Dietary consumption of processed meat increases risk of lung cancer

Background: Processed meat, commonly consumed in Italy and other western countries, contains high levels of nitrates and nitrites (added for preservation or improvement of color and taste). These nitrogen species are transformed into carcinogenic N-nitroso compounds. High consumption of processed meat has been found associated with increased risk of colorectal, breast, and bladder cancers. However, the epidemiologic evidence for an association between dietary intake of processed meat and lung cancer risk is sparse. Objective: To investigate the relationship between dietary consumption of processed meat and lung cancer risk in the Environment And Genetics in Lung cancer Etiology (EAGLE), a population-based case-control study of lung cancer. Methods: Between 2002 and 2005, 2101 primary lung cases were enrolled from 13 hospitals of a defined catchment area including 216 municipalities of the Lombardy Region of Italy. Healthy controls (2120) were randomly selected and recruited from the same residential area, matched on gender, residence, and age (\ub15 years) to the cases. Comprehensive epidemiological data were collected through an interview-based computer-assisted questionnaire and dietary intakes via a short self-administered questionnaire. Processed meats consumed by the EAGLE participants included cooked ham, smoked ham, \u201craw\u201d ham (prosciutto), salami, baloney, salted beef, coppa (Italian sausages), and bacon. Logistic regression analysis was used to compute odds ratios (ORs) and 95% confidence intervals (CIs). All analyses were adjusted for the matching variables, body mass index, education, alcohol consumption, and smoking history (cigarette intensity, duration of cigarette smoking, and years since last cigarette smoked for former smokers). Results did not change after further adjustment for consumption of total fruits and vegetables or previous lung diseases. Results: Compared to the lowest tertile of intake frequency, statistically significant positive associations were found for the middle (OR: 1.23; 95% CI: 1.03-1.49) and highest (OR: 1.63; 95% CI: 1.34-1.97) tertiles of processed meat intake and lung cancer risk (p-trend: <<0.001). The significant positive associations persisted after stratification by smoking status, and was stronger in never smokers (OR: 2.1; 95% CI: 1.24-3.56; p-trend: 0.006). Analyses by lung cancer histology, showed elevated associations for adenocarcinoma (OR=1.83; 95% CI: 1.43-2.34) and squamous cell carcinoma (OR=1.83; 95% CI: 1.34-2.5), but not for small cell carcinoma (OR=1.1; 95% CI: 0.72-1.69). Conclusions: Consumption of processed meat was significantly associated with higher risk of lung cancer in this population-based case-control study independent of smoking status. Further investigation into the mechanisms by which processed meat might contribute to the etiology of lung cancer is warranted

Nut consumption and lung cancer risk : Results from two large observational studies

Background: Epidemiologic evidence on the association between nut consumption and lung cancer risk is limited. Methods: We investigated this relationship in the Environment and Genetics in Lung Cancer Etiology (EAGLE) study, a population-based case-control study, and the National Institutes of Health (NIH) American Association of Retired Persons (AARP) Diet and Health Study, a prospective cohort. We identified 2,098 lung cases for EAGLE and 18,533 incident cases in AARP. Diet was assessed by food frequency questionnaire for both studies. Multivariable ORs and HRs and respective 95% confidence intervals (CI) were calculated using unconditional logistic regression and Cox proportional hazards regression for EAGLE and AARP, respectively. Results: Higher frequency of intake of nut consumption was inversely associated with overall lung cancer risk (highest vs. lowest quintile, OREAGLE = 0.74; 95% CI, 0.57-0.95; HRAARP = 0.86; 95% CI, 0.81-0.91), regardless of smoking status. Results from the prospective cohort showed similar associations across histologic subtypes and a more pronounced benefits from nut consumption for those who smoked 1 to 20 cigarettes/day (OREAGLE = 0.61; 95% CI, 0.39-0.95; HRAARP = 0.83; 95% CI, 0.74-0.94). Conclusions: Nut consumption was inversely associated with lung cancer in two large population-based studies, and associations were independent of cigarette smoking and other known risk factors. Impact: To our knowledge, this is the first study that examined the association between nut consumption and lung cancer risk by histologic subtypes and smoking intensity

