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Cited by 103Nutritional Studies and DietHepatocellular Carcinoma Treatment and PrognosisDietary Effects on Health

Dietary patterns and risk of hepatocellular carcinoma among U.S. Men and women

Open access
Ma, Yanan, Yang, Wanshui, Simon, Tracey G., Smith‐Warner, Stephanie A., Fung, Teresa T., Sui, Jing, Chong, Dawn, VoPham, Trang +5 more·2019·Hepatology
DOI 10.1002/hep.30362PMC PMC6545168
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Abstract

Although adherence to healthy dietary guidelines has been associated with a reduced risk of several health outcomes, including cardiovascular diseases, type 2 diabetes, and some cancers, little is known about the role of dietary patterns in the development of hepatocellular carcinoma (HCC). We prospectively assessed the associations of three key commonly used a priori dietary patterns—the Alternative Healthy Eating Index‐2010 (AHEI‐2010), Alternate Mediterranean Diet (AMED), and Dietary Approaches to Stop Hypertension (DASH)—with risk of incident HCC in the Health Professionals Follow‐Up Study (HPFS) and the Nurses’ Health Study (NHS), two large prospective cohort studies. Diet was assessed almost every 4 years using validated food frequency questionnaires (FFQs). Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression. During up to 32 years of follow‐up, 160 incident HCC cases were identified. After adjustment for most HCC risk factors, participants in the highest tertile of Alternative Healthy Eating Index‐2010 (AHEI‐2010) had a multivariable HR of 0.61 (95% CI, 0.39‐0.95; P trend = 0.03), compared with those in the lowest tertile. There was a suggestive, but nonsignificant, inverse association for Alternate Mediterranean Diet (AMED; HR = 0.75; 95% CI, 0.49‐1.15; P trend = 0.18) and a null association for Dietary Approaches to Stop Hypertension (DASH; HR = 0.90; 95% CI, 0.59‐1.36; P trend = 0.61) in relation to the risk of HCC development. Conclusion: Our findings suggest that better adherence to the AHEI‐2010 may decrease the risk of developing HCC among U.S. adults. Future studies are needed to replicate our results, examine these associations in other populations, and elucidate the underlying mechanisms.

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Crossref · 10.1002/hep.30362

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  • In an observational study, high intake of red meat, saturated fat, cholesterol, and refined sugars are associated with an increased liver cancer risk.

    “In an observational study, high intake of red meat, saturated fat, cholesterol, and re fi ned sugars are associated with an increased liver cancer risk. 105”

    From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [105]

    The Results report that participants with higher healthy-diet scores generally ate less red and processed meat, and the Discussion associates higher scores with lower hepatocellular carcinoma risk. But the paper assesses dietary patterns, not whether high intake of each listed item increases risk. Its Discussion describes earlier findings on sugar and red meat as inconsistent, and our copy does not establish the claimed associations for saturated fat, cholesterol, or refined sugars. (LLM, conf=0.82)

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  • The Mediterranean diet or similar healthy eating patterns are associated with a lower risk of liver cancer.

    “In contrast, the Mediterranean diet or similar healthy eating patterns are associated with a lower risk of liver cancer. 105”

    From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [105]

    The Abstract reports a lower hepatocellular carcinoma risk with higher AHEI-2010 scores. The inverse association for the Alternate Mediterranean Diet was suggestive but not statistically significant, while DASH showed no association, so the sentence overstates the consistency of the finding across healthy eating patterns. (LLM, conf=0.85)

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  • Prospective studies have shown that better adherence to healthy eating patterns may decrease the risk of developing HCC.

    “Prospective studies have also shown that better adherence to healthy eating patterns may decrease the risk of developing HCC.”

    From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [105]

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Research works printed but not linked: 2

  1. [6]Zhang W, Xiang YB, Li HL, Yang G, Cai H, Ji BT, Gao YT, Vegetable-based dietary pattern and liver cancer risk: results from the Shanghai women’s and men’s health studies. Cancer Sci 2013; 104: 1353– 1361. 23841909 PMC3879410
  2. [17]Chiuve SE, Fung TT, Rimm EB, Hu FB, McCullough ML, Wang M, Stampfer MJ, Alternative Dietary Indices Both Strongly Predict Risk of Chronic Disease. The Journal of Nutrition 2012; 142: 1009– 1018. 22513989 PMC3738221

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Authors
Ma, Y., Yang, W., Simon, T. G., Smith‐Warner, S. A., Fung, T. T., Sui, J., Chong, D., VoPham, T., Meyerhardt, J. A., Wen, D., Giovannucci, E. L., Chan, A. T., & Zhang, X.
Affiliations
  • Brigham and Women's Hospital (US)
  • Anhui Medical University (CN)
  • Massachusetts General Hospital (US)
  • Harvard University (US)
  • National Cancer Centre Singapore (SG)
  • China Medical University (CN)
Corresponding author
Zhang, Xuehong
ORCID
Venue
Hepatology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2019-03-05
Volume
70
Issue
2
Pages
577-586
ISSN
  • 0270-9139 (ISSN-L)
  • 1527-3350
DOI
10.1002/hep.30362
PMC
PMC6545168
OpenAlex
W2902131526
Cited by
103
References
47
Citations by year
2026: 10 · 2025: 18 · 2024: 19 · 2023: 13 · 2022: 10 · 2021: 17 · 2020: 12 · 2019: 4
FWCI
7.85
Type
journal article
Language
en
Open access
Licence
Locations
  • Hepatology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Cancer Institute (K07CA188126, P01CA087969, UM1CA186107, UM1CA167552, R03CA176717, T32CA009001)
  • National Institute of Diabetes and Digestive and Kidney Diseases (P30DK046200, K24DK098311)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Hepatology › Hepatocellular Carcinoma Treatment and Prognosis
  • Health Sciences › Medicine › Physiology › Dietary Effects on Health
Keywords
hepatocellular carcinoma, dietary habits, Alternative Healthy Eating Index-2010, alternate Mediterranean diet, DASH diet, cancer risk, diet and cancer prevention, Health Professionals Follow-up Study, Nurses' Health Study
MeSH terms
Diet, Healthy, Adult, Aged, Diet, Female, Carcinoma, Hepatocellular, Humans, Liver Neoplasms, Male, Middle Aged, Prospective Studies, Risk Factors, United States, Risk Assessment, Diet, Mediterranean

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