Associations of Pre- and Postdiagnosis Diet Quality With Risk of Mortality Among Men and Women With Colorectal Cancer

Purpose Dietary patterns, indicators of overall diet quality, are associated with colorectal cancer (CRC) incidence but less consistently with mortality among CRC survivors. We prospectively evaluated associations of diet quality pre- and postdiagnosis with risk of mortality among men and women with CRC. Patients and Methods In the Cancer Prevention Study-II Nutrition Cohort, 2,801 participants were cancer free at baseline in 1992/1993 and subsequently diagnosed with invasive, nonmetastatic CRC during follow-up through June 2013. Pre- and postdiagnosis diet data were available for 2,671 and 1,321 participants, respectively, among whom 1,414 and 722 died. Concordance with the Dietary Approaches to Stop Hypertension (DASH), American Cancer Society nutrition guidelines (ACS-score), prudent, and Western dietary patterns was used to evaluate diet quality. Results Extreme scoring group comparisons showed that prediagnosis ACS-score was inversely associated with all-cause (hazard ratio high v low [HRHigh vLow], 0.78; 95% CI, 0.65 to 0.95) and CRC-specific (HRHigh vLow, 0.74; 95% CI, 0.54 to 1.03) mortality, whereas the Western diet score was associated with higher all-cause mortality (HRHigh vLow, 1.30; 95% CI, 1.03 to 1.64). For postdiagnosis diet, the ACS-score was associated with lower risk of all-cause (HRHigh vLow, 0.62; 95% CI, 0.47 to 0.83) and CRC-specific (HRHigh vLow, 0.35; 95% CI, 0.17 to 0.73) mortality, the DASH score was inversely associated with all-cause (HRHigh vLow, 0.79; 95% CI, 0.62 to 0.99) and CRC-specific (HRHigh vLow, 0.56; 95% CI, 0.35 to 0.89) mortality, and the prudent score was inversely associated with all-cause mortality (HRHigh vLow, 0.72; 95% CI, 0.56 to 0.93). Among participants with a low diet quality before diagnosis, improved DASH (HR, 0.54; 95% CI, 0.31 to 0.92) and prudent (HR, 0.53; 95% CI, 0.29 to 0.95) scores from pre- to postdiagnosis were inversely associated with CRC-specific mortality. Conclusion Dietary patterns reflective of high intakes of plant foods and low intakes of animal products before and after CRC diagnosis are associated with longer survival.

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Cardiovascular and all-cause mortality attributable to loneliness in older Swedish men and women.

10.21203/rs.2.22585/v2 ◽

2020 ◽

Author(s):

Masuma Novak ◽

Margda waern ◽

Lena Johansson ◽

Anna Zettergren ◽

Lina Ryden ◽

...

Keyword(s):

Cardiovascular Mortality ◽

Cox Regression ◽

Mortality Data ◽

Men And Women ◽

Face To Face ◽

Risk Of Mortality ◽

Increased Risk ◽

All Cause Mortality ◽

Adjusted Model

Abstract Background. This study examined whether loneliness predicts cardiovascular- and all-cause mortality in older men and women. Methods. Baseline data from the Gothenburg H70 Birth Cohort Studies, collected during 2000 on 70-year-olds born 1930 and living in Gothenburg were used for analysis (n=524). Mortality data were analyzed until 2012 through Swedish national registers. Results. Perceived loneliness was reported by 17.1% of the men and 30.9% of the women in a face-to-face interview with mental health professional. A total of 142 participants died during the 12-year follow-up period, with 5 334 person-years at risk, corresponding to 26.6 deaths/1000 person-years. Cardiovascular disease accounted for 59.2% of all deaths. The cumulative rates/1000 person-years for cardiovascular mortality were 20.8 (men) and 11.5 (women), and for all-cause mortality 33.8 (men) and 20.5 (women), respectively. In Cox regression models, no significant increased risk of mortality was seen for men with loneliness compared to men without loneliness (cardiovascular mortality HR 1.52, 95% CI 0.78 - 2.96; all-cause HR 1.32, 95% CI 0.77 - 2.28). Increased risk of cardiovascular mortality was observed in women with loneliness compared to those without (HR 2.25 95% CI 1.14 - 4.45), and the risk remained significant in a multivariable-adjusted model (HR 2.42 95% CI 1.04 - 5.65). Conclusions. Loneliness was shown to be an independent predictor of cardiovascular mortality in women. We found no evidence to indicate that loneliness was associated with an increased risk of either cardiovascular- or all-cause mortality in men.

