Association between pre- and post-diagnosis healthy eating index 2020 and ovarian cancer survival: evidence from a prospective cohort study

• Published in: Food & function 2024-08, Vol.15 (16), p.848-8417
• Main Authors: Liu, Jia-Cheng, Liu, Fang-Hua, Zhang, De-Yu, Wang, Xiao-Ying, Wu, Lang, Li, Yi-Zi, Xu, He-Li, Wei, Yi-Fan, Huang, Dong-Hui, Li, Xiao-Ying, Xiao, Qian, Xie, Meng-Meng, Liu, Pei-Chen, Gao, Song, Liu, Chuan, Liu, Ning, Gong, Ting-Ting, Wu, Qi-Jun
• Format: Article
• Language: English
• Subjects: Cancer; Cohort analysis; Diagnosis; Diet; Dietary intake; Eating; Eating behavior; Fatalities; Food intake; Medical records; Ovarian cancer; Regression analysis; Regression models; Statistical analysis; Survival
• ISSN: 2042-6496; 2042-650X; 2042-650X
• DOI: 10.1039/d4fo02417f

Background : Previous studies on the association between diet quality and ovarian cancer (OC) survival are limited and inconsistent. We evaluated the relationship between pre- and post-diagnosis diet quality based on the Healthy Eating Index-2020 (HEI-2020), as well as their changes and OC survival. Methods : This prospective cohort study involved 1082 patients with OC aged 18-79 years, enrolled between 2015 and 2022. Detailed dietary intake before and after diagnosis was recorded using a validated food frequency questionnaire. Deaths were ascertained until February 16th, 2023 via medical records and active follow-up. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI). Results : We included 549 OC cases with a median follow-up of 44.9 months, representing 206 total deaths. Higher HEI scores were associated with better OS (pre-diagnosis: HR T3 vs. T1 0.66, 95%CI: 0.46-0.93, HR 1−SD 0.84, 95%CI: 0.73-0.96; post-diagnosis: HR T3 vs. T1 0.68, 95%CI: 0.49-0.96, HR 1-SD 0.80, 95%CI: 0.69-0.92). Compared to the stable group, the group with decreased HEI scores (>3%) from pre- to post-diagnosis had worse OS (HR 1.93, 95%CI: 1.26-2.97). Conclusion : High pre- and post-diagnosis diet quality was associated with improved OC survival, whereas deterioration in diet quality after diagnosis was associated with decreased OC survival. Adherence to the healthy eating index-2020 before and after diagnosis is associated with better overall survival in patients with ovarian cancer.