Healthful Plant-Based Dietary Pattern and Risk of Hepatocellular Carcinoma in a Multiethnic Population: A Cohort Study

• Published in: The American journal of clinical nutrition 2023-07, Vol.118 (1), p.194-200
• Main Authors: Kim, Jihye, Setiawan, Veronica Wendy, Wilkens, Lynne R., Le Marchand, Loïc, Park, Song-Yi
• Format: Article
• Language: English
• Subjects: Adult; Carcinoma, Hepatocellular - etiology; Cohort analysis; Cohort Studies; Diet; Diet, Vegetarian; Ethnicity; Food; Hepatocellular carcinoma; Humans; Liver cancer; Liver Neoplasms - epidemiology; Liver Neoplasms - etiology; Minority & ethnic groups; multiethnic cohort; Multiracial people; Original; plant food quality; plant-based diets; Plants; Population studies; Race; Risk management; Risk reduction; Sex
• ISSN: 0002-9165; 1938-3207; 1938-3207
• DOI: 10.1016/j.ajcnut.2023.04.031

Plant-based dietary patterns assessed by a priori indices are associated with various health outcomes, but have rarely been examined in relation to liver cancer. This study investigated the associations between plant-based diets and risk of hepatocellular carcinoma (HCC) and evaluated whether the associations vary by sex and race and ethnicity. Data were from a total of 170,321 African American, Japanese American, Latino, Native Hawaiian, and White adults aged 45–75 y who completed a food frequency questionnaire in the Multiethnic Cohort Study. Cox models with adjustment for potential confounders were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for HCC according to 3 plant-based diet scores: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). During a mean follow-up of 19.6 y, 722 incident HCC cases were identified. Multivariate-adjusted HR (95% CI) per 10-point increase was 0.82 (0.71–0.94) for PDI, 0.84 (0.74–0.96) for hPDI, and 1.08 (0.95–1.23) for uPDI. We found no significant differences by sex (all Pheterogeneity ≥ 0.53) or race and ethnicity (all Pheterogeneity ≥ 0.31). Greater adherence to plant-based diets rich in healthy plant foods and low in less healthy plant foods is associated with a reduced risk of HCC in a multiethnic population.