Intakes of red meat, processed meat, and meat mutagens increase lung cancer risk

Red and processed meat intake may increase lung cancer risk. However, the epidemiologic evidence is inconsistent and few studies have evaluated the role of meat mutagens formed during high cooking temperatures. We investigated the association of red meat, processed meat, and meat mutagen intake with lung cancer risk in Environment And Genetics in Lung cancer Etiology, a population-based case-control study. Primary lung cancer cases (n = 2,101) were recruited from 13 hospitals within the Lombardy region of Italy examining approximately 80% of the cases from the area. Noncancer population controls (n = 2,120), matched to cases on gender, residence, and age, were randomly selected from the same catchment area. Diet was assessed in 1,903 cases and 2,073 controls and used in conjunction with a meat mutagen database to estimate intake of heterocyclic amines (HCA) and benzo(a)pyrene (BaP). Multivariable odds ratios (OR) and 95% confidence intervals (95% CI) for sex-specific tertiles of intake were calculated using unconditional logistic regression. Red and processed meat were positively associated with lung cancer risk (highest-versus-lowest tertile: OR, 1.8; 95% CI, 1.5-2.2; P trend < 0.001 and OR, 1.7; 95% CI, 1.4-2.1; P trend < 0.001, respectively); the risks were strongest among never smokers (OR, 2.4; 95% CI, 1.4-4.0; P trend = 0.001 and OR, 2.5; 95% CI, 1.5-4.2; P trend = 0.001, respectively). HCAs and BaP were significantly associated with increased risk of lung cancer. When separated by histology, significant positive associations for both meat groups were restricted to adenocarcinoma and squamous cell carcinoma but not small cell carcinoma of the lung. In summary, red meat, processed meat, and meat mutagens were independently associated with increased risk of lung cancer

Environment and genetics in lung cancer etiology (EAGLE): a novel population-based case-control study of lung cancer

EAGLE is a large population-based case-control study designed to investigate the genetic and environmental determinants of lung cancer, smoking persistence, survival and therapy efficacy through combined analysis of genetic, environmental, clinical, and behavioral data. Field activities have recently concluded. Lung cancer cases were enrolled from 13 hospitals within the Lombardy region of Italy. The healthy controls were randomly selected from the same residential area of the lung cancer cases. The participation rate was high, 85% in cases and 73% in controls. The study includes 2,117 incident lung cancer cases, both males (78%) and females (22%) of Italian nationality, ages 35 to 79 years old, with verified lung cancer of any histological type, and 2,120 healthy population-based controls matched to cases by age, gender, and residence. Adenocarcinoma was the most frequent histology subtype overall (38%) and in never smokers (62%), and differed by sex (50% in females and 35% in males, overall). Interestingly, bronchoalveolar carcinoma showed the highest frequency in former smokers (53%) compared to current smokers (26%) and never smokers (21%). In contrast, all other histological subtypes, particularly small cell and large cell, had higher frequency in current smokers. Stage I tumors were more frequent in former (49%) than current (43%) smokers, while later stages were more frequent in current smokers. We collected extensive epidemiological, behavioral, and clinical data, as well as multiple biospecimens from virtually all lung cancer cases and controls. Tissue specimens, including multiple fresh \u201cnormal\u201d lung tissue and tumor samples, were collected from surgical cases. As expected, tobacco smoking was associated with lung cancer (OR=5.0, 95% CI=4.0-6.1, and OR=11.0, 95% CI=8.8-13.6, in former and current smokers, respectively, when compared with never smokers and adjusting for matching variables). Initial analyses show that family history of cancer in first-degree relatives (OR=1.3, 95% CI=1.1-1.4), and low education level (p=0.003, test for trend, from elementary to post-graduate education) are risk factors for lung cancer in EAGLE, even after adjustment for smoking and matching variables. We are exploring the role of passive smoking, sex, occupation, diet, willingness to participate in the study, and other factors in the association with lung cancer, and behavioral data (Fagerstrom index, measures of depression, anxiety, and personality) in relation to smoking persistence. Extensive genetic investigations are also underway. This study will help answer many questions related to lung cancer etiology