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Cardiovascular and all-cause mortality attributable to loneliness in older Swedish men and women

BMC Geriatrics ◽

10.1186/s12877-020-01603-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Masuma Novak ◽

Margda Waern ◽

Lena Johansson ◽

Anna Zettergren ◽

Lina Ryden ◽

...

Keyword(s):

Cardiovascular Mortality ◽

Cox Regression ◽

Mortality Data ◽

Men And Women ◽

Face To Face ◽

Risk Of Mortality ◽

Increased Risk ◽

All Cause Mortality ◽

Adjusted Model

Abstract Background This study examined whether loneliness predicts cardiovascular- and all-cause mortality in older men and women. Methods Baseline data from the Gothenburg H70 Birth Cohort Studies, collected during 2000 on 70-year-olds born 1930 and living in Gothenburg were used for analysis (n = 524). Mortality data were analyzed until 2012 through Swedish national registers. Results Perceived loneliness was reported by 17.1% of the men and 30.9% of the women in a face-to-face interview with mental health professional. A total of 142 participants died during the 12-year follow-up period, with 5334 person-years at risk, corresponding to 26.6 deaths/1000 person-years. Cardiovascular disease accounted for 59.2% of all deaths. The cumulative rates/1000 person-years for cardiovascular mortality were 20.8 (men) and 11.5 (women), and for all-cause mortality 33.8 (men) and 20.5 (women), respectively. In Cox regression models, no significant increased risk of mortality was seen for men with loneliness compared to men without loneliness (cardiovascular mortality HR 1.52, 95% CI 0.78–2.96; all-cause HR 1.32, 95% CI 0.77–2.28). Increased risk of cardiovascular mortality was observed in women with loneliness compared to those without (HR 2.25 95% CI 1.14–4.45), and the risk remained significant in a multivariable-adjusted model (HR 2.42 95% CI 1.04–5.65). Conclusions Loneliness was shown to be an independent predictor of cardiovascular mortality in women. We found no evidence to indicate that loneliness was associated with an increased risk of either cardiovascular- or all-cause mortality in men.

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Diet quality indices and gastrointestinal cancer risk: results from the Lifelines study

European Journal of Nutrition ◽

10.1007/s00394-021-02648-3 ◽

2021 ◽

Author(s):

Sara Moazzen ◽

Francisco O. Cortes-Ibañez ◽

Bert van der Vegt ◽

Behrooz Z. Alizadeh ◽

Geertruida H. de Bock

Keyword(s):

Colorectal Cancer ◽

Cancer Risk ◽

Diet Quality ◽

Dietary Quality ◽

Quality Indices ◽

Cancer Society ◽

Upper Gi ◽

Gi Cancer ◽

Incident Cases

Abstract Objective To investigate the long-term association between four dietary quality indices and the risk of gastrointestinal (GI) cancer. Methods Baseline details of the dietary intake of participants, assessed by a single food frequency questionnaire from the prospective Lifelines population-based cohort were translated to diet quality scores using several dietary and dietary-lifestyle indices. Incident cases of GI cancer were then assessed by linkage to the Dutch nationwide histo-cytopathology registry. The association between GI cancer risk and diet quality (defined as higher quintiles on dietary indices compared to the first quintile) was assessed by multivariable Cox proportional hazard models. Results We included 72,695 participants aged 51.20 ± 8.71 years with a median follow-up to cancer diagnosis of 8 years (interquartile range 2 years). During follow-up, 434 colorectal cancers and 139 upper GI cancers were diagnosed. There was a significant reduction in colorectal cancer risk for high categories in the American Cancer Society (ACS) Index (hazard ratio 0.62; 95% CI 0.46–0.84). However, high dietary index scores were not associated with strong beneficial effects on upper GI cancer risk. Conclusion High quintiles on the ACS Index were associated with a significantly reduced risk of colorectal cancer. This index may be of use in a colorectal cancer prevention program.

