Healthy dietary patterns, genetic risk, and gastrointestinal cancer incident risk: a large-scale prospective cohort study

Yimin Cai; Canlin Hong; Jinxin Han; Linyun Fan; Xinyu Xiao; Jun Xiao; Yongchang Wei; Ying Zhu; Jianbo Tian; Xu Zhu; Meng Jin; Xiaoping Miao

doi:10.1016/j.ajcnut.2023.11.015

Healthy dietary patterns, genetic risk, and gastrointestinal cancer incident risk: a large-scale prospective cohort study

Am J Clin Nutr. 2024 Feb;119(2):406-416. doi: 10.1016/j.ajcnut.2023.11.015. Epub 2023 Nov 30.

Authors

Yimin Cai¹, Canlin Hong², Jinxin Han³, Linyun Fan², Xinyu Xiao², Jun Xiao⁴, Yongchang Wei⁵, Ying Zhu², Jianbo Tian⁶, Xu Zhu⁷, Meng Jin⁸, Xiaoping Miao⁹

Affiliations

¹ Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
² Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, Hubei, China.
³ Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
⁴ Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
⁵ Department of Gastrointestinal Oncology, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
⁶ Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, Hubei, China. Electronic address: miaoxp@hust.edu.cn.
⁷ Department of Gastrointestinal Surgery, Renmin Hospital, Wuhan University, Wuhan, Hubei, China. Electronic address: tianjb@whu.edu.cn.
⁸ Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. Electronic address: Mengjin@tjh.tjmu.edu.cn.
⁹ Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, Hubei, China. Electronic address: miaoxp@hust.edu.cn.

PMID: 38042409
DOI: 10.1016/j.ajcnut.2023.11.015

Abstract

Background: Dietary patterns have been associated with several cancers, especially gastrointestinal cancer (GIC). However, whether a healthy dietary pattern could modify the risk of GIC among people with different genetic backgrounds is not clear.

Objective: The objective of the study was to investigate how dietary patterns and genetic susceptibility contribute to the risk of GIC independently and jointly.

Methods: This large-scale prospective cohort study included 105,463 participants in UK Biobank who were aged 40-72 y and cancer-free at baseline. Dietary intake (Oxford WebQ) was used to calculate dietary pattern scores including dietary approach to stop hypertension (DASH) score and healthful plant-based diet index (hPDI). Genetic risk was quantified by a polygenic risk score (PRS) comprising 129 known GIC-associated loci. Cox proportional hazards regression was performed to estimate the associations of dietary patterns and PRS with GIC incidence after adjusting for potential confounders.

Results: Over a median follow-up of 11.70 y, 1,661 participants were diagnosed with GIC. DASH and hPDI were associated with 20% and 36% reductions, respectively, in GIC risk. Low PRS was associated with a 30 % decrease in GIC risk (HR: 0.70; 95% CI: 0.62, 0.79). Participants with healthy dietary scores at high-genetic risk had a lower GIC risk with HR of 0.77 (95% CI: 0.60, 0.98) for DASH and 0.66 (95% CI: 0.52, 0.84) for hPDI than those with unhealthy dietary score. Participants with both high-dietary score and low-genetic risk showed the lowest risk of GIC, with HR of 0.58 (95% CI: 0.45, 0.75) for DASH and 0.45 (95% CI: 0.34, 0.58) for hPDI.

Conclusions: Adherence to DASH and hPDI were associated with a lower risk of some gastrointestinal cancers, and these 2 dietary patterns may partly compensate for genetic predispositions to cancer. Our results advance the development of precision medicine strategies that consider both dietary patterns and genetics to improve gastrointestinal health.

Keywords: dietary patterns; gastrointestinal cancer; gene-diet interaction; genetic risk.

MeSH terms

Diet
Dietary Patterns
Gastrointestinal Neoplasms* / etiology
Gastrointestinal Neoplasms* / genetics
Genetic Predisposition to Disease
Genetic Risk Score
Humans
Hypertension*
Plants
Prospective Studies
Risk Factors