1 epidemiological study found an increased risk of NHL associated with breads and cereals 17 ; 3 studies observed inverse associations, in particular for intake of whole-grain foods 12,14,21

Dietary and Lifestyle Factors and Risk of Non-Hodgkin's Lymphoma in Oman

“…However, when the total protein intake was examined in quartiles as the percentage energy contribution from protein, no association was observed with risk of NHL (1.00, 0.67, and 1.11). The increased NHL risk associated with higher protein intake observed in this study is consistent with the data reported in some previous studies, which suggested that high intake of protein can influence the metabolic pathways of immune system and may increase the risk of NHL (Talamini et al, 2006, Mozaheb et al, 2012. Although the evidence from animal studies supports an etiologic role of high protein consumption, the results from epidemiological studies are inconsistent.…”

“…No apparent association was observed between the quartiles for the daily intake of number of servings from fruits and milk and milk products with NHL risk (OR=1.00, 0.95, 1.88 for fruit and OR=1.00, 0.51, 0.81 for milk and milk products). Our results support the hypothesis that higher consumption of cereals, in particular the refined grains, is associated with increased risk of NHL (Talamini et al, 2006). Our results are also consistent with the data from other case-control studies, which showed that the consumption of breads and cereal products was positively associated with NHL risk (Ward et al, 1994;Zheng et al, 2004).…”

“…A populationbased case-control study from eight Canadian provinces found that high total energy intake showed a relatively strong association with risk of NHL (Purdue et al, 2004). However, some other studies did not observe such association (Chang et al, 2006;Talamini et al, 2006). Obesity, energy homeostasis and physical inactivity have been reported to influence the immune function and therefore may influence the risk of NHL (Pischon et al, 2008;Kobat et al, 2012).…”

Red Meat Intake and Risk of Non-Hodgkin Lymphoma: A Meta-Analysis

“…The power to evaluate the association for CLL/SLL or for T cell lymphoma histologic types was limited. An excess risk of NHL has been reported with higher intake of meat (Purdue et al, 2004), red meat (Chiu et al, 1996;Zhang et al, 1999;Purdue et al, 2004;Kilfoy et al, 2012;Stefani et al, 2013), and processed meat (Purdue et al, 2004), whereas other studies found no association with meat consumption (Cross et al, 2006;Talamini et al, 2006;Chang et al, 2006;Erber et al, 2009;Rohrmann et al, 2011;Daniel et al, 2012).…”

“…A total of 11 published articles regarding the relationship between intake red meat,processed meat DOI:http://dx.doi.org/10.7314/APJCP.2014.15.23.10421 Red Meat Intake and Risk of Non-Hodgkins Lymphoma: a Meta-Analysis and the NHL were identified by applying the inclusion criteria (Figure 1) (Zhang et al, 1999;Purdue et al, 2004;Chang et al, 2005;Cross et al, 2006;Talamini et al, 2006;Erber et al, 2009;Rohramann et al, 2010;Daniel et al, 2012;Kilfoy et al, 2012;Stefani et al, 2013) 8 articles documented processed meat (Purdue et al, 2004;Cross et al, 2006;Talamini et al, 2006;Rohramann et al, 2010;Daniel et al, 2012;Kilfoy et al, 2012;Stefani et al, 2013) and 5 articles reported intake red meat and risk subtype NHL (Purdue et al, 2004;Chang et al, 2005;Erber et al, 2009;Daniel et al, 2012;Kilfoy et al, 2012).…”