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Urinary sodium to potassium ratio: A simple and useful indicator of diet quality in population-based studies

10.21203/rs.2.12332/v1 ◽

2019 ◽

Author(s):

Parvin Mirmiran ◽

Zahra Gaeini ◽

Zahra Bahadoran ◽

Asghar Ghasemi ◽

Norouzirad Reza ◽

...

Keyword(s):

Diet Quality ◽

Dietary Patterns ◽

Dietary Pattern ◽

Population Based ◽

Urinary Sodium ◽

Dash Score ◽

Dietary Intakes ◽

Linear Regression Models ◽

Significant Positive Association ◽

Spot Urine

Abstract Background Urinary sodium (Na) and potassium (K) are related to dietary intakes of Na and K, and well-known risk factors of hypertension and cardiovascular events. This study aimed to evaluate the associations between urinary Na/K ratio and different dietary patterns. Methods we recruited 1864 adult men and women (aged 18-93 years), participated in the sixth examination of Tehran Lipid and Glucose Study. Fasting spot urine samples were collected and concentrations of Na and K were determined. The principle component analysis (PCA) was conducted to drive major dietary patterns among population. Mediterranean dietary pattern score, as well as DASH score, were calculated. Linear regression models adjusted for potential confounding variables were used to assess associations between dietary patterns scores and urinary Na/K ratio. Results Mean age of participants was 43.7±13.9 years, and 47% were men. Mean urinary Na and K concentrations were 139±41.0 and 57.9±18.6 mmol/L, respectively. Mean urinary Na/K was 2.40±0.07. A significant positive association was found between Western dietary pattern and urinary Na/K ratio (β=0.06; 95% CI= 0.01, 0.16). Traditional dietary pattern derived from usual dietary intakes of Iranian adults, as well as Mediterranean and DASH dietary pattern scores were inversely associated to urinary Na/K ratio (β= –0.14; 95% CI= –0.24, –0.11, β=–0.07; 95% CI= –0.09, –0.01, β=–0.12; 95% CI= –0.05, –0.02, respectively). Conclusions Urinary Na/K ratio may suggest as a simple, inexpensive and helpful method to monitor and improve diet quality in population-based studies.

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Dietary Patterns of Persons with Chronic Conditions in a Multi-Ethnic Asian Population

10.21203/rs.3.rs-1016513/v1 ◽

2021 ◽

Author(s):

Tan Yeow Wee Brian ◽

Lau Jue Hua ◽

PV AshaRani ◽

Kumarasan Roystonn ◽

Fiona Devi ◽

...

Keyword(s):

