Dietary Fiber, Whole Grains, and Head and Neck Cancer Prognosis: Findings from a Prospective Cohort Study

Nutrients. 2019 Sep 27;11(10):2304. doi: 10.3390/nu11102304.


No studies, to date, have examined the relationship between dietary fiber and recurrence or survival after head and neck cancer diagnosis. The aim of this study was to determine whether pretreatment intake of dietary fiber or whole grains predicted recurrence and survival outcomes in newly diagnosed head and neck cancer (HNC) patients. This was a prospective cohort study of 463 participants baring a new head and neck cancer diagnosis who were recruited into the study prior to the initiation of any cancer therapy. Baseline (pre-treatment) dietary and clinical data were measured upon entry into the study cohort. Clinical outcomes were ascertained at annual medical reviews. Cox proportional hazard models were fit to examine the relationships between dietary fiber and whole grain intakes with recurrence and survival. There were 112 recurrence events, 121 deaths, and 77 cancer-related deaths during the study period. Pretreatment dietary fiber intake was inversely associated with risk of all-cause mortality (hazard ratio (HR): 0.37, 95% confidence interval (CI): 0.14-0.95, ptrend = 0.04). No statistically significant associations between whole grains and prognostic outcomes were found. We conclude that higher dietary fiber intake, prior to the initiation of treatment, may prolong survival time, in those with a new HNC diagnosis.

Keywords: cancer; cancer survivors; diet; epidemiology; fruit; nutritional epidemiology; obesity; survivorship; vegetables.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Diet / adverse effects*
  • Diet / statistics & numerical data
  • Diet Surveys
  • Dietary Fiber / analysis*
  • Female
  • Head and Neck Neoplasms / mortality*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / etiology*
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Whole Grains*


  • Dietary Fiber