The application of six dietary scores to a Middle Eastern population: a comparative analysis of mortality in a prospective study

Background The associations between dietary indices and mortality have not been evaluated in populations from the Middle East, which have different dietary patterns compared to the US and Europe. In this study, we evaluated the association between six dietary indices and mortality in the Golestan Cohort Study (GCS) in Iran, which is the largest prospective study in the Middle East with 50,045 participants. Methods The six dietary indices, namely the Healthy Eating Index (HEI-2015), Alternative Healthy Eating Index (AHEI-2010), Alternative Mediterranean Diet (AMED), Dietary Approach to Stop Hypertension created by Fung (DASH-Fung) and Mellen (DASH-Mellen), and the World Cancer Research Fund (WCRF/AICR) index, were applied to data from a food frequency questionnaire, computed and divided into quintiles. Adjusted Cox models were used to estimate hazards ratio (HR) and 95 confidence intervals (CI) for overall and cause-specific mortality, using the lowest quintile as a reference group. Results Among 42,373 participants included in the current analyses, 4424 subjects died during 10.6 years of follow-up. Participants with the highest quintile dietary scores, compared with the lowest quintile dietary scores, had significantly decreased overall mortality in the AHEI-2010, AMED, DASH-Fung, and WCRF/AICR indices (HR 0.88, 95 CI = 0.80�0.97; 0.80, 0.70�0.91; 0.77, 0.70�0.86; and 0.79, 0.70�0.90, respectively). A reduced cardiovascular mortality was found for high AHEI-2010 and DASH-Fung scores (17 and 23, respectively), and a reduced cancer mortality for high HEI-2015, AMED, and DASH-Fung scores (21, 37 and 25, respectively). Conclusion Various indices of dietary quality are inversely associated with overall mortality, and selectively with cancer and cardiovascular mortality in the GCS, which contribute to the generalizability and validity of dietary guidelines. © 2019, This is a U.S. government work and its text is not subject to copyright protection in the United States; however, its text may be subject to foreign copyright protection

The application of six dietary scores to a Middle Eastern population: a comparative analysis of mortality in a prospective study

Background The associations between dietary indices and mortality have not been evaluated in populations from the Middle East, which have different dietary patterns compared to the US and Europe. In this study, we evaluated the association between six dietary indices and mortality in the Golestan Cohort Study (GCS) in Iran, which is the largest prospective study in the Middle East with 50,045 participants. Methods The six dietary indices, namely the Healthy Eating Index (HEI-2015), Alternative Healthy Eating Index (AHEI-2010), Alternative Mediterranean Diet (AMED), Dietary Approach to Stop Hypertension created by Fung (DASH-Fung) and Mellen (DASH-Mellen), and the World Cancer Research Fund (WCRF/AICR) index, were applied to data from a food frequency questionnaire, computed and divided into quintiles. Adjusted Cox models were used to estimate hazards ratio (HR) and 95% confidence intervals (CI) for overall and cause-specific mortality, using the lowest quintile as a reference group. Results Among 42,373 participants included in the current analyses, 4424 subjects died during 10.6&nbsp;years of follow-up. Participants with the highest quintile dietary scores, compared with the lowest quintile dietary scores, had significantly decreased overall mortality in the AHEI-2010, AMED, DASH-Fung, and WCRF/AICR indices (HR 0.88, 95% CI = 0.80\u20130.97; 0.80, 0.70\u20130.91; 0.77, 0.70\u20130.86; and 0.79, 0.70\u20130.90, respectively). A reduced cardiovascular mortality was found for high AHEI-2010 and DASH-Fung scores (17% and 23%, respectively), and a reduced cancer mortality for high HEI-2015, AMED, and DASH-Fung scores (21, 37 and 25%, respectively). Conclusion Various indices of dietary quality are inversely associated with overall mortality, and selectively with cancer and cardiovascular mortality in the GCS, which contribute to the generalizability and validity of dietary guidelines