Diet Quality ◽

Dietary Patterns ◽

Chronic Conditions ◽

Chronic Condition ◽

Age Groups ◽

Asian Population ◽

Sociodemographic Factors ◽

Dash Score ◽

Attitudes And Practices ◽

Knowledge Attitudes And Practices

Abstract Background: Chronic conditions are a leading cause of death and disability worldwide and respective data on dietary patterns remain scant. The present study aimed to investigate dietary patterns and identify sociodemographic factors associated with Dietary Approach to Stop Hypertension (DASH) scores within a multi-ethnic population with various chronic conditions. Method: The present study utilised data from the Knowledge, Attitudes, and Practices on diabetes study in Singapore – a nationwide survey conducted to track the knowledge, attitudes, and practices pertaining to diabetes. The study analysed data collected from a sample of 2,895 Singapore residents, with information from the sociodemographic section, DASH diet screener, and the modified version of the World Mental Health Composite International Diagnostic Interview (CIDI) version 3.0 checklist of chronic medical conditions. Results: Respondents with no chronic condition had a mean DASH score of 18.5 (±4.6), those with one chronic condition had a mean DASH score of 19.2 (±4.8), and those with two or more chronic conditions had a mean DASH score of 19.8 (±5.2). Overall, the older age groups [35– 49 years (B = 1.78, 95% CI: 1.23 – 2.33, p <0.001), 50–64 years (B = 2.86, 95% CI: 22.24 – 3.47, p <0.001) and 65 years and above (B = 3.45, 95% CI: 2.73 – 4.17, p <0.001)], Indians (B = 2.54, 95% CI: 2.09 – 2.98, p <0.001) reported better diet quality, while males (B = -1.50, 95% CI: -1.87 – -1.14, p <0.001) reported poorer diet quality versus females. Conclusion: Overall, respondents with two or more chronic conditions reported better quality of diet while the sociodemographic factors of age, gender and ethnicity demonstrated a consistent pattern in correlating with diet quality, consistent with the extant literature. Results provide further insights for policymakers to refine ongoing efforts in relation to healthy dietary practices for Singapore.

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Urinary sodium-to-potassium ratio: a simple and useful indicator of diet quality in population-based studies

European Journal of Medical Research ◽

10.1186/s40001-020-00476-5 ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Parvin Mirmiran ◽

Zahra Gaeini ◽

Zahra Bahadoran ◽

Asghar Ghasemi ◽

Reza Norouzirad ◽

...

Keyword(s):

Diet Quality ◽

Dietary Patterns ◽

Dietary Pattern ◽

Principal Component ◽

Population Based ◽

Urinary Sodium ◽

Current Evidence ◽

Dash Score ◽

Dietary Intakes ◽

Spot Urine

Abstract Background Current evidence regarding the prognostic relevance of urinary sodium-to-potassium ratio (Na-to-K ratio), as an indicator of diet quality is limited. This study was conducted to investigate whether urinary Na-to-K ratio could be related to habitual dietary patterns, in a general population. Methods This study was conducted in the framework of the Tehran Lipid and Glucose Study (2014–2017) on 1864 adult men and women. Urinary Na and K concentrations were measured in the morning spot urine samples. Dietary intakes of the participants were assessed using a validated 147-item Food Frequency Questionnaire (FFQ) and major dietary patterns were obtained using principal component analysis. Mediterranean dietary pattern and Dietary Approaches to Stop Hypertension (DASH) score, were also calculated. Multivariable-adjusted linear regression was used to indicate association of dietary patterns and urinary Na-to-K ratio. Results Mean (± SD) age of participants was 43.7 ± 13.9 years and 47% were men. Mean (± SD) urinary Na, K and the ratio was 139 ± 41.0 and 57.9 ± 18.6 mmol/L, 2.40 ± 0.07, respectively. Higher urinary Na-to-K ratio (> 2.37 vs. < 1.49) was related to lower intakes of vegetables (282 vs. 321 g/day), low-fat dairy (228 vs. 260 g/day) and fruits (440 vs. 370 g/day). Western dietary pattern was related to higher urinary Na-to-K ratio (β = 0.06; 95% CI 0.01, 0.16). Traditional dietary pattern, Mediterranean and DASH diet scores were inversely associated with urinary Na-to-K ratio (β = − 0.14; 95% CI − 0.24, − 0.11, β = − 0.07; 95% CI − 0.09, − 0.01, β = − 0.12; 95% CI − 0.05, − 0.02, respectively). Conclusions Spot urinary Na-to-K ratio may be used as a simple and inexpensive method to monitor diet quality in population-based epidemiological studies.

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Associations of Recreational Physical Activity and Leisure Time Spent Sitting With Colorectal Cancer Survival

Journal of Clinical Oncology ◽

10.1200/jco.2012.45.9735 ◽

2013 ◽

Vol 31 (7) ◽

pp. 876-885 ◽

Cited By ~ 140

Author(s):

Peter T. Campbell ◽

Alpa V. Patel ◽

Christina C. Newton ◽

Eric J. Jacobs ◽

Susan M. Gapstur

Keyword(s):

