Inflammatory potential of diet and risk of lymphoma in the European Prospective Investigation into Cancer and Nutrition

• Published in: European journal of nutrition 2020-03, Vol.59 (2), p.813-823
• Main Authors: Solans, Marta, Benavente, Yolanda, Saez, Marc, Agudo, Antonio, Jakszyn, Paula, Naudin, Sabine, Hosnijeh, Fatemeh Saberi, Gunter, Marc, Huybrechts, Inge, Ferrari, Pietro, Besson, Caroline, Mahamat-Saleh, Yahya, Boutron-Ruault, Marie-Christine, Kühn, Tilman, Kaaks, Rudolf, Boeing, Heiner, Lasheras, Cristina, Sánchez, Maria-Jose, Amiano, Pilar, Chirlaque, María Dolores, Ardanaz, Eva, Schmidt, Julie A., Vineis, Paolo, Riboli, Elio, Trichopoulou, Antonia, Karakatsani, Anna, Valanou, Elisavet, Masala, Giovanna, Agnoli, Claudia, Tumino, Rosario, Sacerdote, Carlotta, Mattiello, Amalia, Skeie, Guri, Weiderpass, Elisabete, Jerkeman, Mats, Dias, Joana Alves, Späth, Florentin, Nilsson, Lena Maria, Dahm, Christina C., Overvad, Kim, Petersen, Kristina Elin Nielsen, Tjønneland, Anne, de Sanjose, Silvia, Vermeulen, Roel, Nieters, Alexandra, Casabonne, Delphine
• Format: Article
• Language: English
• Subjects: Adult; Aged; B-cell lymphoma; Cancer; Cancer and Oncology; Cancer och onkologi; Causality; Chemistry; Chemistry and Materials Science; Chronic inflammation; Clinical Medicine; Cohort Studies; Diet; Diet - adverse effects; Europe; Female; Health Sciences; Humans; Hälsovetenskap; Inflammation; Inflammation - pathology; Inflammatory score of the diet; Klinisk medicin; Lymphocytes B; Lymphoma; Lymphoma - epidemiology; Lymphoma - pathology; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Middle Aged; Non-Hodgkin's lymphoma; Nutrition; Nutrition and Dietetics; Nutritional Status; Näringslära; Original Contribution; Prospective Studies; Regression analysis; Risk Factors; Statistical analysis
• ISSN: 1436-6207; 1436-6215; 1436-6215
• DOI: 10.1007/s00394-019-01947-0

Introduction Chronic inflammation plays a critical role in lymphomagenesis and several dietary factors seem to be involved its regulation. The aim of the current study was to assess the association between the inflammatory potential of the diet and the risk of lymphoma and its subtypes in the European Investigation into Cancer and Nutrition (EPIC) study. Methods The analysis included 476,160 subjects with an average follow-up of 13.9 years, during which 3,136 lymphomas (135 Hodgkin lymphoma (HL), 2606 non-Hodgkin lymphoma (NHL) and 395 NOS) were identified. The dietary inflammatory potential was assessed by means of an inflammatory score of the diet (ISD), calculated using 28 dietary components and their corresponding inflammatory weights. The association between the ISD and lymphoma risk was estimated by hazard ratios (HR) and 95% confidence intervals (CI) calculated by multivariable Cox regression models adjusted for potential confounders. Results The ISD was not associated with overall lymphoma risk. Among lymphoma subtypes, a positive association between the ISD and mature B-cell NHL (HR for a 1-SD increase: 1.07 (95% CI 1.01; 1.14), p trend = 0.03) was observed. No statistically significant association was found among other subtypes. However, albeit with smaller number of cases, a suggestive association was observed for HL (HR for a 1-SD increase = 1.22 (95% CI 0.94; 1.57), p trend 0.13). Conclusions Our findings suggested that a high ISD score, reflecting a pro-inflammatory diet, was modestly positively associated with the risk of B-cell lymphoma subtypes. Further large prospective studies on low-grade inflammation induced by diet are warranted to confirm these findings.