Adherence to 5 Diet Quality Indices and Pancreatic Cancer Risk in a Large US Prospective Cohort

Am J Epidemiol. 2022 Aug 22;191(9):1584-1600. doi: 10.1093/aje/kwac082.

Abstract

Few prospective studies have examined associations between diet quality and pancreatic ductal adenocarcinoma (PDAC), or comprehensively compared diet quality indices. We conducted a prospective analysis of adherence to the Healthy Eating Index (HEI)-2015, alternative HEI-2010, alternate Mediterranean diet (aMed), and 2 versions of Dietary Approaches to Stop Hypertension (DASH; Fung and Mellen) and PDAC within the National Institutes of Health (NIH)-AARP Diet and Health Study (United States, 1995-2011). The dietary quality indices were calculated using responses from a 124-item food frequency questionnaire completed by 535,824 participants (315,780 men and 220,044 women). We used Cox proportional hazards regression models to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for each diet quality index and PDAC. During follow-up through 2011 (15.5-year median), 3,137 incident PDAC cases were identified. Compared with those with the lowest adherence quintile, participants with the highest adherence to the HEI-2015 (HR = 0.84, 95% CI: 0.75, 0.94), aMed (HR = 0.82, 95% CI: 0.73, 0.93), DASH-Fung (HR = 0.85, 95% CI: 0.77, 0.95), and DASH-Mellen (HR = 0.86, 95% CI: 0.77, 0.96) had a statistically significant, lower PDAC risk; this was not found for the alternative HEI-2010 (HR = 0.93, 95% CI: 0.83, 1.04). This prospective observational study supports the hypothesis that greater adherence to the HEI-2015, aMed, and DASH dietary recommendations may reduce PDAC.

Keywords: AHEI-2010; DASH; HEI-2015; aMed; diet; pancreatic cancer.

Publication types

  • Observational Study
  • Research Support, N.I.H., Intramural

MeSH terms

  • Cohort Studies
  • Diet
  • Diet, Mediterranean*
  • Female
  • Humans
  • Male
  • Pancreatic Neoplasms* / epidemiology
  • Pancreatic Neoplasms* / prevention & control
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • United States / epidemiology