Physical Activity ◽

Colorectal Cancer ◽

Cancer Diagnosis ◽

Leisure Time ◽

Cancer Survival ◽

Sitting Time ◽

Recreational Physical Activity ◽

Risk Of Death ◽

All Cause Mortality ◽

Before And After

Purpose Little is known about the association of recreational physical activity or leisure time spent sitting with survival after colorectal cancer diagnosis. This study examined the associations of prediagnosis and postdiagnosis recreational physical activity and leisure time spent sitting with mortality among patients with colorectal cancer. Patients and Methods From a cohort of adults without colorectal cancer at baseline in 1992-1993, we identified 2,293 participants who were diagnosed with invasive, nonmetastatic colorectal cancer up to mid-2007. At baseline, before their cancer diagnosis, and again after their cancer diagnosis, participants completed detailed questionnaires that included information concerning recreational physical activity and leisure time spent sitting. Results During a maximum follow-up of 16.1 years after colorectal cancer diagnosis, 846 patients with colorectal cancer died, 379 of them from colorectal cancer. Engaging in 8.75 or more metabolic equivalent (MET) hours per week of recreational physical activity (equivalent to approximately 150 minutes per week of walking) compared with fewer than 3.5 MET hours per week was associated with lower all-cause mortality (prediagnosis physical activity: relative risk [RR], 0.72; 95% CI, 0.58 to 0.89; postdiagnosis physical activity: RR, 0.58; 95% CI, 0.47 to 0.71). Spending 6 or more hours per day of leisure time sitting compared with fewer than 3 hours per day was associated with higher all-cause mortality (prediagnosis sitting time: RR, 1.36; 95% CI, 1.10 to 1.68; postdiagnosis sitting time: RR, 1.27; 95% CI, 0.99 to 1.64). Conclusion More recreational physical activity before and after colorectal cancer diagnosis was associated with lower mortality, whereas longer leisure time spent sitting was associated with higher risk of death.

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Mortality attributable to poor dietary patterns in Canada: Evidence from the nationally-representative nutrition survey linked with health administrative data

International Journal for Population Data Science ◽

10.23889/ijpds.v3i4.672 ◽

2018 ◽

Vol 3 (4) ◽

Author(s):

Mahsa Jessri ◽

Deirdre Hennessy ◽

Claudia Sanmartin ◽

Anan Bader Eddeen ◽

Doug Manuel

Keyword(s):

Diet Quality ◽

Dietary Patterns ◽

Dietary Guidelines ◽

Dietary Quality ◽

Administrative Databases ◽

Evidence Based ◽

Quality Indices ◽

Nutrition Survey ◽

All Cause Mortality ◽

Nationally Representative

IntroductionDietary pattern modeling and linkage with health outcomes is essential for development of evidence-based dietary guidelines to support reduction of chronic diseases. National nutrition surveys are not routinely linked with health administrative databases, resulting in a lack of evidence on the health impact of unhealthy diets at the population level. Objectives and ApproachThis study is the first to use a nationally-representative nutrition survey (i.e., Canadian Community Health Survey-Nutrition-2004) linked with health administrative databases to examine the association of 5 key dietary quality indices with mortality risk. In total, 16,212 adults ≥20 years were followed for an average of 7.3 years. Two 24-hour dietary recalls were used to estimate the usual dietary intakes using the National Cancer Institute’s method. Weighted regression calibration was performed to obtain a true parameter relating diet (continuous) to mortality. Population Attributable Fractions were calculated to estimate the burden of all-cause mortality attributable to poor dietary patterns in Canada. ResultsThe 5 dietary quality indices examined were Dietary Approaches to Stop Hypertension(DASH); Dietary Guidelines for Americans Adherence Index 2015(DGAI); Healthy Eating Index-2010(HEI); Alternative HEI-2010(AHEI); and Mediterranean Style Dietary Pattern Score(MSDPS). Having a better diet quality (90%ile vs. 10%ile of index score) was associated with a significant 31-51% reduction in all-cause mortality hazard ratio among adults 45 to 80 years and 10-35% reduction in those ≥20 years (in order of significance: DASH, DGAI, HEI, AHEI and MSDPS). Survival benefit was incrementally greater for higher diet quality scores; however, even the 90%ile scores (Reference) were notably lower than the recommended levels (45.99% of recommended score). On average, 26.42% of all mortality in Canada was attributable to poor dietary patterns (range: 19.01% for MSDPS to 31.39% for DGAI). Conclusion/ImplicationsThe diet-attributable burden of mortality was higher than those reported for other behavioural risks (e.g., smoking). This research informs future formulation of nutrition interventions and policies with a focus on dietary patterns. This project demonstrates the importance of leveraging linked data and analytical capacity to inform future evidence-based nutrition policies.

