Xuehong Zhang

MD, ScD

The Brigham and Women’s Hospital, Inc.

Assistant Professor

PLCO (Learn more about this study)

PLCO-598

Mar 16, 2020

Dietary inflammatory potential and risk of liver cancer in the PLCO study

In the United States, the incidence of primary liver cancer has tripled since the early 1980s1-3 and >40% of liver cancer is not attributable to currently known risk factors including HBV/HCV infections, aflatoxin, excessive alcohol intake, smoking, obesity, type 2 diabetes mellitus (T2DM), and non-alcoholic fatty liver disease (NAFLD).4 Hence, a better understanding of the possible causes of US liver cancer is urgently needed. Inflammation plays an important and complex role in liver carcinogenesis, and many aforementioned liver cancer risk factors5 contribute to systemic and localized liver inflammation.6-8 Diet can modulate inflammation,9-11 but population-based studies of diet and liver cancer risk are few.12, 13 In the Nurses’ Health Study, Health Professionals Follow-up Study and the NIH-AARP study, we found that a pro-inflammatory diet (measure by empirical dietary inflammatory pattern [EDIP] score) was positively associated with liver cancer risk (manuscript in preparation), whereas EDIP components with potential anti-inflammatory properties, including fiber-rich foods such as vegetables and fiber itself,14 were inversely associated with liver cancer risk. This fiber finding is consistent with the only other published study,15 but no study has examined pro-inflammatory diet and liver cancer. To expand on these finding, we propose to prospectively determine associations of liver cancer risk with an empirical food-based dietary inflammatory pattern (EDIP) and its select food components in the PLCO study.

We propose to test the following hypotheses:

1. A pro-inflammatory diet is positively associated with liver cancer risk, as evidenced by higher EDIP scores based on a weighted sum of 18 food groups that characterize dietary inflammatory potential.
2. Components of the EDIP score with potential anti-inflammatory properties, including foods such as vegetables, are inversely associated with liver cancer risk.