Cited by 52Nutritional Studies and DietHepatocellular Carcinoma Treatment and PrognosisAlcohol Consumption and Health Effects

High-quality diets are associated with reduced risk of hepatocellular carcinoma and chronic liver disease: the multiethnic cohort

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Bogumil, David, Park, Song‐Yi, Le Marchand, Loïc, Haiman, Christopher A., Wilkens, Lynne R., Boushey, Carol J., Setiawan, Veronica Wendy·2019·Hepatology Communications

Abstract

Hepatocellular carcinoma (HCC) and chronic liver disease (CLD) are major sources of morbidity and mortality globally. Both HCC incidence and CLD mortality are known to vary by race. There is limited research on the association between dietary measures and these outcomes in a diverse population. We prospectively investigated the associations between four diet quality index (DQI) scores (Healthy Eating Index‐2010, Alternative Healthy Eating Index‐2010, Alternate Mediterranean Diet [aMED], and Dietary Approaches to Stop Hypertension), HCC incidence, and CLD mortality in the Multiethnic Cohort. We analyzed data from 169,806 African Americans, Native Hawaiians, Japanese Americans, Latinos, and whites, aged 45 to 75 years. DQI scores were calculated by using a validated food frequency questionnaire administered at baseline. During an average 17 years of follow‐up, 603 incident cases of HCC and 753 CLD deaths were identified among study participants. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) for each DQI were estimated using Cox regression. Higher aMED scores, reflecting favorable adherence to a healthful diet, were associated with a lower risk of HCC (quintile [Q]5 versus Q1 HR, 0.68; 95% CI, 0.51‐0.90; trend, P = 0.02). In racial/ethnic‐specific analyses, there was no significant heterogeneity across groups (interaction, P = 0.32); however, the association only remained statistically significant among Latinos (Q4 versus Q1 HR, 0.47; 95% CI, 0.29‐0.79; trend, P = 0.006). All DQI measures were inversely associated with CLD mortality, with no significant heterogeneity by race/ethnicity. Conclusion: Higher aMED scores were associated with a lower risk of HCC. A higher score of any DQI was associated with a lower risk of CLD mortality. These results suggest that better diet quality may reduce HCC incidence and CLD mortality.

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  1. [3]Setiawan VW, Wei PC, Hernandez BY, Lu SC, Monroe KR, Le Marchand L, et al. Disparity in liver cancer incidence and chronic liver disease mortality by nativity in Hispanics: the multiethnic cohort. Cancer 2016; 122: 1444‐ 1452. 26916271 PMC4840042

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Authors
Bogumil, D., Park, S., Le Marchand, L., Haiman, C. A., Wilkens, L. R., Boushey, C. J., & Setiawan, V. W.
Affiliations
  • University of Southern California (US)
  • University of Hawaii Cancer Center (US)
  • Epidemiology Program,University of Hawaii Cancer Center,Honolulu,HI
Corresponding author
Setiawan, Veronica Wendy
Venue
Hepatology Communications
Published
2019-01-31
Volume
3
Issue
3
Pages
437-447
ISSN
2471-254X (ISSN-L)
OpenAlex
W2913844796
Cited by
52
References
35
Citations by year
2026: 9 · 2025: 12 · 2024: 9 · 2023: 5 · 2022: 3 · 2021: 5 · 2020: 9
FWCI
3.91
Type
journal article
Language
en
Open access
Locations
  • Hepatology Communications (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
  • National Cancer Institute (CA164973, R01CA228589, P30CA071789, U01CA164973, CA228589)
  • National Institute of Environmental Health Sciences (P30ES007048)
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 › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Keywords
hepatocellular carcinoma, diet quality, alternate Mediterranean diet, Healthy Eating Index-2010, Alternative Healthy Eating Index-2010, DASH diet, dietary adherence, racial and ethnic differences, Hispanic Americans, multi-ethnic cohort

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