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Postdiagnostic Mediterranean and Healthy Nordic Dietary Patterns Are Inversely Associated with All-Cause Mortality in Long-Term Colorectal Cancer Survivors

Journal of Nutrition ◽

10.3945/jn.116.244129 ◽

2017 ◽

Vol 147 (4) ◽

pp. 636-644 ◽

Cited By ~ 25

Author(s):

Ilka Ratjen ◽

Clemens Schafmayer ◽

Romina di Giuseppe ◽

Sabina Waniek ◽

Sandra Plachta-Danielzik ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Survivors ◽

Dietary Patterns ◽

Colorectal Cancer Survivors ◽

All Cause Mortality

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Abstract P410: Added Sugars Intake, Diet Quality and All-Cause Mortality Among US Adults: Prospective Data from National Health and Nutrition Examination Survey III

Circulation ◽

10.1161/circ.129.suppl_1.p410 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Molly Jung ◽

Robert C Kaplan ◽

Yasmin Mossavar-Rahmani ◽

Shankar Viswanathan ◽

Judith Wylie-Rosett ◽

...

Keyword(s):

Energy Intake ◽

National Health ◽

Diet Quality ◽

Healthy Eating Index ◽

Nutrition Examination Survey ◽

Men And Women ◽

Added Sugars ◽

Health And Nutrition ◽

Usual Intake ◽

All Cause Mortality

Objectives: To better understand the relationship between added sugars intake and diet quality, and to estimate associations between added sugars intake with all-cause mortality Methods: National Health and Nutrition Examination Survey III data were linked to mortality data (1988-2006), among 13,902 US adults between ages 18-74 yr having energy intake within 500-3500calories for women and 800-4000 calories for men, no history of a heart attack, stroke, or congestive heart failure. Usual intake of added sugars and energy were estimated using the NCI method and categorized into gender-specific quartiles. Diet quality was assessed using the Healthy Eating Index 2005 score (HEI-2005). Associations between added sugars intake and mortality were estimated using Cox proportional hazards regression adjusting for age, race/ethnicity, body mass index (BMI), and usual total energy intake after testing for multiplicative interaction by each of these covariates. Results: Mean intake of added sugar was 17.2 (95% Confidence Interval (CI) 16.8, 17.6) teaspoons (tsp) in women and 25.0 (95% CI 24.4, 25.7) tsp in men. Higher usual intake of added sugars was associated with being younger, a current smoker, and having between 12 and 15 years of education among both men and women. Higher usual intake of added sugars was related to a lower HEI score in women versus a higher HEI score in men (Quartile (Q) 4 for HEI =61.62 versus Q1=64.73 in women, p=0.0002; (Q4=62.71 vs. Q1=60.07 in men, p=0.0209). Higher HEI scores for the grain, fruit, vegetable, meat, and variety components were related to lower intake of added sugars; whereas, the fats, cholesterol, and sodium components of the HEI were related to higher intake of added sugars in men and women. During a median follow-up period of 14 years, a total of 1,889 deaths were recorded. After multivariable adjustment, higher added sugars intake was not associated with increased all-cause mortality (hazard ratio (HR) 95% CI of Q4 vs Q1, 1.08 (0.77, 1.52)). Interpretation: Epidemiological studies suggested that higher sugars intake is associated with an increased risk of obesity and cardiovascular diseases (CVD). These findings indicate higher intake of added sugars is associated with lower diet quality in women, but not men. Added sugars intake was not significantly associated with all-cause mortality in this representative sample of the US population.

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