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Dietary Patterns and Risk of Hepatocellular Carcinoma Among U.S. Men and Women
Open accessAbstract
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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“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]
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“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]
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“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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Self-citationAlternative Dietary Indices Both Strongly Predict Risk of Chronic Disease
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Self-citationGlobal estimates of cancer prevalence for 27 sites in the adult population in 2008
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Tacke, F., Horn, P., Wai-Sun Wong, V., Ratziu, V., Bugianesi, E., Francque, S., Zelber-Sagi, S., Valenti, L., Roden, M., Schick, F., et al. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.04.031 · Cited by 2,210
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Morze, J., Danielewicz, A., HOFFMANN, G. E., & Schwingshackl, L. (2020) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2020.08.076 · Cited by 391
An updated systematic review and meta-analysis on adherence to mediterranean diet and risk of cancer
Morze, J., Danielewicz, A., Przybyłowicz, K. E., Zeng, H., HOFFMANN, G. E., & Schwingshackl, L. (2020) · European Journal of Nutrition · doi:10.1007/s00394-020-02346-6 · Cited by 375
Lifestyle interventions in nonalcoholic fatty liver disease
Younossi, Z. M., Zelber-Sagi, S., Henry, L., & Gerber, L. H. (2023) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-023-00800-4 · Cited by 281
Metadata
- 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
- Published
- 2019-03-05
- Volume
- 70
- Issue
- 2
- Pages
- 577-586
- ISSN
- 0270-9139 (ISSN-L)
- 1527-3350
- 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
- green
- www.ncbi.nlm.nih.gov
- 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 (medical) › 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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