Adherence to the Chinese or American Dietary Guidelines is Associated with a Lower Risk of Primary Liver Cancer in China: A Case-Control Study
by
Pei-Yan Chen 1, Ai-Ping Fang 1, Xiao-Yan Wang 1, Qiu-Ye Lan 1, Gong-Cheng Liao 1, Zhao-Yan Liu 1, Dao-Ming Zhang 1, Yao-Yun Zhang 2, Yu-Ming Chen 3,4
and Hui-Lian Zhu 1,3,*
Pei-Yan Chen 1, Ai-Ping Fang 1, Xiao-Yan Wang 1, Qiu-Ye Lan 1, Gong-Cheng Liao 1, Zhao-Yan Liu 1, Dao-Ming Zhang 1, Yao-Yun Zhang 2, Yu-Ming Chen 3,4 and Hui-Lian Zhu 1,3,*
1
Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
2
Department of Hepatobiliary Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
3
Guangdong Provincial Key Laboratory of Food, Nutrition and Health; Guangzhou 510080, China
4
Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
*
Author to whom correspondence should be addressed.
Nutrients 2018, 10(8), 1113; https://doi.org/10.3390/nu10081113
Received: 24 July 2018 / Revised: 9 August 2018 / Accepted: 15 August 2018 / Published: 17 August 2018
(This article belongs to the Special Issue Diet Quality and Health Outcomes)
Adherence to healthy dietary guidelines has been related to a lower risk of several cancers, but its role in primary liver cancer (PLC) has not been fully investigated, especially among Eastern populations. This study enrolled 720 PLC patients and 720 healthy controls who were frequency-matched by age and sex between September 2013 and October 2017 in South China. Dietary quality was assessed by the Chinese Healthy Eating Index (CHEI) and the Healthy Eating Index 2015 (HEI-2015), which manifests as scores of adhering to the 2016 Dietary Guidelines for Chinese and adhering to the 2015–2020 Dietary Guidelines for Americans, respectively. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression models, adjusting for potential confounders. Higher scores in both the CHEI and HEI-2015 were associated with a lower risk of PLC (per 5-points increment of the total scores: OR: 0.43, 95% CI: 0.38–0.50 for CHEI; OR: 0.47, 95% CI: 0.40–0.55 for HEI-2015). The protective associations persisted significantly in the stratified analyses by sex, smoker status, alcohol consumption, HBV infection, and histological types of PLC, without statistical evidence for heterogeneity (p-interaction > 0.05). Closer adherence to the most recent dietary guidelines for Chinese or Americans may protect against PLC.
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Keywords:
dietary index; diet; liver cancer; risk factors; case-control study
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MDPI and ACS Style
Chen, P.-Y.; Fang, A.-P.; Wang, X.-Y.; Lan, Q.-Y.; Liao, G.-C.; Liu, Z.-Y.; Zhang, D.-M.; Zhang, Y.-Y.; Chen, Y.-M.; Zhu, H.-L. Adherence to the Chinese or American Dietary Guidelines is Associated with a Lower Risk of Primary Liver Cancer in China: A Case-Control Study. Nutrients 2018, 10, 1113.
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