1.
Cancer-Specific and General Nutritional Scores and Cancer Risk: Results from the Prospective NutriNet-Santé Cohort.
Lavalette, C, Adjibade, M, Srour, B, Sellem, L, Fiolet, T, Hercberg, S, Latino-Martel, P, Fassier, P, Deschasaux, M, Kesse-Guyot, E, et al
Cancer research. 2018;(15):4427-4435
Abstract
Several national and international authorities have proposed nutritional and lifestyle recommendations with the aim of improving health of the general population. Scores of adherence to these recommendations can be calculated at the individual level. Here, we investigated the associations between four nutritional scores and overall, breast, prostate, and colorectal cancer risk in a large prospective population-based cohort: the cancer-specific World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) score, the Alternate Healthy Eating Index 2010 (AHEI-2010), a score based on adherence to the Mediterranean diet (MEDI-LITE), and the French National Nutrition Health Program-Guideline Score (PNNS-GS). This study included 41,543 participants aged ≥40 years from the NutriNet-Santé cohort (2009-2017). A total of 1,489 overall incident cancers were diagnosed. A one-point increment of the WCRF/AICR score was significantly associated with decreased overall [12%; 95% confidence interval (CI), 8%-16%; P < 0.0001], breast (14%; 95% CI, 6%-21%; P = 0.001), and prostate (12%; 95% CI, 0%-22%; P = 0.05) cancer risks. Hazard ratio for colorectal cancer risk was 0.86 (95% CI, 0.72-1.03; P = 0.09). The PNNS-GS score was associated with reduced colorectal cancer risk (P = 0.04) and AHEI-2010 was associated with reduced overall cancer risk (P = 0.03). The WCRF/AICR score performed best. Compared with other tested scores, it included a stronger penalty for alcohol, which is a major risk factor for several cancer sites. Better adherence to nutritional recommendations, especially those designed for cancer prevention, could substantially contribute to decreased cancer incidence.Significance: This large prospective population-based cohort study suggests that following dietary recommendations such as the ones proposed by the World Cancer Research Fund/American Institute for Cancer Research could significantly contribute to cancer prevention. Cancer Res; 78(15); 4427-35. ©2018 AACR.
2.
Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort.
Fiolet, T, Srour, B, Sellem, L, Kesse-Guyot, E, Allès, B, Méjean, C, Deschasaux, M, Fassier, P, Latino-Martel, P, Beslay, M, et al
BMJ (Clinical research ed.). 2018;360:k322
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Plain language summary
Foods that are heavily processed tend to have high levels of total fat, sugar and salt and low levels of fibre and vitamins. They also tend to have high levels of contaminants (caused for example by high heat treatment), food additives and plastic packaging exposure. This large prospective population-based cohort study assessed the association between ultra-processed food consumption and the incidence of cancer. The study found that ultra-processed food intake was associated with a higher overall cancer risk and a higher breast cancer risk. A 10% increase in the consumption of ultra-processed foods was associated with an increase of more than 10% greater risk of overall and breast cancer risk. The authors call for further studies to better understand the different elements of food processing and their association to cancer risk.
Abstract
OBJECTIVE To assess the prospective associations between consumption of ultra-processed food and risk of cancer. DESIGN Population based cohort study. SETTING AND PARTICIPANTS 104 980 participants aged at least 18 years (median age 42.8 years) from the French NutriNet-Santé cohort (2009-17). Dietary intakes were collected using repeated 24 hour dietary records, designed to register participants' usual consumption for 3300 different food items. These were categorised according to their degree of processing by the NOVA classification. MAIN OUTCOME MEASURES Associations between ultra-processed food intake and risk of overall, breast, prostate, and colorectal cancer assessed by multivariable Cox proportional hazard models adjusted for known risk factors. RESULTS Ultra-processed food intake was associated with higher overall cancer risk (n=2228 cases; hazard ratio for a 10% increment in the proportion of ultra-processed food in the diet 1.12 (95% confidence interval 1.06 to 1.18); P for trend<0.001) and breast cancer risk (n=739 cases; hazard ratio 1.11 (1.02 to 1.22); P for trend=0.02). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet (lipid, sodium, and carbohydrate intakes and/or a Western pattern derived by principal component analysis). CONCLUSIONS In this large prospective study, a 10% increase in the proportion of ultra-processed foods in the diet was associated with a significant increase of greater than 10% in risks of overall and breast cancer. Further studies are needed to better understand the relative effect of the various dimensions of processing (nutritional composition, food additives, contact materials, and neoformed contaminants) in these associations. STUDY REGISTRATION Clinicaltrials.gov NCT03335644.